Acute lymphoblastic leukemia is a malignant pathology of the hematopoietic system when tumour mass grows from the lymphoblasts (immature lymphoid cells).
It is the most common oncological disease among children between the ages of 1 to 6 years old. Leukemic cells spreads rapidly through the bloodstream, affecting the lymph nodes, spleen, bone marrow and central nervous system.
Main risk factors of acute lymphoblastic leukemia are:
Other possible risk factors which influence the likelihood of developing acute lymphoblastic leukemia are:
Acute lymphoblastic leukemia more often develops among the representatives of European people. Boys get sick more often than girls.
The hematopoietic system is greatly affected when acute lymphoblastic leukaemia is present. It results in a reduced number of all blood cells like platelets, leukocytes and erythrocytes.
This can lead to three syndromes:
Most often patients having acute lymphoblastic leukemia complain about:
General symptoms of intoxication appear. Patient loses weight. Night sweats, appetite loss, decreased body temperature is observed.
Local symptoms that depend on the location of the tumour location:
Other clinical signs of the acute lymphoblastic leukemia depend on the illness prevalence and location:
Clinical blood count (CBC) leads to a reasonable suspicion of acute lymphoblastic leukemia. This is due to a decreased number of red blood cells, platelets and white blood cells as well as a change in leukocyte counts. Also too many immature white blood germ cells (lymphoblasts) are detected in the smear.
Additional laboratory methods are:
A diagnosis is confirmed only after the bone marrow biopsy. It is usually taken from the pelvic bones, sometimes from the chest. Specialists look at the number of blast cells in the biopsy specimen. Their norm is no more than 5%. When the illness is present, their number will grow up to 20-30% and more.
Additional research methods that are used to detect the prevalence of the illness and to define its prognosis are:
Chemotherapy is the main form of acute lymphoblastic leukemia treatment. There are many types of treatments. Medicines and doses are chosen depending on the stage of the pathological process and a number of prognostic factors represented in the table below.
First, they indicate the induction treatment. Its aim is to achieve remission. Remission considered being a reduction of blast cells in the bone marrow sample. Then consolidation stage follows. This is a drug therapy aimed at preserving prolonged remission.
Some patients are treated with stem cells at the consolidation cells. Cells are harvested from the bone marrow or peripheral blood. These are then cultivated and are injected into to the patient. Transplantation can be autologous (patient’s own cells are used) or allogenic (donor’s stem cells are used). Allogenic transplantation is more effective as well as more dangerous for the patient.
New methods of treatment are constantly being developed. They help to increase life expectancy of the patients who have acute lymphoblastic leukemia.
Among the latest medicinal achievements are:
It is possible to reach remission among 80-90% of patients. Half of them will have recurrence sooner or later. General effectiveness of treatment is about 40%.
Prognosis is much better for kids than for the adult patients. There is a general 5-year survival for 85% of children with acute lymphoblastic leukemia.
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