Acute leukemia - causes, symptoms, diagnosis and treatment

Blood cancer, leukemia, leukemia or leukemia - these names define a type of malignant tumor that affects the bone marrow and is characterized by a high rate of metastasis. The disease is most often diagnosed in older people and children. A tumor occurs in the bone marrow as a result of the replacement of normal hematopoietic cells with malignant ones. This leads to disruption of the normal functioning of the hematopoietic system. The body stops producing platelets, leukocytes and red blood cells in the quantities necessary for life, producing white blood cells instead.

In the acute form of the disease, which occurs in children in 95% of cases, cells called blasts mutate. In the chronic form of leukemia, they degenerate into malignant mature blood cells. With the appearance of metastases, lymph nodes, kidneys, lungs, spleen, liver, etc. are affected.

Healthy organ tissue is gradually displaced, which leads to the following complications:

the likelihood of developing infections increases;
anemia appears;
the risk of hemorrhage increases.

Classification

According to the nature of the flow, the following are distinguished:

acute form of blood cancer with characteristic transience, headaches and convulsions, vomiting, bruising on the skin, weakness and decreased vitality;
a chronic form with a slow course, weakness, bleeding gums, weight loss, increased body temperature, and frequent infectious diseases.

Chronic and acute forms of leukemia do not flow into one another.

According to the features of the clinical picture, the following are distinguished:

Lymphocytic leukemia, occurring in most cases in children 2-8 years old (boys - 80% of cases). The main reasons: genetic predisposition, infection of the mother during pregnancy. Symptoms of lymphocytic leukemia:

enlarged lymph nodes, pale skin, breathing problems;
sudden weight loss, fatigue, weakness;
hardening or change in the size of the testicles;
the appearance of ulcers when the skin is injured.

Acute myeloid leukemia most often develops after age 50. The cause is DNA defects in immature bone marrow cells. The symptoms of the disease are:

dizzy, feeling weak and unwell;
no appetite;
pain appears in the joints and bones;
Infectious diseases are becoming more frequent;
increased bleeding is observed.

Acute monoblastic leukemia is diagnosed quite rarely. It can occur in a chronic or acute form. Main symptoms:

enlarged lymph nodes;
the appearance of scattered hemorrhages on the body;
enlargement and hyperemia of the testicles in men;
pale skin;
abdominal pain and a feeling of heaviness in the liver area;
stomatitis;
arthralgia.

Multiple myeloma most often affects people over 43 years of age. The disease manifests itself as anemia, frequent bacterial infections, arthralgia, fractures, and bleeding.

Chronic myelocytic cancer in adults is diagnosed mainly in men 27-50 years old. The course is long-lasting and asymptomatic. Main symptoms:

feeling of aching bones;
weight loss, nausea and vomiting, discomfort and pain in the abdominal cavity;
body temperature rises, shortness of breath is observed;
Lymph nodes enlarge, dizziness and headaches are observed.

Lymphocytic cancer is practically asymptomatic. The main manifestations are:

frequent infections;
discomfort in the liver area;
enlarged lymph nodes;
sweating and weakness.

Monocyte chronic blood oncopathology is diagnosed more often in patients over 57 years of age. The course is practically asymptomatic.

How common is acute leukemia in adults?

In 2002, 8149 cases of leukemia were identified in Russia. Of these, acute leukemia accounted for 3257 cases, and subacute and chronic leukemia - 4872 cases.

It is estimated that 33,440 new cases of leukemia will be diagnosed in the United States in 2004. Approximately half of the cases will be acute leukemia. The most common type of acute leukemia in adults is acute myeloid leukemia (AML). At the same time, 11,920 new cases of AML are expected to be identified.

During 2004, 8,870 patients may die from acute leukemia in the United States.

The average age of patients with acute myeloid leukemia (AML) is 65 years. This is a disease of older people. The chance of developing leukemia for a 50-year-old person is 1 in 50,000, and for a 70-year-old it is 1 in 7,000. AML occurs more often in men compared to women.

Acute lymphoblastic leukemia (ALL) is more often diagnosed in children than in adults, and is most common before the age of 10 years. The probability of being diagnosed with ALL in a 50-year-old person is 1 in 125,000, and for a 70-year-old it is 1 in 60,000.

African Americans are 2 times less likely to develop ALL than the white population of America. Their risk of developing AML is also slightly lower than that of the white population.

With AML and ALL in adults, long-term remission or recovery can be achieved in 20-30% of cases. Depending on certain features of leukemia cells, the prognosis (outcome) of patients with AML and ALL may be better or worse.

Causes

The main reasons due to which this oncopathology may occur are:

genetic predisposition;
severe viral diseases that led to weakening of the body;
ionizing radiation;
medications, long-term use of antibiotics, chemicals (polymer materials, paints, varnishes, household chemicals);
frequent stress.

But modern diagnostics show that oncology may have nothing to do with risk factors. There are cases when diagnostics revealed pathology in a person who had no apparent reason for the development of the disease.

Causes and risk factors

The etiological factors that inevitably become the “trigger” for malignant cell mutation have not yet been precisely established. However, the risks of developing acute leukemia increase significantly if:

radiation exposure to which a person is exposed;
infection with certain viruses that suppress the immune system (Epstein-Barr disease, T-lymphotropic virus, etc.);
unfavorable heredity;
smoking tobacco;
prolonged exposure to certain chemical compounds, including medications;
stress, depression;
environmental pollution.

Symptoms and signs of leukemia

A feature of blood cancer is the similarity of symptoms, especially in the early stages, with other diseases. Among them:

fatigue, weakness, decreased vitality and immunity;
the appearance of bruises on the body with minor mechanical impact;
frequent rashes of unknown etiology, poor wound healing;
enlargement of the liver, spleen and other organs;
pain in bones and joints;
memory impairment, insomnia or drowsiness;
decreased hemoglobin level, anemia.

Provided timely treatment, the doctor can prescribe effective therapy and cure the disease.

The following signs indicate the transition of the disease to a severe stage:

weight is significantly reduced;
mucous membranes often bleed;
the skin turns yellow or becomes very pale;
wounds heal poorly or fester;
There is bloating and pain in the hypochondrium.

The formation of dense subcutaneous nodes (lymphatic tissue tumors) in the areas of natural folds helps determine blood cancer in children.

Circulatory and lymphatic systems

To understand the different types of leukemia, it is helpful to have basic information about the circulatory and lymphatic systems.

Bone marrow is the soft, spongy, inner part of bones. All blood cells are produced in the bone marrow. In infants, bone marrow is found in almost all the bones of the body. By adolescence, bone marrow is stored mainly in the flat bones of the skull, shoulder blades, ribs, and pelvis.

Bone marrow contains blood-forming cells, fat cells, and tissues that help blood cells grow. Early (primitive) blood cells are called stem cells. These stem cells grow (mature) in a specific order and produce red blood cells (erythrocytes), white blood cells (white blood cells) and platelets.

Red blood cells carry oxygen from the lungs to other tissues of the body. They also remove carbon dioxide, a waste product of cellular activity. A decrease in the number of red blood cells (anemia, anemia) causes weakness, shortness of breath and increased fatigue.

White blood cells help protect the body from germs, bacteria and viruses. There are three main types of leukocytes: granulocytes, monocytes and lymphocytes. Each type plays a special role in protecting the body against infection.

Platelets prevent bleeding from cuts and bruises.

The lymphatic system consists of lymphatic vessels, lymph nodes and lymph.

Lymphatic vessels resemble veins, but they do not carry blood, but a clear liquid - lymph. Lymph consists of excess tissue fluid, waste products and immune system cells

Lymph nodes (sometimes called lymph glands) are bean-shaped organs located along the lymphatic vessels. Lymph nodes contain cells of the immune system. They can increase in size more often during inflammation, especially in children, but sometimes their increase can be a sign of leukemia, when the tumor process has spread beyond the bone marrow.

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When to see a doctor

You should seek help from an oncohematologist if your health condition worsens if the following symptoms and signs are present:

a sharp deterioration in health;
unreasonable increase in body temperature;
the appearance of rashes and bruises on the body;
poor wound healing;
pain in bones and joints;
symptoms of anemia;
hemoglobin levels and immunity are reduced.

Signs of deteriorating health in any case are a reason to contact the oncology center so that the doctor can prescribe additional tests and adjust the treatment.

Rehabilitation

The list of clinical recommendations for acute leukemia during the rehabilitation period includes:

measures to improve immunity;
balanced diet;
detoxification therapy;
restoration of intestinal microflora;
anti-stress psychotherapy;
improving sleep quality.

During the recovery period, it is important to follow all the orders of the attending oncologist and complete the recommended treatment courses on time and in full.

Diagnosis of leukemia in the oncology center

Diagnosis of leukemia in the oncology center, located at 2nd Tverskoy-Yamskaya Lane, is carried out in several stages:

initial examination by a doctor with medical history;
general and biochemical blood test;
taking tests using modern diagnostic techniques: MRI, ultrasound, PET/CT, radiography, scintigraphy, SPECT.

One of the most informative diagnostic methods is bone marrow puncture (immunohistochemistry of punctate, cytochemical and cytogenetic analyses).

Highly qualified oncology specialists use the latest diagnostic equipment, which guarantees high diagnostic accuracy and safety for patients.

Stages

Oncohematologists distinguish the following stages of acute leukemia.

Initial. It proceeds secretly and lasts from several months to several years. Diagnosed only by bone marrow examination, as blood tests show only minor abnormalities in the white blood cell count and there are no symptoms.
Expanded. The number of immature cells in the blood increases sharply, which leads to a deterioration in health and the appearance of initial symptoms of the disease.
Remission. Manifestations of oncopathology decrease, however, a certain number of blast cells remain in the bone marrow (with complete remission - no more than 5%).
Relapse. The number of immature cells in the patient's bone marrow and blood increases, and his condition worsens.
Terminal. The most severe stage of the disease, which is characterized by numerous complications of acute leukemia: vital internal organs are affected, extensive bleeding, ulceration and tissue necrosis occur.

Treatment of blood cancer at the oncology center

When developing tactics in the treatment of blood cancer, the type of pathology and individual characteristics of the patient are taken into account. Oncology doctors provide effective treatment using the following methods:

chemotherapy, which is the process of introducing chemical drugs into the body that have a destructive effect on the tumor, using innovative syringe and infusion pumps;
targeted drug therapy, during which only tumor cells are destroyed;
radiation therapy (radiotherapy).

How are acute leukemias in adults classified?

Most tumors are classified into stages of disease (I, II, III, and IV), which are based on the size of the tumor and its extent.

This staging is not appropriate for leukemia because leukemia is a disease of the blood cells that does not usually cause tumor formation.

Leukemia affects the entire bone marrow and in many cases, by the time of diagnosis, has already involved other organs in the process. In leukemia, laboratory studies of tumor cells make it possible to clarify their characteristics, which help in assessing the outcome (prognosis) of the disease and choosing treatment tactics.

Three subtypes of acute lymphoblastic leukemia and eight subtypes of acute myeloid leukemia have been identified.

There are four main types of leukemia:

acute versus chronic

lymphoblastic versus myeloid

"Acute" means rapidly developing. Although the cells grow quickly, they are not able to mature properly.

"Chronic" means a condition where the cells appear mature but are actually abnormal (altered). These cells live too long and replace some types of white blood cells.

"Lymphoblastic" and "myeloid" refer to the two different types of cells from which leukemia arises. Lymphoblastic leukemia develops from bone marrow lymphocytes, myeloid leukemia arises from granulocytes or monocytes.

Leukemia can occur in both children and adults, but different types of leukemia predominate in one group or the other.

Acute lymphoblastic leukemia (ALL)

— Occurs in children and adults

- More often diagnosed in children

— Accounts for slightly more than half of all cases of leukemia in children

Acute myeloid leukemia (AML) (often called acute nonlymphoblastic leukemia)

- Affects children and adults

— Accounts for less than half of all cases of leukemia in children

Chronic lymphocytic leukemia (CLL)

- Occurs only in adults

— Detected twice as often as chronic myeloid leukemia (CML)

Chronic myeloid leukemia (CML)

- Mainly affects adults and is very rarely detected in children

— CLL is diagnosed twice as rarely.

Treating oncology under compulsory medical insurance – what is needed for this?

You can receive FREE medical care at the Oncology Center under the State Guarantee Program of Compulsory Medical Insurance (Compulsory Medical Insurance) and High-Tech Medical Care.

The service is valid for all Russian citizens.

To find out more details, as well as for what nosologies and services this program works, please call +7, or you can read in more detail here.

Treatment and diagnosis of oncology are expensive medical services. The examinations alone cost a lot of money, and this is only the beginning of an already difficult path. Therefore, many patients are forced to postpone cancer treatment, since financial losses can literally ruin them. In this regard, the Sofia Clinic offers a number of services under the health insurance policy. Free cancer treatment under compulsory medical insurance is available to all Russian citizens. First of all, patients with very serious diagnoses, for whom treatment is a matter of life and death, can count on it. Such cancer patients are provided with quotas, which are financed from the federal and local budgets. As part of treatment under compulsory medical insurance, the following procedures are performed:

PET/CT;
radiation therapy;
chemotherapy;
IHC;
surgery.

The decision to provide free oncology treatment under compulsory medical insurance is made by three commissions - the clinic, the health department and the medical institution itself. You can shorten this path if you immediately contact us and ask what procedures our clinic issues quotas for. The doctor (therapist or oncologist) will prepare a statement with the diagnosis and information about what diagnostics you have already undergone. You will need to submit to the regional health authority:

medical direction;
application for treatment of cancer under the compulsory medical insurance policy;
Russian passport and insurance policy;
SNILS;
consent to the processing of personal data;
pension certificate (for pensioners).

What happens after treatment of acute leukemia?

After completion of treatment for acute leukemia, dynamic observation in the clinic is necessary. Such observation is very important, as it allows the doctor to monitor possible relapse (return) of the disease, as well as side effects of therapy. It is important to tell your doctor immediately if you experience any symptoms.

Typically, relapse of acute leukemia, if it occurs, occurs during treatment or shortly after its completion. Relapse develops very rarely after remission, the duration of which exceeds five years.

Benefits of onco

The success of oncology treatment greatly depends on the level of the clinic. And it’s not just about the professionalism of doctors and specialists conducting diagnostics. All therapeutic procedures must be performed using modern and high-tech medical equipment. The same applies to devices on which diagnostics are carried out. The data obtained with their help must be as accurate as possible so that the doctor can determine the location of the lesion and the stage of oncological pathology. And don’t forget about patient comfort. Diagnosis and treatment of oncological diseases takes a lot of time. Patients often have to spend the whole day within the walls of a medical facility, and some patients are undergoing inpatient treatment. Therefore, it is important that the environment and atmosphere be as favorable as possible. Onko took into account both his own 30 years of experience and the experience of foreign medical institutions. This allows us to diagnose cancer tumors and treat cancer patients with maximum efficiency, safety and comfort. See for yourself:

Each of our doctors is a highly qualified specialist with many years of experience both in Russia and in hospitals in the USA, Europe and Israel. We employ leaders of domestic medicine, as well as competent international consultants.
Diagnostics and therapeutic procedures are carried out in beautiful and cozy rooms. We have decorated our departments in a stylish design so that the interior looks as little as possible like a hospital room. Also for patients and their accompanying people there is a café and a restaurant on the roof with panoramic views of the city.
High safety and quality levels have been repeatedly confirmed by numerous certificates and awards. We carry out our activities in strict accordance with domestic and international standards, which allows us to minimize side effects and significantly increase the chances of recovery.

Treatment of acute leukemia in adults

Acute leukemia in adults is not one disease, but several, and patients with different subtypes of leukemia respond differently to treatment.

The choice of therapy is based both on the specific subtype of leukemia and on certain characteristics of the disease, called prognostic features. These features include the patient's age, white blood cell count, response to chemotherapy, and whether the patient has previously been treated for another tumor.

Chemotherapy

Chemotherapy refers to the use of drugs that destroy tumor cells. Typically, anticancer drugs are prescribed intravenously or orally (by mouth). Once the drug enters the bloodstream, it is distributed throughout the body. Chemotherapy is the main treatment method for acute leukemia.

Chemotherapy for acute lymphoblastic leukemia (ALL).

Induction . The goal of treatment at this stage is to destroy the maximum number of leukemia cells in a minimum period of time and achieve remission (no signs of the disease).

Consolidation . The goal at this stage of treatment is to destroy those tumor cells that remain after induction.

Maintenance therapy . After the first two stages of chemotherapy, leukemia cells may still remain in the body. At this stage of treatment, low doses of chemotherapy are prescribed for two years.

Treatment of damage to the central nervous system (CNS) . Due to the fact that ALL often spreads into the membranes of the brain and spinal cord, patients are injected with chemotherapy into the spinal canal or given radiation therapy to the brain.

Chemotherapy for acute myeloid leukemia (AML):

Treatment of AML consists of two phases: remission induction and therapy after remission is achieved.

During the first phase, most normal and leukemic bone marrow cells are destroyed. The duration of this phase is usually one week. During this period and for the next few weeks, the white blood cell count will be very low and therefore measures will be required against possible complications. If remission is not achieved as a result of weekly chemotherapy, repeated courses of treatment are prescribed.

The goal of the second phase is to destroy the remaining leukemia cells. Treatment for a week is then followed by a period of bone marrow recovery (2-3 weeks), then chemotherapy courses are continued several more times.

Some patients are given very high doses of chemotherapy to kill all the bone marrow cells, followed by a stem cell transplant.

Side effects.

In the process of destroying leukemia cells, normal cells are also damaged, which, along with tumor cells, also grow rapidly.

Cells in the bone marrow, oral and intestinal mucosa, and hair follicles grow rapidly and are therefore exposed to chemotherapy.

Therefore, patients receiving chemotherapy have an increased risk of infection (due to a low white blood cell count), bleeding (low platelet count), and increased fatigue (low red blood cell count). Other side effects of chemotherapy include temporary baldness, nausea, vomiting, and loss of appetite.

These side effects usually go away soon after chemotherapy is stopped. Typically, there are methods to combat side effects. For example, antiemetic drugs are given along with chemotherapy to prevent nausea and vomiting. Cell growth factors are used to increase the white blood cell count and prevent infection.

You can reduce the risk of infectious complications by limiting contact with germs by thoroughly cleaning your hands and eating specially prepared fruits and vegetables. Patients receiving treatment should avoid crowds and patients with infection.

During chemotherapy, patients may be given strong antibiotics to further prevent infection. Antibiotics may be given at the first sign of infection or even earlier to prevent infection. If the number of platelets decreases, a platelet transfusion is possible, as is a transfusion of red blood cells if there is a decrease and the occurrence of shortness of breath or increased fatigue.

Tumor lysis syndrome is a side effect caused by the rapid breakdown of leukemia cells. When tumor cells die, they release substances into the bloodstream that damage the kidneys, heart and central nervous system. Giving the patient plenty of fluids and special medications will help prevent the development of severe complications.

Make an appointment

Our oncology clinic is located in the very center of Moscow, close to several metro stations - Novoslobodskaya, Tverskaya, Chekhovskaya, Belorusskaya and Mayakovskaya. For visitors arriving by car, there is ample parking available on the medical grounds. Our employee will help you find your way around the clinic, take you to the right department and tell you where this or that office is located.

You can make an appointment with a specialist:

by calling a phone number;
online by filling out a special form on the website;
ordering a call back.

Types of disease

The modern classification of leukemia includes several principles of division into types. First of all, it is worth mentioning the division of cases of the disease according to the nature of the course into:

acute, characterized by rapid development and the formation of a large number of immature blood cells - blasts;
chronic, which are characterized by a long course and pathological production of mature leukocytes with altered properties.

Another principle for classifying leukemia is based on the level of differentiation of the affected cells, which can be:

undifferentiated;
quotational;
blast.

In addition, oncologists distinguish many types of leukemia according to the types of cells whose pathological changes underlie the disease. According to this principle, lymphoblastic, monoblastic, myeloblastic, lymphocytic, myeloma and other types of disease are distinguished.

Why does malignant pathology appear?

Scientists are still unclear about some of the causes of leukemia in children. However, there are some theoretical and practical justifications for answering the question of why children suffer from leukemia. The following causes of leukemia in children are distinguished:

Genetic predisposition. Pathological genes are formed as a result of intrauterine chromosomal changes, which produce substances that prevent the maturation of healthy cells.
Viral infection of the body. As a result of diseases of viral etiology suffered by a child, for example, chicken pox, mononucleosis, ARVI, etc., viruses are integrated into the cellular genome.
Immunodeficiency. The immune system cannot cope with the destruction of foreign organisms and ceases to destroy its own pathological cells, including malignant ones.
Radiation causes mutations in blood cells. Risk factors include maternal exposure to radiation (X-rays, tomography) during gestation, as well as living in a radioactive zone.
Adverse habits of parents, especially mothers. Smoking, drinking alcohol and drug addiction.
Secondary leukemia after radiation or chemotherapy for another cancer.

Leukemia also develops in children due to the formation of ozone holes as a result of active solar radiation. The causes of leukemia in children also lie in genetic pathologies, such as Down syndrome, Bloom syndrome, etc., as well as polycythemia.

Forecasts

The success of leukemia treatment depends on many factors, but in most cases the prognosis is favorable. Acute forms are more complex, since the rapid course of the disease leaves less time for the doctor to act. In the chronic form, favorable outcomes, according to statistics, account for up to 85% of cases.

In any case, there remains a chance for a long-term remission and complete relief from the disease. In adults, the probability of a positive outcome is at least 40%, in children - up to 90%.