What is acute lymphocytic leukemia? Acute lymphoblastic leukemia is a malignancy that affects the blood and bone marrow and is characterized by the production of large numbers of immature lymphoblastoid cells. These leukemia cells accumulate in the bone marrow, destroying its normal hematopoiesis; and are able to spread throughout the body through the bloodstream, causing anemia, bleeding and infection in patients.
Its incidence?
Acute lymphoblastic leukemia is a relatively rare malignancy, accounting for 0.3% of cancer incidence and affecting approximately 1 to 1.5 out of 100,000 people in the general population.
Who is at risk for the disease?
Acute lymphoblastic leukemia occurs most frequently in children, accounting for 80% of childhood acute leukemia and 20% of adult acute leukemia, with an average age of onset of 25 to 35 years, and is more common in men than women.
What are its causes?
The cause of acute lymphocytic leukemia is not known, but it is thought that certain factors may cause disruption of genes that control normal hematopoiesis. Factors that have been found to increase the risk of acute leukemia include: 1) exposure to high doses of radiation, such as nuclear accidents or radiation therapy for cancer; 2) industrial chemicals, such as organic solvents like benzene or chemotherapy for cancer; 3) smoking and environmental pollution; 4) myelodysplastic syndrome (MDS); 5) inherited diseases: Down syndrome, Fanconi’s anemia, etc. s anemia, etc.
What are its symptoms?
Its main symptoms are caused by the lack of normal blood cells. It includes: 1. anemia, which is characterized by weakness, dizziness, pallor or shortness of breath after activity; 2. recurrent infections that are not easily cured, mainly due to the lack of normal white blood cells, especially neutrophils; 3. bleeding tendency: easy bleeding, bleeding, gum bleeding, stool bleeding and irregular menstrual bleeding, due to thrombocytopenia; 4. organ infiltration: painless enlargement of lymph nodes, liver and spleen enlargement, swollen gums and sternal pressure pain, etc.
How is the disease diagnosed?
Acute lymphoblastic leukemia is diagnosed mainly by blood tests and bone marrow aspiration biopsy; it is manifested by abnormally high peripheral blood leukocytes and a large accumulation of leukemic cells in the bone marrow, and the diagnostic criteria are ≥20% of primary cells (leukemic cells) in the bone marrow or peripheral blood.
Which subtype of acute lymphoblastic leukemia do I belong to?
Acute lymphoblastic leukemia is not a single tumor, but a group of leukemias occurring in the bone marrow lymphoblastoid cell lineage. the FAB classification system classifies acute myeloid leukemia into 3 subtypes by morphologic differences in microscopic leukemia cells. The WHO classification system now classifies acute lymphoblastic leukemia more accurately by morphology, immunophenotype, cytogenetics and molecular cytology of leukemia cells, providing more information to predict disease prognosis and guide the choice of treatment. It also provides risk stratification for acute lymphoblastic leukemia through the above tests.
How is it treated?
Because this tumor progresses very rapidly, it needs to be treated immediately after a definitive diagnosis. Treatment relies on many factors: the subtype of acute myeloid leukemia, genetic abnormalities in the leukemic cells, age and physical health status.
The treatment of acute lymphoblastic leukemia is individualized based on risk stratification and is divided into four parts: 1. induction chemotherapy, which aims to clear the body of leukemia cells, obtain complete remission, and enable the bone marrow to obtain normal hematopoiesis, etc.; 2. consolidation therapy after remission, which aims to maintain normal hematopoiesis in the bone marrow and remove residual leukemia foci from the body to prevent relapse. 3. maintenance chemotherapy, which usually takes 2 to 3 years to reduce the rate of leukemia recurrence; 4. Central system leukemia prevention, acute lymphoblastic leukemia has a higher risk of central system invasion and requires intrathecal chemotherapy and high-dose chemotherapy to reduce the incidence of central leukemia.
What is the efficacy of the treatment?
Acute lymphoblastic leukemia is a curable malignancy with survival rates decreasing with age of onset, e.g., long-term disease-free survival rates for acute lymphoblastic leukemia in children exceed 80%, while long-term disease-free survival rates for adults are only about 30% to 40%.
What are the side effects of treatment?
Treatment relapse varies depending on the type and severity of the disease and is largely dependent on the treatment regimen received and individual factors. In general, the stronger the treatment regimen, the more severe the associated side effects. Most side effects are manageable and reversible.
Chemotherapy mainly causes myelosuppression, often within a week of chemotherapy, and recovery takes time, depending on the type and dose of chemotherapy drugs and the patient’s response to leukemia treatment. During this period, patients usually need to receive adequate supportive treatment such as the use of laminar bed isolation, leukocyte-raising therapy, antibiotic therapy and blood transfusions. Other complications of chemotherapy are: 1. fatigue 2. loss of appetite, nausea and vomiting 3. mouth ulcers 4. diarrhea or constipation 5. infertility 6. possibility of second tumors