Leukemia-signs,causes and symptoms
Leukemia is a cancer blood cells. Cells blood are produced in the bone marrow, a tissue that is present in most bones. Leukemia, bone marrow begins producing too many WBC (White cells) and sometimes they do not even perform these duties. These cells continuously multiply when normal to stop this process. They may have a cell division much faster than other cells. Over time, these abnormal cells replace the normal cells get - leukocytes, red blood cells and platelets. Leukocytes are designed to help body fight infection. Red blood cells are designed to ensure good oxygenation at the cellular level, necessary for proper functioning of the body, and platelets help stop bleeding. The moment when the leukemia cells replace the normal, blood and can not perform the functions. As a result it may cause bleeding and bruising (Bruises) with ease, there may be a state fatigue continue or persons concerned may be frequently sick.
Classification
There are four main types of leukemia. Health status in acute leukemia may worsen quickly. Patients with acute leukemia often felt immediately. Those with chronic form of evolution is a slow and often symptoms are not visible than when disease is advanced. These two forms - acute and chronic - divide each type of leukemia. These cell types are based on affected - lymph tropic .
So there:
- Acute lymphoblast leukemia (ALL): Is common in children but can occur in adults
- Acute myeloid leukemia (AML): Can affect both adults and children
- Lymphocyte leukemia disease (CLL): Is the most common form of the adult leukemia, affecting mainly the elderly and children are very rare this type, usually affecting people over fifty
- Chronic myelogenous leukemia (CML): This form occurs mainly in adults.
Leukemia Causes
Leukemia causes are not well known. It is unknown why some people this disease and others do not.
Research has shown that some people are more likely than others to make this disease. A risk factor is any factor that may increase the chance of getting a disease. Risk factors for leukemia include:
- Treatments chemotherapy (Used in cancer treatment)
- Exposure to a series of radiation or chemicals in the workplace
- Smoking.
Most people with this disorder have these risk factors. Leukemia usually is not transmitted genetically, but there are rare cases of chronic lymphatic leukemia terms.
Leukemia Symptoms
Symptoms depend on how the disease is advanced and may include:
- Fever and sweating nocturnal
- Frequent and unusual infections
- Asthenia and fatigue
- Headache
- Occurrence of ecchymosed (bruises) on the body and bleeding Gum and rectum
- Increasing the size of the abdomen, pain in his left or right shoulder due Spleen enlarged
- swelling lymph nodes from the armpit, neck or upper canal
- Loss of appetite and loss, weight because there is a feeling of fullness.
Chronic forms of leukemia, most often than not give any symptoms when the disease is advanced.
What Happens
In most cases of leukemia there are too many white blood cells modified. These cells replace the normal bone marrow and lymph nodes to gather at the Spleen and liver. This leads to hinder fight body with various infections.
White blood cells help the body fight infection occurred. Red blood cells are designed to ensure good oxygenation at the cellular level, necessary for proper functioning of the body, and platelets help stop bleeding. The moment when the leukemia cells replace the normal, blood and can not perform the functions. As a result it may cause bleeding and bruising easily, there may be a state fatigue continue or persons concerned may be frequently sick.
Treatment chemotherapy or radiotherapy used to treat other cancer such as Cancer Breast, Hodgkin's lymphoma (disease malignant what initially starts in the lymph nodes) can cause leukemia months or years after starting treatment.
Survival rates vary depending on the type of leukemia. Survival rate at five years, the percentage of people who are alive after five years to detect the disease, but must remember that every case is different, this rate is only statistical. New research is under way to develop other more effective treatments for this disease.
Survival rates at five years are:
- 20% for acute myelogenous leukemia (AML)
- 65% for acute lymphoblast leukemia (ALL)
- 73% in chronic lymphocytes leukemia cells (CLL)
- 31% -57% for chronic myelogenous leukemia (CML), to the possibility of a bone marrow transplant from an unrelated donor.
Risk Factors
A risk factor is that it can increase the chance of getting this disease. However, most people with leukemia have none of the known risk factors.
Risk factors for occurrence of leukemia are:
- smoking: 20% of people with acute myeloid leukemia smoke or use tobacco products that contain
- Exposure to levels of CREC radiation: People who were close to atomic bomb blast areas from Japan, during the World War II or the people in Ukraine who were held in the area where the nuclear accident at Chernobyl have a very big risk to make leukemia
- Exposure to chemicals such as benzene or formaldehyde: exposure sometimes this is done at work
- chemotherapy and radiotherapy used in cancer treatment
- Genetic diseases such as Down syndrome (Disease Congenital determined by the presence of a supernumerary chromosome in the chromosome pair 21)
- HIV infection
- Other blood diseases such as myelodysplastic syndrome
- Transmission genetics, especially in the form of chronic myeloid leukemia.
Watchful waiting
Watchful waiting period is the period during which the doctor makes regular checks, but does not prescribe a treatment. It is also called surveillance or observation period, during which your symptoms will follow. May be an option treatment if an elder, but this option is also depending on the type of leukemia and overall health.
Watchful waiting period gives the same results or even better than aggressive treatment in early stages of chronic lymphocytes leukemia. It is estimated that one in three people suffering from chronic lymphocytes leukemia did not need treatment. Those affected by this form can survive long without treatment. Watchful waiting period is not recommended other forms of leukemia.
During this time patients will have to do these things:
- To respect the doctor appointments
- Make regular medical tests, including scans and blood tests
- Discuss with your doctor all symptoms occurred in November.
Medical specialists recommend
Health professionals who can recognize and evaluate symptoms of leukemia are:
- GP
- Doctor of internal medicine
- Pediatrician
- Resident doctor
The diagnosis of leukemia will be made by your doctor or oncologist hematology, with an examination - bone marrow aspiration and biopsy it. These medical specialists will advice and treatment of leukemia in each case separately.
Investigations
If the doctor suspects a diagnosis of leukemia, and it will interest the patient's medical history. And will perform a physical exam and check node shipping the armpit, neck and the canal and will feel spleen and liver to see if they have exceeded the normal range.
The doctor will ask and analysis blood, such as a full blood count and a blood profile. These tests will provide important information about blood cells. These examinations are made when a person accused fatigue fever, bruising or weight loss.
Your doctor may recommend other tests, such as:
- radiography lung to see if perhaps a infection the lung is due to persistent cough, cough with expectoration of blood, the chest pain or breathing difficulties
- CT (computed tomography) in the thorax, and abdomen, to find out whether leukemia has spread to this level
- Lumbar puncture, to see if specific modified leukemia cells, and is CSF (cerebrospinal fluid)
- MRI (magnetic resonance) the nervous system Central to find the cause of events such as confusion, paralysis, nausea, vision impairment, par aesthesia (Numbness), headache (headache). These symptoms suggest that the leukemia has spread to the central nervous system
Aspiration of bone marrow biopsy are needed to determine the type of leukemia in these cases: acute lymphoblast leukemia, acute myeloid leukemia, chronic myelogenous leukemia. Aspiration is not necessary in case of chronic lymphocytes leukemia, because blood tests are sufficient. Once the doctor knows the type of leukemia, because biopsy bone marrow it may provide all necessary information about treatment. In addition, a biopsy a lymph node or other tissue can be done to look for cancer cells.
Treatment - General
The goal of leukemia treatment is to destroy cancer cells and allow healthy cells, normal bone marrow to form. Decisions on treatment are based on the type of leukemia, disease stage, patient age that is, but also on overall health.
Treatment of acute leukemia
Chemotherapy is a treatment which uses a number of drugs used in cancer treatment. Usual treatment is a form of acute leukemia.
This treatment is done in three phases:
- Induction: for this stage of treatment is remission, remission is the time when cancer cells were destroyed and there is replacement of normal blood cells, this is achieved using high dose drugs very strong, which is administered over a period of seven to ten days, then the body will take several weeks to start producing healthy cells, the patient will be hospitalized this time
- Enhancing: even when tests show no cancer cells can be few more, for this phase of treatment is to destroy these cells, which were left, in this phase are given, most times, all the same drugs as and induction phase, but the dosage range to be taken may be different, for example, may receive a second cycle, or treatment, which lasts five days, but a period of one to three months
- Maintenance: goal of this stage is to prevent recurrence of cancer cells, in this period will be given lower doses of medication over a period of two to three years, sometimes at this stage of therapy and may require a bone marrow transplant (bone marrow transfer from a donor to a recipient).
Some types of acute and rapidly disseminate the central nervous system, and the spine. Chemotherapy and efficacy is the body's levels as barriers to those body parts. Another type of chemotherapy, which is called chemotherapy intrathecal, treats these areas by injecting drugs directly into the spinal column, to destroy cancer cells at this level.
Treatment of acute exacerbated forms
Sometimes the patient's condition is very good, despite treatment as the disease progresses. During remission there may be a rebound or relapsing disease. Even when this occurs, there are treatments to help leukemia or therapy improves survival:
- Clinical trials: people affected by the disease may enter a research program, either at baseline or when leukemia is worse, these programs are trying new treatments for leukemia
- stem cell transplantation: if a donor could be found, chemotherapy and radiotherapy destroy malignant cells and are used instead of donor healthy cells, these cells may be from bone marrow or cord blood, these cells can restore healthy cell deposits in blood recipients and to increase immunity, if there is a relapse after such transplant, a transfusion with more than WBC of donor blood can install remission
- Drugs: sometimes using other drugs than those used in the initial chemotherapy
- Repeating the induction phase: sometimes the same drug that led to remission of leukemia and now can demonstrate their effectiveness.
Treatment of chronic form
Though acute leukemia requires immediate treatment in the chronic form of administration is not always need treatment quickly. Usually evolves into much more slowly than the acute form.
The possibilities of treatment in chronic form are:
- Watchful waiting period: treatment often is not necessary in the early stages of chronic lymphocytes leukemia form, it evolves very slowly and may not be any symptoms to guide patient to doctor, patient and his doctor will decide whether to start treatment or to wait a while, during this period the doctor will carefully monitor the health, it is estimated that one in three people with chronic lymphocytes leukemia, has never needed treatment
- Stem cell transplantation: if you can find a donor, administered drugs will kill cancer cells and make room for healthy cells from the blood received from the donor, cells may be of bone marrow or umbilical cord blood
- Biological therapy: Is a series of drugs that increase the body's own ability to fight cancer; two such drugs are very used by doctors and interferon-alpha used especially in treating chronic myeloid leukemia
- radiotherapy: this form of treatment, using radiation kill cancer cells, also has a role in reducing lymph nodes, as well as Spleen, Which have changed due to the extension of disease at this level, sometimes radiotherapy is used for whole body irradiation, preparing the body for transplant or to treat chronic lymphocytes leukemia
- Clinical trials: are used to discover which medicine or treatment is efficient and safe, people with chronic leukemia are often guided by these clinical trials to determine how best treatment
- Chemotherapy: is destroy cancer cells with drugs, there are a variety of drugs used in fighting this disease, increasing the survival rate
- Treatment of infections: in case of chronic leukemia, the body is no longer able to fight infections, so your patient will follow along with carefully all signs that may indicate an infection, such as Pneumonia, Or fungal infections shingles; Early treatment of these infections or others, may help patients to boost their chances of fighting this disease, some of those infections could be prevented by administration of vaccines such as those against flu or pneumonia.
If chronic lymphocytes leukemia diagnosed, physicians should continue, very patient and other cancer. Persons with such a diagnosis have greater risk of making another form of cancer than any other person.
Treatment aggravated forms of chronic leukemia
If chronic myelogenous leukemia gets worse, still there is hope. Substance imatinib in combination with other drugs can lead to disease treatment. New drugs are studied in clinical trials for those who do not go well with imatinib.
If there is a relapse after a bone marrow transplant, a transfusion of more leukocytes (white cells) from donor to patient restore remission phase.
Palliative care
As the disease progresses, would be a good idea to use him and palliative care. Palliative care is a kind of treatment that addresses those who are unable to mobilize or whose condition often worsens. It differs from curative treatment, which treats the disease itself. Palliative care aimed at improving quality of life, not only through treatment of the disease, but a particular attention to the mind and soul. Some people may resort to the curative treatment and palliation.
By this treatment can move more easily across a range of symptoms of disease, or over some adverse effects of drug therapy. May also help in overcoming the negative feelings that may arouse the disease, to establish plans related to drug therapy, to help those close to the patient to better understand disease and how to help him get over this difficult period. If the persons concerned are susceptible to this type of therapy that they should seek medical attention, it being possible its best guide in this regard.
Dead issue
If the disease has returned after treatment, as well as together with your family and patient to establish a different treatment and resolve the legal issues that may arise in case of treatment failure. It is better for the patient to decide on his desires, when able to do so. He must think well to subsequent treatment. It can be left those decisions about further treatment on account of a close person. It can happen that for the patient or family to change in time from curative treatment to maintain rather a certain comfort and dignity. The doctor put a series of questions about what the patient wants, when curative treatment is no longer a solution. There are a number of specialists who can provide palliative treatment even at his house.
Note!
The doctor can not speak of remission and healing when we talk about the goal of treatment. Although many of those with leukemia are treated successfully, the term remission is used because cancer may return. It is important to discuss with your doctor about a possible return of the disease.
Clinical trials play an important role in treating leukemia. They are testing the newest drugs and newer therapies. Most of these clinical trials have all the treatments that can recommend and will be closely watched. Should discuss with your doctor about the possibility of entering into such a clinical trial, which may be beneficial for him.
Prophylaxis
Nobody knows how it might prevent the occurrence of leukemia. Many of those who have this disease have risk factors. A risk factor is that factor which increases the chance to be sick. Some people exposed to high doses of radiation, exposed to benzene, Smoking or those who are chemotherapy have risk of leukemia.
Outpatient treatment
During leukemia treatment at any stage, there are a number of measures to be taken home, for as good a passer over the side effects of therapy or for the evolution of the disease itself. Sometimes these measures are all that is needed for a number of problems. If your doctor has prescribed some medications to minimize symptoms that may occur, they must be taken regularly. Also, the patient should eat a balanced, try a series of exercises can do well and rest as much.
Such outpatient treatment consists of:
- Outpatient treatment for nausea and vomiting: includes monitoring and immediate treatment of the signs of dehydration, such as: dry mouth, salivate viscous, reducing the amount of urinate or changing its color (Dark urine) and any dizziness appeared in standing
- Treatment for diarrhea: includes balanced diet and follow signs dehydration, consult a doctor before taking medicines for diarrhea
- Outpatient treatment for constipation: include exercise light, good hydration and a diet rich in fiber, have asked your doctor before taking any medicine laxative;
- You can ask your doctor and if there food be avoided during chemotherapy; many may be prescribed not to eat fresh fruits and vegetables and to eat only well cooked food; bacteria that may exist fruits and vegetables sometimes can not be removed by washing well and bacteria that may exist meat die not unless it is well cooked when going treatment for leukemia, immune system is low and there is a greater risk of illness from these bacteria
- Treatment for fatigue: includes a better rest period radiotherapy or chemotherapy, should that besides conduct daily activities, those who follow these treatments be rested as much, fatigue is felt especially at the end of treatment
- Outpatient treatment for insomnia: must set a schedule for sleep, so that there is a better rest
- Of diet during treatment: be followed to prevent weight loss and preserve tonicity.
Emotions related to this diagnosis
Persons, who have the diagnosis of leukemia, may experience different feelings. Many deny this diagnosis are filled anger and very upset. Many become depressed, or others may have fewer emotions. There is a normal reaction in a human way to react to learning the diagnosis. There are several steps you can take to respond as well to find out this diagnosis. Some people feel better to talk with family or friends, while others need solitude.
If these emotions can influence the trial of that person, it is better to discuss this with your doctor. The hospital treats such diseases where there are specialized persons (psychologist) who can discuss. And discussions with others who have had similar problems may be useful.
There are a number of emotional problems that have to confront the patient with leukemia, such as:
- The diagnosis and treatment can be very stressful: this condition stress can be reduced by talking with loved ones, learning to relaxation techniques may be helpful
- New physical changes that may occur can arouse strong emotions: for a better adaptation to the new image is needed to discuss this with your partner, it can recommend a number of specialized individuals or organizations that can help the leukemia patient with information and even with effective
- hair loss: This is a very bad time for some people, not all drugs used to treat Cancer leading to hair loss or if it happens to be visible only at issue, the doctor will inform the patient if this side effect of therapy can occur.
If treatment for leukemia or disease itself causes pain, there are a number of measures to be taken. Must follow medical advice on medicines to be used for pain killers. Home treatment for pain involves the administration of NSAIDs or using alternative therapies such as biofeedback"(Method of treatment that uses a system to monitor the physiological state, which helps the patient control his mental and physical condition, by controlling processes such as temperature unintentional, blood pressure, gastrointestinal function and brain activity). Any Outpatient treatment should be discussed with your doctor.
Medications
Chemotherapy represents the standard treatment for many types of leukemia. Even when cure is not possible, chemotherapy may help improve the general status and to prolong life.
This treatment usually includes a combination of drugs, because drugs used in different ways to attack cancer cells. This combination is also used to prevent cancer cells resistance to a particular drug used. Other drugs used to treat leukemia help prevent infection and the body's capacity to produce new healthy cells.
Nausea and vomiting are the most common side effects of chemotherapy and most feared. Chemotherapy but not necessarily for the patient to present these events.
Medication Choices
Acute leukemia:
- Chemotherapy Combination doctors have a range of products from which to choose for this treatment, for example, can be administered a combination of prednisone, incrusting, daunorubicin, asparagines and cyclophosphamide if a leukemia Acute lymphoblast leukemia, other commonly used drugs in this combination are: doxorubicin, idarubicin, cytarabine, fludarabine and mercaptopurine
- methotrexate and cytosine arabina: they can be injected into the spinal canal to treat leukemia that has reached brain or to prevent extension of leukemia at this level
- Mitoxantrone: is a chemotherapy drug that attacks cancer cells
- Antibiotics and immunoglobulin: the prevention and fight against infection, they are especially important when the patient does not have enough normal white cells to fight infection
- imatinib: interfere with cancer cell growth, is often manage patients with chronic myelogenous leukemia, but sometimes those with acute lymphoblast leukemia
- Red blood cell and platelet transfusions may be required
- Erythropoietin and stimulating haematopoietic new cells help the body produce healthy blood
- allopurinol: can be taken to avoid damage kidney and occurrence of gout
- Gentuzumab: can be used in case of acute myeloid leukemia relapse, helping the body to destroy cancer cells.
Chronic leukemia:
- Chemotherapy for this type may involve a single drug or combination of drugs, for example, can be administered a combination of cyclophosphamide, vincristine, prednisone; Other versions of drugs are fludarabine, clorambucil, hydroxyurea, Cytarabine, busulfan, rituximab and alemtuzumab - Interferon alpha, which helps the immune system to fight disease and prevent cancer cell growth, is often administered in chronic myelogenous leukemia
- allopurinol: Can be used to prevent kidney and appearance Gout.
Medications for nausea and vomiting:
Nausea and vomiting are some of the most common side effects of chemotherapy, these effects are usually temporary and disappear when treatment is stopped. Your doctor will prescribe some medicine for nausea prevention. These may be:
- Serotonin antagonists such as ondansetron, granisetron or dolasetron, these drugs are going very well in combination with corticosteroids, such as dexamethasone
- Aprepitant: is used in combination with ondansetron and dexamethasone in treatment for 3 days
- Fenotiazide
- metoclopramide.
Note!
Researchers always investigating new drugs through clinical trials to treat leukemia. These trials have made it possible for many people with leukemia to live longer. Talk to your doctor about the possibility of entering into such a clinical trial.
Surgery
There may need surgery to remove Spleen. This operation is called a splenectomy. For people with chronic lymphocytes leukemia, there may need removal of the spleen, because at this level destroy red blood cells and platelets.
Sometimes a lymph node affected, can be excised for the diagnosis of leukemia. This process is called lymphadenectomy.
Surgery is sometimes necessary to place a catheter central venous (a vein than chest level). The catheter is a small tube used to administer chemotherapy and other drugs. The catheter can be used to take blood samples when necessary. This prevents the patient sting many times during treatment.
Other treatments
These treatments can be used to treat leukemia:
- radiotherapy: kill cancer cells and shrink tumors, may be applied to one area of body or whole body, is sometimes used to treat leukemia that has spread to the brain and CNS or to prevent dissemination, can be used to decrease lymph nodes affected or to prepare the body for a bone marrow transplant
- stem cell transplantation: transplants are usually from bone marrow or blood, some transplants are autologous cells, meaning that Stem coming from their body, others are Allogeneic, meaning the stem cells are donated by another person, for transplant is to destroy all cells bone marrow, Including cancer cells and their replacement with new, healthy
- Clinical trials: they are investigating new ways of treating leukemia, many patients are included in these trials helping them to boost chances of survival, the doctor may advise the patient to such a trial can answer all questions on this and can help patients decide whether this is good for him.
Note!
Many cancer patients are willing to try alternatives to treatment in the hope of healing. Be a discussion with your doctor before trying special diets, unapproved drugs, natural products or treatments unusual about the patient can hear. Some of these methods may get weirder side effects of chemotherapy or reduce benefits. | 
