Source: China Blood Network Time: 2005-12-27 9: 03: 01
The incidence of some patients is related to taking drugs by mistake, such as taking analgin after the most common cold: taking acetaminophen for psoriasis; Others are career-related, such as excessive exposure to chemicals benzene and benzene-containing substances. It is also reported that hair dye can also cause leukemia. Judging from the epidemic areas with developed petroleum and chemical industries, the number of patients is increasing. With the continuous development of industry, the incidence of this disease is still likely to rise. When the human body's own disease resistance is low and its immunity declines, it is most likely to get sick because of the influence of external pathogenic factors.
Preventive measures are as follows: It is recommended to take medicine under the guidance of a doctor when catching a cold; Psoriasis patients should pay attention to frequent examination of blood picture during medication to ensure safe medication. The above diseases are best treated by natural therapy and traditional Chinese medicine. For those who are engaged in the chemical industry, often exposed to pesticides or live in areas with serious environmental pollution, it is necessary to do a good job of protection and regular physical examination to achieve early prevention, early detection and early treatment. Another Chinese herbal medicine, Jiang Shi, was recommended. Many years ago, this medicine was put into wells or used as tea in some areas of southern China, which played a certain role in preventing leukemia. The medicine has hemostatic, antiinflammatory, expectorant, bactericidal, cancer cell destruction, nitrosamine content reduction in water, and bacteria and fungal viruses elimination effects. In addition, internal prevention can not be ignored. Traditional Chinese medicine believes that kidney governs bone, bone produces marrow, and marrow leads to brain. Tonifying the kidney and strengthening the body is equivalent to enhancing immunity. The commonly used medicine is Liuwei Dihuang Pill, and more fitness methods can be mastered. Such as Tai Ji Chuan and Qigong, to enhance immunity.
Leukemia is a malignant disease of white blood cells in human blood. There are a large number of abnormal leukemia cells in blood, bone marrow and various tissues and organs of patients with this disease. These cells proliferate continuously, and patients may have a series of symptoms, because different types of white blood cells have different clinical manifestations. According to the maturity of white blood cells, leukemia can be divided into acute and chronic types. In acute leukemia, almost all patients' leukemia cells are immature and naive. Taking granulocytes as an example, most of them are primary granulocytes and promyelocytes, with advanced promyelocytes as the main ones. What needs to be explained here is that chronic leukemia does not evolve from acute leukemia. According to the different types of white blood cells, they can be divided into lymphocyte type, granulocyte type, monocyte type, plasma cell type and megakaryocyte type, and sometimes they can be mixed by two kinds of cells, such as granulocyte-monocytic leukemia.
1. What is leukemia?
Leukemia is a malignant disease of hematopoietic tissue, commonly known as "hematologic cancer". It is characterized by tumor proliferation of a certain type of leukemia cells in bone marrow or other hematopoietic tissues, which can infiltrate various organs and tissues in the body, damage the functions of various organs, and produce corresponding symptoms and signs. Anemia, fever, infection, hepatosplenomegaly and lymph node bleeding are common in clinic. Infantile cells may appear in bone marrow and peripheral blood.
2. Why is leukemia called "blood tumor"?
Leukemia has the same characteristics as other malignant tumors. Namely:
(1) Like malignant tumor cells, leukemia cells can proliferate indefinitely.
(2) Leukemia cells, like other malignant tumor cells, can invade all organs of human body without hindrance, affect organ function, and lead to systemic failure and death;
(3) Leukemia can also manifest as local infiltration, forming a tumor-like mass. Such as skin infiltration nodules and common green tumors in children's eye sockets. Therefore, most people often refer to leukemia as "cancer of the blood system".
3. Why do you get leukemia?
The reason is not clear. Because of radiation, ionizing radiation, viruses, chemicals (including poisons and drugs) and possible genetic or immune function defects of individuals, hematopoietic cells can become cancerous. Due to the defects of differentiation and maturity, the cells after malignant transformation maintain the ability of division and proliferation. Therefore, this malignant cell (leukemia cell) can proliferate and accumulate in the body, and spread from hematopoietic tissue to blood and various organs of the whole body, thus producing clinical manifestations of leukemia.
4. Is leukemia contagious?
Leukemia is not an infectious disease. Although the exact cause of human leukemia is not clear, there are many theories about the pathogenesis of leukemia, and no leukemia has been infected because of close contact with leukemia patients. Although some studies have found that some viral infections, such as human T-lymphotropic virus type I (H- butyl LV- 1), can induce some D-cell leukemia, which is mainly caused by gene mutation of patients caused by retrovirus itself. Although it is caused by this kind of virus infection, it is mainly the internal factor of this kind of patients. In addition, it has also been reported that in some families, several family members suffer from the same type of leukemia, but this is not caused by mutual infection, but mainly because there are some genetic defects among such family members. If leukemia is contagious, then the medical staff who are in close contact with leukemia patients must be the first victims, but in actual work, leukemia does not exist among medical staff.
5. Can leukemia be inherited?
It should be said that not all leukemias have genetic susceptibility, but we do see that some leukemias are more likely to occur in a certain race (such as white people), some genetic defects (such as Ih, wn syndrome), and some familial diseases (such as Fzlnco mountain anemia). Among identical twins, if one of them suffers from acute leukemia, the probability of the other suffering from acute leukemia (25%) is significantly higher than that of the general population (5/65438+ 1 million). All the above suggest that some genetic factors may have an influence on the pathogenesis of leukemia.
6. Who is prone to leukemia? What are the clinical manifestations of leukemia?
At present, the research on the etiology of leukemia shows that whether an individual suffers from leukemia may depend on the interaction of internal and external factors. According to relevant research, the incidence of leukemia in people with the following conditions may be higher than that of ordinary people, that is, the institute? Quot high-risk population:
(1) People exposed to ionizing radiation due to some special needs or accidents, such as survivors of nuclear radiation such as atomic bomb explosion, are treated with X-rays or γ-rays or 32P for tumors or other patients.
(2) Long-term or chronic exposure to certain chemical reagents or drugs, such as benzene and its derivatives, certain anti-tumor drugs such as alkylating agents or certain immunosuppressants, ethyl dimorpholine, etc.
(3) People infected by a retrovirus (such as HTLV-I virus).
(4) Patients with some congenital and hereditary diseases, such as Down syndrome, Fanconi anemia and Bloom syndrome.
The main clinical features of leukemia are that the growth of normal hematopoietic cells is inhibited and leukemia cells infiltrate into organs. Due to the infiltration or inhibition of leukemia cells on bone marrow, the normal hematopoietic function is blocked, and the clinical manifestations are as follows:
(1) Anemia occurs due to the decrease of mature red blood cells, which can be manifested as dizziness, fatigue, palpitation and pallor.
(2) Due to the decrease of normal mature white blood cells (mainly granulocytes), the anti-infection ability decreases, and fever or signs of infection appear repeatedly.
(3) Due to the decrease of mature platelets, the skin mucosa has a tendency of spontaneous bleeding. Such as spontaneous exudation of nasal mucosa and gingival area; It is difficult to stop bleeding after tooth extraction or other trauma; Ecchymosis and bleeding spots appear on the skin; Female patients have increased menstruation and prolonged menstruation; A few patients may have gastrointestinal bleeding such as black stool, bloody stool, fundus or intracranial hemorrhage.
(4) Organ infiltration: The manifestations vary according to the affected parts, such as enlargement of the liver (or spleen and lymph nodes); Gingival hyperplasia; Sternal tenderness; A few patients have testicular enlargement, skin or subcutaneous nodules; If the nervous system is involved, it can also be manifested as headache, vomiting, vision changes and so on.
7. Is it necessary for leukemia patients to be infected if they have a fever?
The fever of leukemia patients is not necessarily caused by infection, but leukemia itself can also cause fever. Leukemia patients, especially those with leukemia cells, often show fever because of abnormal differentiation and proliferation of blood cells and abnormal nucleic acid metabolism, which release more energy. This fever can only be controlled by remission of leukemia after chemotherapy. But generally speaking, the fever of leukemia patients is mostly caused by infection. Even if you can't find a clear infection focus temporarily, you should use antibiotics in time.
8. What are the common infection sites of leukemia?
There are many infection sites in leukemia patients, and the common ones are:
(1) Oral cavity is the most common. Include gums, oral mucosa and soft palate. It is characterized by ulcer or erosion, bleeding and severe cellulitis caused by soft tissue infection.
(2) Bleeding and erosion of nasal mucosa, which can cause perforation of nasal septum in severe cases.
(3) Respiratory tract includes trachea, bronchus and lung infection. Patients often have symptoms such as cough, expectoration, chest pain and breath holding.
(4) Patients who are prone to hemorrhoids, anal fissure or constipation around the anus. It often manifests as local pain, redness, erosion and soft tissue cellulitis infection.
(5) Female urinary tract is more common. It is characterized by frequent urination, urgency, dysuria and other urethral irritation symptoms or hematuria.
(6) Furuncle, ulcer, etc. Appears locally on the skin.
9. Why are leukemia patients anaemic?
The causes of anemia in leukemia patients are:
(1) Decreased erythropoiesis. This is because the abnormal proliferation of leukemia cells in bone marrow inhibits the proliferation of red blood cells;
(2) The development and maturation of red blood cells are also interfered by leukemia, and the life span of red blood cells is shortened;
(3) Leukemia patients are often accompanied by bleeding, which further aggravates anemia. Of course, after chemotherapy, the damage of chemical drugs to red blood cells will also aggravate anemia.
10. Why do leukemia patients bleed easily?
The mechanism of bleeding in leukemia patients is complicated, and the reasons are as follows:
(1) In leukemia, the number of platelets decreased and the function was impaired;
(2) the destruction of coagulation factors and the disorder of coagulation mechanism;
(3) Because leukemia cells accumulate in blood vessels, the blood vessel wall is damaged and bleeding is easy to occur.
1 1. What are the common bleeding sites in leukemia patients?
The bleeding site of leukemia patients is very extensive, and almost all parts of the human body can bleed, especially acute leukemia patients. The more common bleeding sites are:
(1) petechiae, ecchymosis, purpura or even hematoma appeared on the skin. It is worse during venipuncture or after trauma;
(2) Oral gingival bleeding and oral mucosa. Slight bleeding after brushing teeth and eating hard objects, severe bleeding without any inducement, and even blood blisters and hematoma;
(3) nasal bleeding after contusion or without inducement;
(4) Other conjunctiva, gastrointestinal tract, urogenital system (female patients with vaginal bleeding) and cerebral hemorrhage.
12. What is the bone pain, joint pain or sternal tenderness in leukemia patients?
A large number of leukemia cells proliferate in the bone marrow cavity of leukemia patients, which leads to an increase in the pressure in the bone marrow cavity. In addition, when the periosteum and joint cavity are infiltrated by leukemia cells, it will also invade the periosteal nerve, cause the pressure in the joint cavity to increase, and cause pain due to bone destruction.
13. What should I do if I have leukemia?
Once a person is suspected or told that he has some type of leukemia, he must keep calm. Although leukemia is a malignant disease of the blood system, it is not a terminal disease since the development of medicine. At this time, it is necessary to cooperate with doctors and actively cooperate with treatment. It is not advisable to give up one's life easily or go to the hospital in disorder, and to delay treatment by superstitious "folk remedies".
14. Should leukemia patients avoid eating?
In terms of diet, it should be said that there is no food that leukemia patients cannot eat. Just to avoid unnecessary complications in the treatment process, leukemia patients should pay attention to the following points in their diet:
(1) Pay attention to food hygiene and avoid eating cold, overnight or spoiled food. Fresh fruits must be washed and peeled before eating.
(2) Try to avoid eating hard or fried food. For example, fish products should be boned and pricked as much as possible to prevent hard objects from piercing the oral membrane when eating, causing oral ulcers and even secondary local infections.
(3) Pay attention to the reasonable collocation of dietary structure, eat less spicy food and try to eat fresh vegetables. Those who have bad defecation habits or habitual constipation before getting sick should pay special attention to supplementing foods rich in cellulose. Try to keep the daily defecation unobstructed, prevent constipation from aggravating hemorrhoids or inducing anal fissure, and increase the chance of local infection.
15. Is there a relationship between blood type and leukemia?
Blood type is determined by special antigen substances on the surface of human red blood cells. So far, there is no correlation between blood type and leukemia at home and abroad.
16. Is leukemia just a white blood cell disease?
Leukemia is not only a disease of white blood cells, because in all series of hematopoietic systems (erythroid, granulocyte, mononuclear, lymphoid, megakaryocyte, etc. ), leukemia can occur not only in white blood cell series (granulocyte, mononuclear and lymphoid), but also in other non-white blood cell series (megakaryocyte and erythroid). In addition, no matter which series of leukemia, except the acute and neoplastic proliferation of cells in a certain stage of this series, the growth of other normal series of cells is also inhibited by the influence of tumor cells on normal hematopoietic tissue. Therefore, any series of leukemia will eventually show different degrees of anemia (erythropenia), bleeding (thrombocytopenia) and susceptibility to infection (abnormal number and quality of white blood cells).
17. Can blood transfusion infect leukemia?
Although blood transfusion can cause the spread of some infectious diseases (blood-borne viral diseases, such as hepatitis B, hepatitis C, AIDS, malaria, etc. In rare cases, there are no reports of leukemia caused by blood transfusion at home and abroad. Of course, we can't completely rule out that after some people have imported blood products contaminated by some special viruses, such as human T lymphocyte type I virus (HAVE disease), the retrovirus RNA contained in the virus will be transformed into protovirus M-sail in the host T lymphocytes and further integrated into the DNA chain of the host T cells. By activating the oncogene of the cell itself, T cells will eventually proliferate and develop into leukemia. These people often have their own internal factors.
18. Is leukemia an incurable disease?
Although leukemia is a malignant disease of hematopoietic tissue, it has become a treatable disease due to the development of medical technology. Through active chemotherapy, radiotherapy, bone marrow or peripheral blood stem cell transplantation and application of biological response regulator, more than half of patients can prolong their survival time. A few patients can still be cured.
19. What is the incidence of leukemia in China?
There are about 3-4 leukemia patients/65,438+10,000 population in China, with more males than females. The incidence of this disease varies from city to city. Acute myeloid leukemia is the most common acute leukemia, followed by acute lymphoblastic leukemia, and most of them are teenagers and children under 20 years old. Chronic myeloid leukemia is more common in adults, while chronic lymphocytic leukemia is more common in the elderly.
20. How to distinguish acute and chronic leukemia?
The difference between acute and chronic leukemia is mainly based on:
(1) The average life expectancy of patients with acute leukemia or untreated natural processes is less than 1 year, while that of patients with chronic leukemia is 1-3 years.
(2) Differentiation and maturation of leukemia cells The main leukemia cells in acute leukemia bone marrow or peripheral blood are primitive (lymphocytes, granulocytes or monocytes) cells, while those in chronic leukemia bone marrow and peripheral blood are mainly mature and immature granulocytes (chronic myeloid leukemia) or mature small lymphocytes (chronic lymphocytic leukemia).
2 1. Will acute and chronic leukemia transform into each other?
The concept of acute and chronic leukemia is essentially different from other diseases (such as acute and chronic hepatitis, acute and chronic gastritis, etc.). ). The difference between acute and chronic leukemia lies in the degree of maturity of leukemia cells, except for the differences of rapid onset, rapid development and natural course of disease. Primordial cells are the main leukemia cells in bone marrow or peripheral blood of acute leukemia. The bone marrow and peripheral blood of chronic leukemia are mainly mature and immature granulocytes or similar mature small lymphocytes. After treatment, patients with acute leukemia have survived for several months or years, but they are still acute leukemia, not chronic leukemia. However, some chronic leukemia, such as chronic myeloid leukemia, can obviously increase the hemogram and the number of bone marrow primordial cells at a certain stage of pathology, and turn into acute leukemia, that is, CML mutation or CML primordial cell crisis.
22. How to distinguish leukemia from leukemia?
The body reacts to some diseases or external stimuli, which is manifested by the obvious increase of white blood cells in peripheral blood and the appearance of immature cells. This phenomenon is called leukemia-like reaction The difference between leukemia-like cells and leukemia is that the changes of white blood cells in leukemia-like cells have no tumor characteristics and have certain disease incentives. When the inducement is removed, the leukemia-like reaction disappears, so the change is temporary, so it is not difficult to distinguish it from leukemia. However, in a few cases, except for obvious changes in white blood cells, bone marrow images showed an increase in the proportion of granulocytes and promyelocytes, similar to acute leukemia. Like leukemia, red blood cells and platelets should not be affected; In addition, cell immunophenotype and chromosome analysis can be used to distinguish leukemia.
23. Is leukemia and septicemia the same thing?
Leukemia and septicemia can have similar clinical manifestations, such as anemia, fever, skin purpura, hepatosplenomegaly, abnormal increase of white blood cells in hemogram and appearance of immature cells. But they are essentially two completely different diseases. The former is a malignant tumor disease of hematopoietic tissue, and the latter is a bacterial infection.
Systemic infection caused by entering the blood circulation. Patients with leukemia may develop sepsis at a certain stage of the course of the disease due to secondary serious infection. Sepsis will never turn into leukemia.
24. What is pre-leukemia?
Pre-leukemia refers to hematological abnormalities with uncertain nature for quite some time before leukemia, and it is a retrospective diagnosis made after leukemia. A considerable number of MDS-RAEB and MDS-RAEB-t patients can turn into leukemia with the development of the disease. The MDS- Rabe and MDS- Rabe -t phases of these patients are called leucorrhea. The main clinical characteristics of leucorrhea are: most patients have anemia in different degrees, which is difficult to improve after various treatments; Some patients can also have fever or bleeding at the same time; The routine blood test showed pancytopenia or any cytopenia of one or two lines, and pathological hematopoiesis phenomena such as giant red blood cells, giant platelets and nucleated red blood cells could be seen. Three-line blood cells or any two-line blood cells in bone marrow show pathological hematopoiesis, in which the proportion of primitive cells can be increased, but it has not yet reached the standard of leukemia.
25. What is FAB typing of acute leukemia?
1976, blood cell morphological experts from France, the United States (AInerican) and Britain discussed and formulated the diagnostic criteria of acute leukemia, referred to as "FAB" typing. According to this standard, acute non-lymphocytic leukemia can be divided into seven subtypes, such as M 1-M7 * *, while acute lymphocytic leukemia can be divided into three types, such as L 1-L3. This classification method has been widely used in the world, and its purpose is to unify the classification and diagnosis of acute leukemia.
25. What is FAB typing of acute leukemia?
1976, blood cell morphological experts from France, the United States (AInerican) and Britain discussed and formulated the diagnostic criteria of acute leukemia, referred to as "FAB" typing. According to this standard, acute non-lymphocytic leukemia can be divided into seven subtypes, such as M 1-M7 * *, while acute lymphocytic leukemia can be divided into three types, such as L 1-L3. This classification method has been widely used in the world, and its purpose is to unify the classification and diagnosis of acute leukemia.
26. What does MIC typing of acute leukemia mean? What are the advantages compared with FAB typing?
MIC is the abbreviation of morphology (M), immunology (I) and cytogenetics (C). MIC typing of acute leukemia, as its name implies, is to classify leukemia according to the morphological, immunological and cytogenetic characteristics of leukemia cells. MIC typing can make up for the deficiency of FAB typing only by morphological typing. In addition to morphological features, MIC is labeled with monoclonal antibodies according to a series of specific antigens (such as myeloid antigens, T, B or non-T and non-B lymphoantigens) carried or expressed on the surface of leukemia cells, so as to improve the accuracy and objectivity of leukemia typing. At the same time, cytogenetic methods such as chromosome banding technique are also used to detect whether there is chromosome abnormality in leukemia patients, which can provide valuable reference for guiding clinical judgment and prognosis.
27. What are the types of acute leukemia?
Acute leukemia can be divided into acute lymphoblastic leukemia (ALL) and acute non-lymphocytic leukemia (ALL). According to the FAB classification standard revised by 1985, ANLL*** can be divided into seven types, such as M 1-M7, which are as follows:
M 1: undifferentiated myeloid leukemia;
M2: partially differentiated promyelocytic leukemia;
M3: acute promyelocytic leukemia;
M4: acute myelomonocytic leukemia;
M5: acute monocytic leukemia;
M6: acute erythroleukemia or erythroleukemia;
M7: Acute megakaryocytic leukemia.
According to their morphological characteristics, FABs can be divided into L 1, L2 and L3 * * *.
L 1 type: primitive lymphocytes have uniform and round nuclei and few cytoplasm;
Type L2: primitive lymphocytes change greatly, the nucleus may be irregular, and the cytoplasm is larger than L1;
L3 type: primitive lymphocytes have fine nuclear chromatin, blue-dark blue cytoplasm and vacuoles.
In addition, according to immunological characteristics, AI can be divided into two categories: T cells and B cells, and then into many subtypes. Except me. 1 type acute lymphoblastic leukemia must be B-cell type acute lymphoblastic leukemia, and there is no obvious correlation between morphological classification and immunological classification of acute lymphoblastic leukemia.
28. How to diagnose acute leukemia?
The diagnosis of leukemia is mainly based on the patient's clinical manifestations, hemogram and bone marrow examination results. gt； 30% as the diagnostic criteria of acute leukemia.
29. What are the clinical characteristics of acute myeloid leukemia?
Acute myeloid leukemia, AML for short. The main manifestation is malignant proliferation of granular primitive cells. It has two subtypes: undifferentiated myeloid leukemia (M 1) and partially differentiated myeloid leukemia (M2). Patients with this disease often have sudden onset, rapid progress, common clinical infection and bleeding, and often die. About 10% cases progress slowly, mostly in the elderly, showing anemia symptoms such as fatigue, pale face and weakness, as well as bleeding and infection.
30. What are the clinical features of acute promyelocytic leukemia?
Acute promyelocytic leukemia (APL) is an acute leukemia characterized by promyelocytic hyperplasia, which belongs to M3 FAB classification. The onset is sudden, rapidly worsening, bleeding tendency is obvious, and disseminated intravascular coagulation is easy to occur. The number of white blood cells in peripheral blood often does not increase, and the promyelocytic cells in bone marrow are >: 30%. This leukemia can be alleviated by inducing mature differentiation or apoptosis of leukemia cells.
3 1. What are the characteristics of acute myelomonocytic leukemia?
Acute myelomonocytic leukemia (M5 leukemia). There are granulocytes and monocytes in bone marrow or (and) peripheral blood, or the primitive cells of "acute granulocytes" have both morphological characteristics of granulocytes and monocytes. If the proliferation of granulocytes and promyelocytes is dominant, the number of granulocytes and monocytes should exceed 20%; If the proliferation of premature cells is dominant, the number of premature cells and premature cells should exceed 20%.
Clinically, "urgent granule list" (and "urgent? Quot the same performance) has the following characteristics:
(1) Gingival hyperplasia, swelling, bleeding, ulcer and necrosis are common;
(2) Nasal mucosa infiltration, nasal congestion, hypoesthesia, hard palate ulceration, throat edema and asphyxia;
(3) Cutaneous leukemia is a common disease, which can be manifested as diffuse maculopapules, hard nodules, lumps, pustules, bullae or exfoliative dermatitis.
(4) Intestinal wall infiltration, ulcer and gastrointestinal dysfunction are common;
(5) Renal failure and proteinuria are common, which are related to monocytes and granulocytes rich in lysozyme, and they are easy to form lysozyme and lysozyme urine;
(6) Joint pain and swelling are common;
(7) In treatment, AML and AML are worse than other acute non-lymphocytic leukemia.
32. What's the difference between erythroleukemia and erythroleukemia?
The manifestation of acute polycythemia is mainly the malignant proliferation of immature red blood cells and immature red blood cells, and the changes of megaloblastic red blood cells can be seen. Clinically it is often misdiagnosed as megaloblastic anemia. Acute erythroleukemia is characterized by malignant proliferation of red and white (mainly granulocytes) lines, which can eventually develop into typical acute myeloid leukemia or acute myelomonocytic leukemia. It is generally believed that erythroleukemia can develop into erythroleukemia, and erythroleukemia can be further transformed into acute leukemia, but not every case has such a transformation process in clinic, and some cases may die of complications before transformation, thus failing to show the whole process of disease development.
33. Why do patients with acute promyelocytic leukemia have more severe bleeding than other leukemia?
This is mainly because there are leukemia cells in this disease; A large number of abnormal particles are rich in coagulant and plasminogen activator. With the proliferation of leukemia cells or the destruction of chemotherapy, procoagulants and plasminogen activators release a lot of human blood, causing disseminated intravascular coagulation and fibrinolysis, and then causing obvious bleeding tendency throughout the body. Gingival bleeding, nosebleed and ecchymosis are common in clinic, and patients often die of intracranial hemorrhage.
34. What is the immunophenotyping of leukemia? What help does it have to the clinic?
Immunotyping of leukemia is to use monoclonal antibodies to detect antigens on the surface or cytoplasm of corresponding white blood cells, analyze the serial sources of il in detail: normal and malignant cells, and accurately understand the different differentiation stages of the detected white blood cells, thus contributing to clinical typing, judging prognosis and guiding treatment. At present, this technology has become an important means of clinical treatment and basic medical research.
35. What is a green tumor?
Green tumor, also known as granulocytoma or granulocytic sarcoma, is a local mass formed by the aggregation of blood cells in the C part of the foot. Because these cells are rich in peroxidase, the tumor-causing section is green, so it is named. Green tumor is common in children and young patients with acute myelopathy, with more males than females. Generally, it invades periosteum, dura mater and ligament tissue, most commonly in orbit, which can cause asymmetric exophthalmos. Secondly, it is also found in tibia, sinuses, ribs, sternum and pelvis. Bone marrow cavity, breast, liver, kidney, gastrointestinal tract, gonad (testis, ovary), muscle and other places can also be involved. This tumor can appear before the typical hematological changes of leukemia.
36. What is congenital leukemia?
All leukemia diagnosed within the fourth week after birth is called congenital leukemia. The skin manifestations of patients are most common at birth, and about 50% of cases often have leukemia nodules of 0.2-0.3cm in addition to purpura. In addition to hepatosplenomegaly, dyspnea is more common, and there are more non-lymphocytes than lymphocytes in cell types. Most children died of respiratory failure within days to months after diagnosis.
37. What is hypoproliferative leukemia?
When acute leukemia has bone marrow images with reduced nucleated cells, it is called low proliferative leukemia. Its main characteristics are: more common in the elderly; The disease progresses slowly; The infiltration of leukemia cells is not obvious, and the liver and spleen are generally not swollen; The number of third-line cells in peripheral blood decreased, and there were no or only a few primitive cells. Bone marrow image showed that proliferation decreased, and primordial cells accounted for more than 30%. Combined chemotherapy is still the main treatment for this type of leukemia, but the prognosis is not good.
38. What is smoking leukemia?
If acute leukemia is imagined as a raging fire, it is not difficult to understand that smoked leukemia is a latent leukemia disease state with potential danger of causing fire burning. The prominent feature of this disease is the slow development of the disease, which lasts for a period of time, as long as months or even years. The hemogram also shows anemia, leukopenia and thrombocytopenia, and the bone marrow is only 5%-30% like primitive cells. Later, with the progress of the disease, clinical symptoms also tend to be serious. At present, this kind of leukemia has been classified into refractory anemia with neutropenia (MDS-RAEB) and refractory anemia with neutropenia (MDS-RAEB-t) with myelodysplastic syndrome.
39. What is chronic leukemia?
Chronic leukemia is a malignant hematological disease, with relatively mature leukemia cells and a longer natural course than acute leukemia. According to the morphological types of leukemia cells, it can be roughly divided into two types: chronic myeloid leukemia and chronic lymphocytic leukemia. The latter also includes some rare types of leukemia, such as polychromatic erythrocytic leukemia, juvenile lymphocytic leukemia, adult T-cell leukemia and so on.
40. What is chronic myeloid leukemia?
Chronic myeloid leukemia is a myeloproliferative disease, which is caused by pluripotent stem cell disease and characterized by infinite proliferation of granulocyte system. It can be seen at any age, but the peak of the disease is around 40 years old. The chromosome of Ph 1 can be detected in 90% patients with the disease, and the structural abnormality of the corresponding gene can also be found in the remaining 10% patients by molecular biology methods. The onset of the disease is hidden, and the early symptoms are mild, such as low fever, night sweats and emaciation. Spleen enlargement is obviously a feature of this disease. Peripheral blood leukocytes increased, mostly granulocytes below the middle and young granulocyte stage; Platelets do not decrease or even increase in the early stage. Bone marrow hyperplasia is extremely active, the proportion of granulocytes increases in the middle and late stages, megakaryocytes are more common, and there may be different degrees of bone marrow fibrosis. The natural course of chronic myeloid leukemia can be divided into three stages:
(1) Chronic symptoms are mild, about 3-4 years;
(2) There are many symptoms and hematological changes in the accelerated phase, and the patient may die of infection or bleeding;
(3) Acute symptoms and hematological changes are similar to those of acute leukemia.
4 1. What are the diagnostic criteria for chronic myeloid leukemia?
Diagnostic criteria for chronic myeloid leukemia are:
(1) neutrophils in peripheral blood increased, with immature granulocytes >: 10%, granulocytes.
(2) Myeloid cells in bone marrow are highly proliferated, mainly granulocytes and primitive granulocytes in the middle and late stage.
(3) Neutrophil alkaline phosphatase (NAP) score decreased;
(4)pH 1 chromosome positive and/or bcr-abl fusion gene positive.
Diagnostic criteria for the accelerated phase of chronic myeloid leukemia are:
(1) Primitive cells in peripheral blood or bone marrow10%-20%;
(2) anemia or thrombocytopenia;
(3) Green tumor.
The standard of chronic granulocyte in acute phase is the same as that of acute leukemia.
42. What is the treatment for chronic myeloid leukemia?
Kit for treat chronic phase of chronic myeloid leukemia