Hemoblastoses are neoplasms that develop from hematopoietic cells. Hemoblastosis is divided into several types: leukemia and hematosarcoma. They are distinguished by the systemic nature of the lesion. If, in the course of leukemia, the bone marrow is primarily affected, hematosarcoma - lymphatic nodes, and bone marrow as a result of metastasis. With leukemia, malignant immature cells are found in the blood, hence the name leukemia . Hematosarcomas are divided into lymphomas and neoplasms of non-lymphatic nature.
Classification of hemoblastoses is also carried out according to the rate of development of the disease: acute hemoblastosis and chronic. Benign stage of hemoblastosis development is replaced by malignant.
Hemoblastosis is one of the five most common malignant tumors. Half of all malignant tumors in childhood are hemoblastoses in children.
Causes of hemoblastoses
The exact causes of hemoblastosis have not yet been established. Most doctors believe that the disease is hereditary, and under adverse conditions (exposure to radiation, chemicals, viruses, severe stressful situations), the disease manifests itself. The men are more susceptible to hemoblastosis. Children, young people (especially those who recently started serving in the army) and elderly people are more often ill.
It is possible to identify the factors contributing to the incidence of hemoblastosis. First, radioactive radiation. There is a high incidence of chemical weapons victims and nuclear power plant accidents that received high doses of X-rays and radiation therapy. The second group of factors is chemical substances. Exposure to benzene (with active and passive smoking), inhalation of volatile organic solvents, varnish, paint (in production), long-term use of certain drugs (cytostatics, gold salts, etc.), chemotherapy. Thirdly, there are cases of cases of hemoblastosis caused by infection with Epstein-Barr viruses and T-lymphocytic human leukemia virus type I. Also, patients with hereditary diseases, in which chromosomes are prone to rupture ( Down's syndrome , Fanconi anemia, Bloom's disease), with non-spreading sex chromosomes ( Klinefelter's syndrome , Turner's syndrome ) are also more likely to fall ill.
The role of the genetic factor can be confirmed by the existence of "leukemic families". If the process of metabolism in the body is broken, this too is the cause of chromosomal mutations.
Symptoms of hemoblastoses
To classify all the symptoms of hemoblastosis, several syndromes are distinguished. Hyperplastic (growth of lymph nodes, liver and spleen). Pain and heaviness in this area are fixed. There is an increase in the volume of the bone marrow, the patient complains of osteoalgia. The enlarged hilar lymph nodes squeeze the upper vena cava, as a result, the blood flow is disturbed, which is characterized by the appearance of edema of the neck, hands, face. Seals on the skin, gums, in the pharynx become noticeable.
With intoxication syndrome, patients feel inexplicable weakness, quickly become tired, a person loses weight, sweating, body temperature.
Anemic syndrome is characterized by weakness, decreased efficiency, dizziness , fainting, ringing in the ears, circles in the eyes. Patients suffer from shortness of breath, palpitations, feel pain in the heart.
With hemorrhagic syndrome, subcutaneous bruising, bleeding from the nose becomes noticeable. Syndrome of infectious complications means joining of various infections as a result of a lack of leukocytes in the blood.
Hemoblastosis can begin to acutely, as acute respiratory disease, may initially be bleeding, the onset of the disease is slow, or latent. Hemoblastosis in children is more often concealed under the guise of ARI.
We can distinguish the stage of exacerbation and weakening (remission) of the disease. Remissions are full and incomplete. Complete remission is a normal clinical condition for at least a month. In this case, the myelogram reflects no more than 5% of cancer cells.
In paraproteinemic hemoblastoses, tumor growth is associated with B-lymphocytes. The onset of the disease is not distinguished by typical features. When the disease develops as a result of the destruction of bones, painful sensations appear in the vertebrae, in the ribs. Due to insufficient production of red blood cells, granulocytes, platelets, anemia, infectious complications, hemorrhages begin. Also there is kidney failure, proteinuria. The viscosity of the blood increases, microcirculation is disturbed.
Paraproteinemic hemoblastosis occurs mainly in old age.
Paraproteinemic hemoblastosis includes myeloma, leukemia (acute plasmablastic), solitary plasmacytoma, Valbensterm disease, heavy chain disease, Ig-secreting lymphomas. The disease is characterized by the presence of malignant growth, which produces abnormal protein, resulting in patients developing immunodeficiency.
Most often from paraproteinemic hemoblastosis occurs myeloma . The causes of the disease are not fully understood. The tumor is located mainly in the bone marrow. It can be distributed differently: abnormal cells are evenly distributed among normal hematopoietic cells and there may be tumor centers with preservation of normal bone marrow. Because of abnormal cells, osteoclasts begin to destroy bone tissue. For certain forms, certain features are characteristic. In the diffuse focal form, osteoporosis develops with foci of complete dissolution of bone tissue, the diffuse form is characterized by osteoporosis, the focal form causes separate foci of osteolysis. With the development of the disease, the bones become thinner, at the end the tumor grows through.
The appearance of the first signs of the disease is characteristic of the third stage of hemoblastosis, when the tumor mass already exceeds 1200 g per square meter.
Diagnosis of hemoblastoses
To diagnose hemoblastosis, anamnesis is collected. The appearance of weakness, shortness of breath, dizziness, pains in the chest, pain in the right hypochondrium, pain in the bones, lymph nodes increased, bleeding appeared.
Analyze the anamnesis of life. Find out whether a person suffers from chronic diseases, hereditary diseases, whether there is dependence on smoking, whether there was long-term treatment with any medications, whether it works in harmful production.
Next - an external inspection. The skin can be pale with hemorrhages. Gums are compacted, healthy teeth are loosened, purulent ulcers appear in the oral cavity. When probing, it is found that the lymph nodes are enlarged. When tapping it is determined that the liver and spleen are enlarged. Measure the pulse, it is rapid, and pressure, it is reduced.
On the analysis of blood, a low amount of red blood cells is seen, the level of hemoglobin is lowered. In the analysis of urine, blood is detected. To reveal the accompanying lesions of the organs, a biochemical blood test is performed. The bone marrow is examined to assess hemopoiesis and classification of hemoblastosis, puncture the sternum, trepanobiopsy. Lymph nodes are examined by puncture or surgical removal. Check the cytochemical reaction, determine the type of tumor cells when staining the tumor cells with the help of special dyes. Bone marrow cells are examined at the chromosome level. Conduct an ultrasound, examine the liver, spleen, kidneys. They make a chest X-ray to assess the condition of the lymph nodes, heart, lungs. Conduct a lumbar puncture to examine the cerebrospinal fluid. They make an MRI, an ECG.
To diagnose hemoblastosis in children, it is necessary to carefully evaluate the manifestations of the disease during its development, taking into account the age and state of health of the child before the onset of the disease. In time, use the entire arsenal of diagnostic methods (cytological, cytochemical, histological, immunological, cytogenetic, cultorial, electron microscopic diagnostics). It is also necessary to confirm the diagnosis in a specialized department, if it was delivered earlier. It is necessary to start using special methods of research as early as possible in order to establish the degree of spread of the tumor. Take into account all clinical and laboratory indicators to determine the prognosis of the disease.
Treatment of hemoblastoses
To begin treatment it is necessary as soon as possible in a hospital. Hemoblastosis in children is treated using special children's schemes. It is better if the treatment is performed in an aseptic room.
The specific treatment depends on the form of hemoblastosis. If it is acute leukemia , treatment is performed in accordance with the type of disease (lymphoblastic or non-lymphoblastic). The basis for the treatment of acute lymphoblastic leukemia is the LOP program. For the treatment of myeloid leukemias, Cytosar-Anthracycline regimens plus Etoposide are used. Promyelocytic leukemia is treated with the help of the biological program ATRA plus chemotherapy. In the treatment of chronic lymphocytic leukemia monoclonal antibodies are prescribed - Rituximab, Fludaru, cytostatics Cyclophosphamide or Sarcolysin with Prednisolone and Methandrostenolone. The course includes 200-300 mg of Sarcolysin 10-20 mg per day. For 10-15 mg per day of methandrostenolone. Supportive therapy - Sarcolysin 10 mg every 5-10 days. When renal insufficiency is replaced by Sarkolizin Cyclophosphamide 400 mg intravenously or intramuscularly, the course - 8-10 g. Supporting course - 400 mg Cyclophosphamide every 5-10 days. Radiation therapy is used to treat local foci of hemoblastosis.
Chronic myelogenous leukemia is treated with the help of Glivec (Imatinib). The traditional treatment for multiple myeloma is Melphalan and Prednisolone. New drugs are Bortezomib (Velkeyd), Thalidomide. For the treatment of Hodgkin's lymphoma, chymeolute methods are used. For hemoblastoses, Gemzar, Navelbin, and Taxanes are also used. Chemotherapy treatment is conducted in courses.
There is a method that allows you to completely recover from leukemia - a bone marrow transplant from a donor. To avoid rejection, it is necessary to choose a donor among close relatives. Symptomatic treatment, transfusion of erythrocyte mass, platelets, plasma are also performed.
The success of hemoblastosis therapy depends on timely diagnosis and the initiation of proper treatment. Care of the patient is important. During the course of chemotherapy, the patient should be washed every day with warm water without using a sponge. In the diet should be cooked vegetables, meat. Do not give solid products to avoid damage to the oral mucosa. In the treatment of corticosteroids, the use of salt and carbohydrate food is restricted. Fresh vegetables and fruits are excluded.
During breaks between chemotherapy courses, it is necessary to monitor the patient, to measure body temperature twice a day, to monitor the state of health.
Traditional medicine advises with a good tolerability of herbs, the use of broths from the Ayr marsh, the leaves of the Blackberry, the oats of the seed, the Veal of the field, the leaves of Bilberry, the leaves of Apple tree, the Veins in the ratio 2: 2: 3: 1: 2: 2: 1. It is taken before meals three times a day. Another version of the decoction with the use of leaves of barberry, birch, angelica officinalis, lovist, Rye stems, field horsetail in equal proportions. You can also use a decoction of Birch Leaves, Angelica officinalis, leaves of Nettle, Oats stems in a ratio of 2: 2: 3: 3
With leukemia, it is also possible to use wipes using the following medicinal plants separately or in the form of fees: Buds grass, Angelica officinalis root, wild strawberry grass, nettle nettle leaves, green stems Pyrée creeping, green stems Rye sowing, Birch leaves, tops Buckwheat grass, leaves Blackberries, grass Wild strawberry forest, grass Yarrow, grass, clear blue.
The treatment of hemoblastosis is long and requires efforts of both specialists and patients, but recently, thanks to the use of modern complex methods, the majority of cases have a complete cure or a significant prolongation of life.