Hello my dear friends. My cousin called me yesterday and told me that her granddaughter Hana was seriously ill. Hana is barely a year old and has acute lymphoblastic leukemia.So I decided to write you an article today about this serious disease.
WHAT IS LEUKEMIA? Leukemia is a cancer of the blood and blood-forming organs that causes an increase in the number of white blood cells (leukocytes) of certain species1.Various forms of leukemia are classified according to the type of white blood cells that are cancerous and according to the rate of disease progression. There are four main types of leukemia: chronic lymphocytic leukemia (CLL), acute lymphoblastic leukemia (ALL), chronic myeloid leukemia (CML), and acute myeloid leukemia (AML). Each type of leukemia has its own characteristics and method of treatment. 1.Leukemia is called lymphocytic (or lymphoblastic) if the cancerous changes occur in a series of bone marrow cells that form lymphocytes (that is, a type of white blood cell).
2.Leukemia is called myelocytic (or myeloid) if the cancerous changes occur in a series of bone marrow cells that would normally form red blood cells, certain types of white blood cells, and platelets.
3.Chronic leukemia is a slowly progressive blood cancer that allows more larger cells to grow. Basically, these cells can perform some of their normal tasks. Chronic leukemia develops slowly, so it can be a long time before people need treatment.
4.Acute leukemia is a disease that affects undifferentiated cells that have not yet fully developed. These immature cells cannot perform their normal tasks. Acute leukemia progresses rapidly and is an aggressive form of the disease.
What is acute lymphoblastic leukemia? It is a cancer of the hematopoietic system characterized by uncontrolled proliferation of immature lymphoid cells.In leukemia, one type of white blood cell (leukocyte) turns into cancer and is no longer under control. These cells divide and multiply, displacing healthy cells in the bone marrow and then spreading to the blood, lymph nodes, liver, spleen and other parts of the body.
Acute lymphoblastic leukemia (ALL) is the most common cancer in children aged 1 to 10 years.Its share is 80% of the number of cases of hematopoietic diseases. According to statistics, boys suffer more often than girls. The first signs are:
Infections occur after which they sometimes do not fully recover, or bruising, or bleeding from the mucous membranes, or a petechial rash on the skin. Fatigue, paleness, irritability (ability to respond to stimuli), pain in the bones, especially of the lower extremities, or abdomen may occur. Enlarged lymph nodes and spleen can be found, less often the liver. Most often, these problems last only two to four weeks before the disease is discovered. Laboratory results of blood tests show decreased or increased white blood cell count, decreased red blood cell count, decreased hemoglobin, decreased platelet count and the presence of blasts in the peripheral blood. As a rule, bone marrow removal by puncture is required to confirm the disease and determine the exact type of leukemia. Lumbar puncture and examination of cerebrospinal fluid for leukemia cells should also be performed.
Causes of the disease:
The main cause of acute lymphoblastic leukemia - the formation of cancer clones (a group of malignant cells that have the ability to spread uncontrolled).
The clone is formed due to chromosomal aberrations:
-transfer - exchange of sites between two chromosomes;
-deletion - represents the loss of a region of chromosomes;
-inversion - reversal of a chromosomal region;
-amplification - making copies of chromosomal regions.
The genetic disorder that causes ALL is thought to take place in the uterus. But additional circumstances of external origin are needed to complete the onset of clone cancer.
Symptoms of the disease:
-fever on the background of general malaise;
-rapid hopeless fatigue;
-severe constant bone pain, large joints;
-often there are infectious diseases on the background of the disease;
-Skin coatings lose color, become pale;
-there is a hemorrhagic rash, frequent, small;
-the lymph nodes are slightly swollen, painful;
-the pain comes from the spleen, the liver.
Diagnostics:
-lumbar puncture (to rule out neuroleukemia);
-Ultrasound of abdominal organs (to determine the condition of parenchymal organs and lymph nodes);
-Chest X-ray (to detect enlarged lymph nodes in the media);
-Biochemical blood test (to detect bleeding from kidney and liver function);
-Differential analysis (performed with severe infectious diseases).
How is the treatment done and how long does it last?
The main method of treatment is chemotherapy in the form of tablets, injections, infusions, administration of drugs into the cerebrospinal fluid with lumbar puncture. Chemotherapy is divided into several phases:
A. introductory, which is intense and kills most leukemic cells;
B. re-intensive treatment that kills surviving leukemia cells;
C. treatment of the central nervous system, where regular intermittent administration of chemotherapy to the cerebrospinal fluid and high doses of a specific drug in the form of venous infusions, in high-risk leukemia by radiation of the head, prevent the development of leukemia in the brain
D. maintenance treatment, where remission (disease-free condition) is maintained with chemotherapy in the form of tablets and occasionally also in the form of venous infusions.
The first three phases together last about six months, and the maintenance phase another year and a half to two and a half years. The intensity and duration of chemotherapy also depend on the risk group of patients. This is influenced by many different factors.
The survival rate of pediatric ALL patients has increased over last 50 years due to the application of highly standardized randomization treatment protocols. However, 10-20% of ALL patients will relapse and die in five year period after therapy completion. The survival rate of infants and adults with ALL is even worse. Increasing the cumulative doses of current protocols did not result in the improved survival rate, despite the higher incidence of toxic effects. Therefore, new therapeutic strategies are needed to improve the ALL therapy efficiency. The most promise hold the genetic and epigenetic drugs, as well as therapy with cells expressing chimeric antigen receptors (CAR), directed specifically towards cancer cells. Due to the unclear safety profile of the abovementioned therapeutics, these new approaches will be at first focused only on patients with resistant ALL.
Such a serious disease as cancer affects the whole family. It is important that parents trust the medical staff in the hemato-oncology department of the pediatric clinic, where they will "carry out" the quickest possible diagnosis and treat the child and monitor him after the end of the disease. It is essential that both parents are involved in the child care program. It is necessary to tell the child, of course, according to his age, what is happening to him. You have to answer honestly and openly. Let his parents tell him why they are sad, because he will only be so sure that they are not angry with him. It is good that they also talk about their plight with the hospital staff. A psychologist is also available. The instructions should be followed strictly, especially at a time of increased risk of infections. Parents must, as far as possible, continue to be involved in the normal course of life, they must also continue to take care of healthy children in the family and their well-being.
Parents can also turn to associations of patients with acute lymphoblastic leukemia in children for help.
Photos are taken from google.com.
Thank you for reading my article.
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I am very affected by these stories ... the children are not to blame ...