What is Myelogenous Leukemia?

Acute myeloid leukemia (AML) is a type of blood cancer with abnormal proliferation of myeloid leukocytes (not lymphoid leukocytes). It is characterized by the rapid proliferation of abnormal cells in the bone marrow, which affects the production of normal blood cells.

Acute myeloid leukemia

Definition of Acute Myeloid Leukemia

Acute myelogenous leukemia is the most common acute leukemia in adults, and its incidence increases with age. Acute myelogenous leukemia is a relatively rare disease, accounting for about 1.2% of deaths from cancer in the United States. ^[1]

Causes of Acute Myeloid Leukemia

1. The virus etiology of human leukemia has been studied for decades. But so far only adult T-cell leukemia must have been caused by the virus.

2. Ionizing radiation Ionizing radiation can cause leukemia. Its effect is related to the size of the radiation dose and the irradiation site. One large dose or multiple small doses of radiation can cause leukemia.

3. The chemical substance benzene has a certain effect on leukemia. Benzene-induced acute leukemia lives in acute granulosus and erythroleukemia.

4. Genetic factors Some leukemias are related to genetic factors.

Inspection laboratory

Hemoglobin and platelet counts are reduced. The total number of white blood cells varies. Generally 20.0 50.0 × 109 / L. A few are higher than 100 × 109 or lower than 10.0 × 109 / L. A large number (sometimes as high as 90%) of abnormal primitive white blood cells were seen in the peripheral blood image in more than half of the patients. Blood cytochemical staining method can determine the type of acute leukemia. About 45% of cases have chromosomal abnormalities. These include haploids. Superdiploid and various marker chromosomes. Myeloproliferative activity. Visibly active or extremely active. Mainly leukemia cells. Bone marrow blasts> 6% are suspicious. More than 30% of the diagnoses were positive. The diagnosis of blasts + early (young) cells 50% can be confirmed. In the whole bone marrow. Red lines and megakaryocytes are highly reduced. When blood and bone marrow are insufficient to confirm acute leukemia. Lymph node puncture fluid smears and specific skin lesion prints can be used to find the corresponding leukemia finely combined pathological prints. Helpful for diagnosis. Blood biochemical examination: terminal deoxynucleotidyl transferase (TDT): increased activity in ALL. No activity in ANLL. Alkaline phosphatase (AKP): obvious in ALL. AML was significantly reduced. Lactate dehydrogenase (LDH): significantly increased at ALL. In addition, serum uric acid concentration increased. Urinary uric acid excretion increases. It is even worse when treated with cytotoxic drugs.

Symptoms of acute myeloid leukemia

With pale face. heat. Physical weakness is the main feature. With heart palpitations. Shortness of breath. Tenderness in the chest. Joint pain. The skin shows a few dense bleeding spots. Swollen lymph nodes. Spleen is slightly larger. Sometimes bleeding appears.

Acute myeloid leukemia complications

Infection

2.Intestinal failure;

3. Hyperuricemia;

4. bleeding;

5. Lung disorders;

6.Electrolyte imbalance;

7. Disseminated intravascular coagulation (DIC).

Acute Myeloid Leukemia Treatment

1. Principles of treatment: The general principle of treatment is to eliminate the leukemia cell population and control the massive proliferation of leukemia cells. Eliminate various clinical manifestations caused by leukemia cell infiltration.

2. Supportive treatment

(1) Pay attention to rest: high fever. Severe anemia or significant bleeding. Should rest in bed. Eat high calories. High protein food. Maintain water. Electrolyte balance.

(2) Prevention of infection: Severe infection is the main cause of death. Therefore, it is very important to prevent infection. A "sterile" ward or area should be located in the ward. In order to isolate people with low neutrophil counts or those receiving chemotherapy. Pay attention to the mouth. Nasopharynx. Hygiene around the anus. Prevent mucosal ulcers. erosion. Bleeding. Treat them promptly if they occur. Food and utensils should be sterilized first. Oral non-absorbable antibiotics such as gentamicin. Colistin and antimycotics such as nystatin. Vancomycin is used to kill or reduce intestinal bacteria and mold. For patients who already have an infection. Bacterial culture and drug sensitivity tests were performed before treatment. In order to choose effective antibiotic treatment. Generally speaking. Fungal infections can use nystatin. Clotrimazole. Miconazole, etc .; Ara-c can be selected for viral infection. Ribavirin. Leukocytes can be given when particle size reduction causes an infection. Plasma is given intravenously for symptomatic treatment.

(3) Correct anemia: Those with significant anemia can transfusion red blood cells or fresh whole blood as appropriate; adrenocortical hormone can be used for autoimmune anemia. Testosterone propionate or anabolic hormone.

(4) Control of bleeding: chemotherapy for leukemia. Relieving the disease is the most effective way to correct bleeding. However, thrombocytopenia and bleeding may occur before chemotherapy is relieved. Oral blood can be used to prevent it. Adrenal corticosteroids are available for severe bleeding. Transfusion of whole blood or platelets. Acute leukemia (especially early granules). Easy to concurrent DIC. Once diagnosed, heparin should be treated quickly. When DIC is combined with fibrinolysis. At the same time as heparin treatment. Give antifibrinolytic drugs (such as p-carboxybenzylamine, hemostatic acid, etc.). If necessary, infusion of fresh blood or plasma.

(5) Prevention and treatment of hyperuricemia: patients with high white blood cell counts are undergoing chemotherapy. Can be destroyed by a large number of white blood cells. break down. Increase blood uric acid. Sometimes the urinary tract is blocked by uric acid stones. So pay special attention to urine output. And check urine sediment and determine uric acid concentration. In addition to encouraging patients to drink more water during treatment. To give purinol 10mg / kg · d. Take it orally three times. For 5 to 6 days in a row; when the blood uric acid is> 59um01 / L, a large amount of infusion and alkalized urine are required.

3. Chemotherapy: Chemotherapy is the main method to treat acute leukemia. Can be divided into two phases of remission induction and maintenance treatment. Intensive treatment can be added in the meantime. Consolidation treatment and central nervous system preventive treatment. Remission induction is intense chemotherapy in combination with large doses of multiple drugs. In order to quickly kill a large number of leukemia cells. L. Achieve complete remission. Lay the foundation for future treatment. The so-called complete remission. Refers to the symptoms of leukemia. The signs disappeared completely. Blood and bone marrow were basically normal. At the time of acute leukemia treatment. The number of leukemia cells in the body is estimated to be 5 × 1010 to 13 ;. A considerable number of leukemia cells remain in the body when the remission standard is reached after treatment. It is estimated to be below 108 ~ 109. And there may still be leukemia cells infiltration in some hidden locations outside the marrow. A series of low-dose, milder treatment regimens to maintain treatment volume for longer duration of treatment. The aim is to consolidate the complete remission obtained by remission induction. And enable patients to maintain this "disease-free" state for a long time to survive. Finally healed. Consolidation treatment is after maintenance treatment. Before maintenance treatment. In the case of patient permission. Repeat the remission induction protocol. Intensive therapy is a protocol that repeats the induction of remission in the middle of several treatment courses. Central neuroprophylactic treatment should be performed immediately after remission of induction therapy. To avoid and reduce the occurrence of central nervous system leukemia. A complete treatment plan should follow these principles.

4. Maintenance treatment: MTXl5mg intramuscularly or orally. 6-MPl00mg / d. CTX200mg / m2 is administered orally. Once a week. Long-term maintenance. And 1 / 2. 1. 2. 4. 7. 16. 16 months after the start of maintenance treatment plus the original induction regimen for consolidation. strengthen. Once every 16 months after six months. At least 2 to 4 years.

Acute myeloid leukemia prevention and care

(1) Avoid exposure to excessive X-rays and other harmful radiation. Personal protection is required for personnel engaged in radiological work. Pregnant women, infants and young children should be especially careful to avoid exposure to radiation.

(2) Prevention and control of various infections. Especially viral infections. Such as type C RNA virus.

(3) Use certain drugs with caution. Such as chloramphenicol. Bute pine. Certain antiviral drugs. Certain antitumor drugs and immunosuppressants. Avoid long-term use or abuse.

(4) Avoid contact with certain carcinogens. Do a good job of occupational protection and monitoring. Such as in the production of phenol. chlorobenzene. Nitrobenzene. spices. drug. pesticide. synthetic fiber. synthetic rubber. plastic. Dye and other processes. Take care to avoid harmful contact. Toxic Chemicals.

(5) Periodic census should be done for people at high risk of leukemia. Pay special attention to leukemia warning signs and early symptoms. Those who have the condition can take Tianxian vitality source for preventive treatment.