Leukocytes are a group of cells in the blood that are collectively referred to as neutrophils, monocytes, lymphocytes, basophils and eosinophils. Neutrophils make up the majority of these cells and play an anti-infective role. Monocytes in the blood are transformed into macrophages when they enter the tissues, which also play an anti-infective role and have the function of identifying and killing aging and damaged red blood cells and platelets in the body. Lymphocytes, on the other hand, are a class of immune cells. Eosinophils and basophils are few in number, but they also play an important physiological function in the physiological activities of the body.
I. What kind of disease is leukemia? What are the common symptoms?
Leukemia, also known as “blood cancer”, is a disease in which the bone marrow produces a large number of abnormal leukemia cells, while normal blood cells are suppressed, resulting in reduced production. At the same time, the abnormal leukemia cells will infiltrate into the liver, spleen and lymph nodes and produce a series of clinical symptoms of hematological malignant diseases. Common symptoms of leukemia include.
1. Anemia. Expression of pale face, lips and mouth, mostly hemoglobin and progressive aggravation.
2, bleeding. Often with nosebleeds, bleeding gums, bleeding spots on the skin, and women may have excessive menstruation.
3, fever, often caused by infection fever, stomatitis is more, serious cases may occur due to bacteria into the blood and bacteraemia.
4, enlargement of lymph nodes and liver and spleen.
5, other symptoms.
Such as bone pain (especially sternal pain is the most frequent), protruding eyes, etc. It should be noted that the above symptoms do not only appear in leukemia patients, and not all leukemia patients have all the above symptoms, however, when more than one of the above symptoms appear, you need to be alert to the possibility of leukemia.
Second, who is prone to leukemia?
In general, the onset of leukemia is the result of a complex multifactorial process in which genetic qualities, viruses, radiation and chemicals may interact and overlap to cause leukemia to occur. People who inhale large amounts of decorative pollution gases and those who are often in long-term contact with gasoline containing benzene have a higher incidence of leukemia than the general population. Therefore, people who are engaged in long-term decoration and drivers should visit hospitals regularly for blood tests and other related tests. Those who have long-term exposure to hair dyes, especially pregnant women, should also take care. In addition to this, there is solid evidence to affirm that various ionizing radiation conditions can cause human leukemia, however, it is still uncertain whether small doses of radiation can cause leukemia. Patients who are frequently exposed to X-rays or gamma rays and physicians who take X-rays should have regular blood tests and other related tests. Certain anti-tumor cytotoxic drug applicators, such as nitrogen mustard, cyclophosphamide, methylbenzylhydrazine, VP16, VM26, etc., are recognized to have leukemogenic effects.
Is there a difference between “acute” and “chronic” leukemia and “acute and chronic” general diseases?
The concept of acute and chronic leukemia is fundamentally different from that of other diseases (e.g., acute and chronic pharyngitis) in that it does not refer to the speed or intensity of the disease, but mainly to the maturity of the leukemia cells. For example, in acute leukemia patients, the onset of the disease is rapid, and after remission by treatment, it does not transform into a chronic type, which is the remission phase of acute leukemia. In acute leukemia, the differentiation of “blood cancer” cells is stagnant at an earlier stage (mostly primitive cells and early naïve cells), while in chronic leukemia, the differentiation of cells is stagnant at a relatively late stage (mostly more mature naïve cells and mature cells). Therefore, the “acute type” and “chronic type” of leukemia cannot be judged solely on the basis of the urgency of disease onset.
Why should I have a bone marrow aspiration and is it dangerous?
Leukemia is characterized by an unrestricted proliferation of leukemia cells in the bone marrow and other hematopoietic tissues, which enter the peripheral bloodstream and cause an increase in peripheral blood leukocytes. Bone marrow aspiration is performed as early as possible to clarify the diagnosis. Bone marrow aspiration to extract bone marrow fluid is a common diagnostic technique and is required for the diagnosis, differential diagnosis and post-treatment evaluation of various hematologic diseases. In addition, bone marrow aspiration is also used for the diagnosis and differential diagnosis of unexplained increase or decrease in the number of red blood cells, white blood cells, platelets and morphological abnormalities and unexplained fever. Bone marrow aspiration is a well-established and safe technique, but it should be noted that patients with hemophilia are prohibited from having bone marrow aspiration.
V. Some patients only need one diagnostic bone marrow aspiration, but why do I need several in a row?
Leukemia is characterized by an unrestricted proliferation of leukemic cells in the bone marrow and other hematopoietic tissues, which enter the peripheral bloodstream,
The production of normal blood cells is significantly inhibited. Most patients with leukemia can be diagnosed with a single bone marrow aspiration. However, the growth of hematopoietic cells in the bone marrow is uneven throughout the body, and a bone marrow aspiration can only extract a small amount of bone marrow from a certain area, which sometimes does not reflect the whole picture of bone marrow hematopoiesis, so multiple aspirations should be performed when necessary to make a clear diagnosis. In addition, in a few patients, due to fibrosis of the bone marrow or too many cellular components, the bone marrow fluid cannot be extracted even after repeated multi-site punctures, and the puncture may be unskilled and the bone marrow fluid may be mixed with blood dilution. These problems can be solved by bone marrow biopsy, which can keep the structure of the removed bone marrow unchanged, thus better reflecting the original appearance of the bone marrow and having more diagnostic significance.
How should leukemia be treated?
The current treatment of leukemia is divided into three stages: induction of remission, consolidation and strengthening, and maintenance. Treatment methods mainly include
1.Combined chemotherapy
Chemotherapy can effectively control the proliferation of leukemia cells and is still the basic and main method of leukemia treatment. However, most of them cannot cure leukemia, and most patients eventually die of leukemia relapse.
2.Hematopoietic stem cell transplantation
Hematopoietic stem cell transplantation is a major advancement in leukemia treatment, in which normal donor or autologous hematopoietic cells are infused into the patient through blood vessels to rebuild normal hematopoietic and immune functions.
3.Gene therapy
Gene therapy for leukemia is gradually moving from theory to clinical practice as a new approach. ④ Other therapeutic methods, such as adjuvant treatment with Chinese herbal medicine, can play a role in increasing the effectiveness and reducing the toxicity.
Seven, what adverse reactions can occur in chemotherapy for leukemia?
The common adverse reactions in leukemia chemotherapy are.
1. Inhibition of bone marrow hematopoiesis, mainly the decline of white blood cells and platelets. It may lead to infection and bleeding, so during each chemotherapy treatment, the doctor will use blood cell-raising drugs, blood transfusion or reduce the dose of combined chemotherapy as appropriate, depending on the patient’s condition.
2. Chemotherapy drugs can damage liver cells to varying degrees, causing different degrees of liver damage. Therefore, before and during the course of combination chemotherapy, liver function should be checked regularly and chemotherapy should be stopped if necessary.
3, to other systems such as cardiovascular, respiratory, urogenital, etc. may also produce corresponding damage depending on the drug, the function of each system should also be checked under the guidance of the doctor before and during the use of drugs.
4, hair loss and skin reactions.
5, among the systemic reactions of chemotherapy, toxic effects and adverse reactions of the digestive system are not uncommon, such as nausea, vomiting, loss of appetite and ulcers of the oral mucosa.
6, intravenous injection of chemotherapy drugs, the operation of careless drug leakage can cause local tissue necrosis and embolic phlebitis.
Eight, to cure leukemia, all have to do bone marrow transplantation?
In the eyes of many people, bone marrow transplantation has become a synonym for leukemia treatment. In fact, among the many weapons used to treat leukemia, bone marrow transplantation does not have a high status. Some specific types of leukemia, such as acute promyelocytic leukemia, have clinical cure rates of 70-95% with all-trans retinoic acid and arsenious acid. More than 50% of children with acute lymphoblastic leukemia common type can be cured by combined chemotherapy. Bone marrow transplantation, on the other hand, involves implanting hematopoietic stem cells into the bone marrow cavity of the patient to rebuild the severely damaged bone marrow function of the leukemia patient, which, in addition to the high medical costs, also threatens the prognosis of some patients with complications such as graft-versus-host disease and even the possibility of relapse. Therefore, the choice of bone marrow transplantation still needs to be carefully considered, taking into account the type, urgency, and course of the disease.
Nine, leukemia home care should pay attention to.
1, pay attention to the hygiene of various parts of the body in contact with the outside world, such as the oral cavity, nasal cavity, vulva, and anal skin should be kept clean to avoid infection.
2, avoid trauma leading to bleeding or aggravation of bleeding, such as in case of dizziness, blurred vision, nausea, vomiting, etc., be alert to the possibility of complications of intracranial hemorrhage.
3, during chemotherapy, encourage patients to drink more boiled water to facilitate urination and prevent uric acid nephropathy, and send patients to hospital for regular checkups.
4, when recuperating and treating at home after the symptoms are relieved, bed rest should be given and nutritious food with high calories, high protein and high vitamins.
5.Pay attention to air circulation in the patient’s apartment, and should not place too many flower pots or other unnecessary items that may carry mold spores, bacteria, etc. Unnecessary visits should also be reduced. These are to reduce the possibility of infection in patients.
6. Keep the bowels open.
X. Why can arsenic agents treat leukemia?
Arsenic agents are made from natural minerals such as arsenic or poisonous sand that contain arsenic after refining and are highly toxic. However, since the 1970s, our oncologists have found from clinical research that it can treat leukemia, especially for acute leukemia type M3 that is acute promyelocytic leukemia. This is because there is a PML/RARα fusion gene in the cells of M3 patients, and cancer cells rely on it to grow and multiply. The arsenic agent is specifically designed to deal with this gene to treat M3 acute leukemia. Of course, as a “highly toxic”
The doctor must take into account the patient’s condition and use the drug reasonably.
XI. What are the benefits of combining Chinese and Western medicine in the treatment of leukemia?
Western and Chinese medical treatments for leukemia each have their own advantages. The main method of Western medicine is chemotherapy, which can kill leukemia cells faster, but also kill normal cells, with more obvious side effects, more or less reducing and destroying the normal functions and defenses of the body. In contrast, TCM uses evidence-based treatment to adjust the patient’s overall function and improve symptoms, with fewer side effects. Combined treatment of Chinese and Western medicine can make use of the tonic and supportive effect of Chinese medicine to reduce the various side effects caused by chemotherapy as a whole, so that patients can tolerate chemotherapy and thus consolidate and improve the efficacy of treatment.
Is it because leukemia is contagious that people who are close to leukemia patients wear masks?
This is not because leukemia is contagious, but to protect the leukemia patient.
Leukemia patients already have a low immunity themselves, and the side effects of chemotherapy drugs make their immunity even lower. Normal people, on the other hand, have normal immunity and can resist and carry some of the less pathogenic pathogens, but these pathogens can be potentially deadly to the patient. When a normal person approaches the patient without a mask, these pathogenic bacteria are likely to be expelled through their respiratory tract and cause fatal injury to the patient.
Can I stop the medication after leukemia is stabilized?
When leukemia is diagnosed, most families actively cooperate with doctors and invest a lot of manpower and material resources in treatment. However, they do not pay much attention to the consolidation treatment after the disease has been stabilized. In fact, leukemia is a disease of the bone marrow, and stabilization only means that the leukemia cells in the bone marrow have been greatly reduced, but not that the disease has been cured. If the consolidation therapy is not taken seriously, it is likely that the remaining small amount of leukemia cells will replicate in large numbers and lead to a relapse of the disease. Therefore, it is important for leukemia patients to actively cooperate with their doctors for consolidation therapy after their condition has stabilized.
XIV. What is the difference between leukemia-like reaction and leukemia?
A leukemia-like reaction is a reactive increase in certain cells caused by some factors stimulating the hematopoietic tissue of the body, resulting in a phenomenon similar to leukemia, but fundamentally different from leukemia. Leukemia-like reactions are most often seen in severe infections with certain bacteria and viruses, in the widespread spread of malignant tumors, in acute hemolysis, and in reactions to certain drugs. The disease is more common in children and adolescents, with no difference in incidence between men and women. Its treatment and prognosis depend on the underlying disease that caused the reaction, and if these underlying diseases can be cured, the leukemia-like reaction will also disappear. The differentiation between this disease and leukemia depends on history taking and laboratory tests.
XV. What about the enlarged spleen in patients with leukemia?
When the spleen is enlarged there is often one or more types of blood cytopenia, often leukocytopenia and thrombocytopenia, which can lead to an increased risk of infection and bleeding. Splenomegaly secondary to leukemia gradually shrinks as the leukemia gets better. However, splenectomy or partial resection may also be considered when the spleen is significantly enlarged producing compression and other serious adverse consequences.