What are the symptoms?
Look pale. Pink or purple spots appear on the skin. The skin is prone to bruises and listlessness, and the neck, armpits and groin lymph nodes are swollen. Fever, joint pain of limbs. Bleeding gums.
If you suspect that your child may have leukemia, you should consult a doctor immediately.
What will the doctor do?
The treatment of acute lymphoblastic leukemia can be divided into two stages. The first stage usually lasts for several weeks, and abnormal leukemia cells can generally be killed by drugs. This situation should continue until there is no abnormality in bone marrow examination. At this point, the child's condition has been alleviated, which is called remission period.
The second stage lasted for another two years, and the children received intensive drug treatment. At this point, the focus of the drug is to kill all leukemia cells that still exist in the body.
Where are the parents?
Children should try to maintain a normal life. Because drug treatment may reduce children's resistance to infection, people infected with the virus, such as chickenpox and measles, should be avoided as much as possible.
What happened after treatment?
At present, 60-70% of children with acute lymphoblastic leukemia have fully recovered through current treatment?
The cause of disease
The exact cause of human leukemia is still unknown. Many factors are considered to be related to the onset of leukemia. Viruses may be the main factor. In addition, there are genetic factors, radiation, chemical poisons or drugs.
Some chromosomal abnormalities are directly related to the occurrence of leukemia. Chromosome breakage and translocation can move and activate the position of oncogene, and the change of gene structure in chromosome can directly cause cell mutation, and the decrease of immune function is beneficial to the occurrence of leukemia.
(1) virus
It has long been proved that type C RNA tumor virus or retrovirus is the cause of spontaneous leukemia in mammals such as mice, cats, cattle, sheep and primates. This virus can synthesize a DNA copy of RNA sequence by endogenous reverse transcriptase, that is, provirus, which can induce malignant transformation when inserted into the chromosomal DNA of the host.
Tumor viruses carry virus-derived tumor genes (v-onc), and most vertebrates (including human cells) have genes homologous to v-onc, which are called tumor genes. After V-onc is integrated into the gene body of the host cell, adjacent genes can be malignant. Retrovirus infection can also activate the source tumor gene and become a malignant transformation gene, resulting in malignant transformation of target cells. Even if the virus gene entering the body does not contain v-onc, if the normal function of the gene changes, it may also cause leukemia.
The viral etiology of human leukemia has been studied for decades, but so far, only adult T-cell leukemia is definitely caused by virus.
(2) Genetic factors
Genetic factors are related to the onset of some leukemia. Among leukemia patients, 8. 1% had a family history of leukemia, while the control group only had 0.5%. The incidence of acute lymphoblastic leukemia in the population of consanguineous marriage is 30 times higher than expected. Some hereditary diseases with chromosome aberration and breakage are often accompanied by high incidence of leukemia, such as Down syndrome, congenital erythema vasodilation (Bloom syndrome) and Fanconi anemia.
50% children with acute lymphoblastic leukemia have a special palmprint called Sydney line. There is a certain relationship between leukemia and HLA antigen types. For example, acute lymphoblastic leukemia is often accompanied by HLA-A2 and A9. It shows that genetic factors are related to the onset of leukemia, but for most leukemia, leukemia is not a genetic disease after all.
(3) Radiation factors
Ionizing radiation has leukemia effect, and its effect is related to radiation dose and radiation site. One large dose (1 ~ 9Gy) or several small doses have leukemia effect.
Large dose irradiation of whole body and radiation field, especially bone marrow, can lead to bone marrow and immunity, so that chromosome breakage and recombination can still be observed several months after irradiation. Radiation can lead to reversible breakage of double-stranded DNA, thus causing the replication and excretion of carcinogenic viruses in cells. Radiation can induce acute and chronic non-lymphocytic leukemia and chronic myeloid leukemia, but no chronic lymphocytic leukemia is found. There is often a bone marrow suppression period before the onset, and its incubation period is about 2 ~ 16 years.
(4) Chemical factors
The leukemia effect of benzene is certain. Acute leukemia caused by benzene is mainly acute myeloid leukemia and erythroleukemia. It is also certain that alkylating agents and cytotoxic drugs can cause secondary leukemia. Most secondary leukemia occurs after long-term treatment with alkylating agents in malignant tumors of primitive lymphatic system and those prone to immunodeficiency. Breast cancer, ovarian cancer and lung cancer are also prone to secondary leukemia after chemotherapy.
Acute lymphoblastic leukemia
Diagnostic criteria domestic diagnostic criteria
1September, 980, the national symposium on experience exchange of leukemia typing was held in Suzhou, Jiangsu Province, and the following suggestions were put forward for the typing criteria of acute lymphoblastic leukemia.
Type I (L 1): Primitive and immature lymphocytes are mainly small cells (diameter < <12mm); The nucleus is round, occasionally sunken and folded, the chromatin is thick, the structure is consistent, and the nucleoli is small and unclear; Little brain, mild or moderate alkalophilia. Usually, no more than 3% of primitive cells are positive for peroxidase or Sudan black staining.
Type Ⅱ (L2): Primarily immature cells are mainly large cells (the diameter can be more than 2 times larger than that of normal small lymphocytes, > >12mm); Irregular nuclei, depressions and folds can be seen. Chromatin is loose, the structure is inconsistent, and the nucleoli is clear, one or more; The cytoplasm is usually large, light or moderately basophilic, and some cells are deeply stained.
Type Ⅲ (L3): Birket-like; Primitive and naive lymphocytes are the same size, mainly large cells; The nucleus has a regular shape. Chromatin is uniform and small, with obvious nucleoli, one or more, showing vesicle shape; The cytoplasm is large, dark blue, and vacuoles are often obvious and honeycomb-shaped.
Leukemia is a malignant disease of hematopoietic system. It is characterized by abnormal proliferation of a series of white blood cells and their immature cells (leukemia cells) in bone marrow or other hematopoietic tissues, which reduces normal blood cell production. Leukemia cells can infiltrate all tissues and organs of the whole body, resulting in corresponding clinical manifestations, while the surrounding blood has qualitative and quantitative changes. If there are unexplained anemia, laziness, burnout, high fever with a body temperature of about 40℃, menorrhagia in women, gingival and subcutaneous bleeding, and bloody feces, you may get leukemia. Go to the hospital for examination and diagnosis in time. The infiltration of leukemia into different parts will cause a series of signs, such as hepatosplenomegaly and lymphadenopathy. Bone and joint infiltration can cause pain; Infiltrative diseases of skin and mucosa become polymorphic lesions; Involvement of the central nervous system can cause symptoms and signs similar to brain tumors or meningitis.
Diagnosis:
① Blood test H: Red blood cells, hemoglobin and platelets decreased to varying degrees, and the blood cell count was very inconsistent, which could be as high as100L or as low as 3000/microliter. Primitive cells and immature cells of various types of leukemia can be seen in the classification.
② Bone marrow examination H: The proliferation of bone marrow cells is obviously active. In the classification, a series of white blood cells (such as granulocytes, lymphoid cells or monocytes) proliferated significantly, and the percentage of primitive cells and immature cells exceeded normal, while a series of red blood cells and megakaryocytes were obviously inhibited.
③ Others: increased blood and urine acid excretion, abnormal karyotype of leukemia.
Treatment:
Chemotherapy is the most basic method to treat leukemia, especially for acute leukemia. Successful cases of immunotherapy and bone marrow transplantation are also increasing year by year. Radiotherapy can also be considered for central system leukemia, chronic myeloid leukemia and chronic lymphocytic leukemia.
Prevention:
To prevent this disease, anti-cancer chemicals should be used with caution, and medical personnel engaged in chemical drug treatment should strengthen their awareness of self-protection in their work to prevent liquid pollution. Personnel engaged in radioactive work should pay attention to personal radiation protection, drink more tea and water at ordinary times, take a bath frequently, and wash the contaminated radioactive substances inside and outside the body surface. At the same time, it is necessary to strengthen physical fitness and prevent the occurrence of various virus infections.
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