1.What is hematological disease?
Hematologic diseases are diseases that originate in the hematopoietic system or affect the hematopoietic system with abnormal blood changes, characterized by anemia, bleeding, fever, and enlarged liver and spleen lymph nodes. The hematopoietic system includes the blood, bone marrow mononuclear a macrophage system and lymphatic tissue. The common ones are various kinds of anemia, bleeding, leukemia, myeloma, lymphoma and various kinds of blood cell count increase or decrease, etc.
2.What factors can cause hematological diseases?
There are many factors that can cause blood diseases, such as: chemical factors, physical factors, biological factors, genetics, immunity, pollution, etc., all can become the cause or direct cause of the development of blood diseases, as many of these causes are the products of modern industry in recent decades, thus making the incidence of blood diseases has a trend of increasing year by year, it can be said that blood diseases are a modern disease.
3.What is anemia?
Anemia is not a disease name, it is a symptom, a common manifestation of many diseases. Most patients with anemia have dizziness, fatigue, weakness of limbs, palpitations and shortness of breath, especially after activity. Physical examination may reveal pallor of the face and mucous membranes, increased heart rate, and, in the case of long-term anemia, heart enlargement.
In the diagnosis, the first thing to do is to determine if the patient is anemic. Do not think that dizziness and weakness, black eyes or even low blood pressure are anemia, but rather to check whether the red blood cell count and hemoglobin amount are lower than normal through routine blood tests. If there is anemia, the cause of the anemia should be further examined.
4.What is leukemia?
More than 100 years ago, Bennett and Virchow in Western Europe found that in patients with anemia and hepatosplenomegaly, after the blood was drawn and left for a period of time, a layer of yellow “pus-like material” was found in the blood, all of which were white blood cells, so it was called leukemia.
Leukemia is a malignant tumor of the hematopoietic system, and is one of the most common malignant tumors in China. According to a retrospective survey, the incidence of leukemia in various regions takes the sixth and seventh place among various tumors. Leukemia among children and adolescents is the first of malignant tumors. Leukemia is a malignant proliferation of leukemic cells in the bone marrow, spleen, liver and other hematopoietic organs, which can enter the blood circulation and infiltrate into all tissues and organs of the body, and is seen clinically with varying degrees of anemia, bleeding, infectious fever, and enlargement of liver, spleen, lymph nodes and bone pain.
Leukemia can be divided into two categories, acute and chronic, according to the degree of leukemia cell differentiation. Different cells according to the blood cells can be divided into various types. For example, granulocytic, monocytic, and lymphocytic leukemia. A certain number of leukemic cells are present in the bone marrow of leukemia patients. Leukemia cells are also seen in peripheral blood, but the percentage varies.
5.Why is leukemia called blood cancer?
First of all, the leukemia cells present in the bone marrow or peripheral blood of a leukemia patient have lost their normal form and function. It has the morphological characteristics of malignant tumor cells: the cells are of different sizes, the development of cytoplasm and nucleus is out of balance, often showing that the development of the nucleus lags behind the cytoplasm, and the nucleolus is large and irregular. Secondly, according to leukocyte genetic studies (chromosomal and hematopoietic cell cultures), it has been unanimously recognized that leukemia is a cancerous transformation of hematopoietic stem cells caused by various factors.
Leukemic cell kinetic studies are also clearly different from normal hematopoietic cells. Third, the pathological changes of leukemia are malignant proliferation of the hematopoietic system, with abnormalities in both proliferation and differentiation of cells, and most patients have extreme proliferation of leukemic cells in the bone marrow. Leukemia cells can enter the peripheral blood circulation and infiltrate into all organs and tissues of the body, almost the same as other solid tumors with hematogenous metastases.
Finally, the pathogenesis of leukemia is the same as that of other tumors, and death can occur within a certain period of time without treatment. The choice of anti-tumor drugs often works, but some aspects of treatment are more difficult than other solid tumors.
6. Is leukemia hereditary?
Can leukemia be passed on to the next generation of children and does it also affect siblings. This is of great concern to every patient and his or her family. Human leukemia is a disease caused by a combination of external environmental factors and internal factors, and the exact causative factors are not well understood. Many observational studies have shown that some aspects of leukemia development are related to genetic factors. This has been well documented by experimental studies in animals.
Patients with congenital genetic disorders, especially congenital chromosomal abnormalities, have a significantly higher risk of developing leukemia disease than normal individuals. For example, a child with Down syndrome (also known as congenital stupidity) has an autosomal abnormality (an extra chromosome 21). It develops leukemia at a rate of up to 95 U1, which is 30-40 times higher than that of normal children. The development of leukemia is closely related to genetic factors.
Genetics may be the main factor in at least a certain proportion of leukemia patients. However, genetic factors are not the only factors causing leukemia, and leukemia should not be viewed as a genetic disease.
7.What are the causes of leukemia?
The etiology of leukemia is complex and can be caused by internal and external factors, and is the result of multiple factors interacting with each other. The main factors that are clear are.
(1) Radiation: In 1945, the United States dropped atomic bombs on Nagasaki and Hiroshima, Japan, respectively. Among the survivors of the atomic bombings, many developed leukemia one after another. Initially discovered 2 to 3 years after the atomic bombing, the incidence of leukemia reached its peak by the fifth year after the explosion and remained at a high level thereafter.
Until 26 years after the explosion, the incidence of leukemia among survivors was still higher than that of the general population. This is the most direct evidence that radiation can cause human leukemia. The incidence of leukemia is also several times higher than normal in patients engaged in radiation work and long-term X-ray treatment, such as patients with ankylosing spondylitis, proving that radiation does have the effect of causing leukemia.
(2) Chemical factors: Chemicals that can definitely cause leukemia in humans include benzene and toluene.
(3) Viral factors: In 1977, an adult T-lymphocytic leukemia was discovered in the southwest coast of Japan, and in 1980, these leukemia cells were successfully cultured in vitro and a new human leukemia virus was isolated. After extensive research, it was confirmed to be the culprit of adult T-cell leukemia. As for the relationship between other types of human leukemia and the virus, it is not well understood.
(4) Genetic factors: Some people have statistically analyzed the occurrence of several cases of leukemia patients in the same family and believe that there may be genetic factors involved. Leukemia is also more likely to occur in some congenital genetic disorders such as congenital stupidity. In identical twin children, the chance of leukemia occurring in one partner is as high as 25% in the other. These examples all indicate the possibility of genetic factors in the development of leukemia.
8.Why do I need a bone marrow aspiration?
Through bone aspiration, doctors can understand the proliferation of bone marrow hematopoietic cells and whether there are any changes in cell morphology. Bone marrow bacterial culture for patients with sepsis or certain infectious diseases can improve the positive rate of bacterial culture. In some patients with malignant tumors, bone marrow metastasis can be detected by bone aspiration.
Therefore, bone aspiration is of great importance for the diagnosis and guidance of clinical treatment of various hematological diseases, certain infectious diseases and malignant tumors. Some patients need multiple bone marrow punctures to make a clear diagnosis. Bone marrow aspiration is an important test, and in most cases, it should be combined with other tests to diagnose diseases.
9.Is bone marrow aspiration very scary?
In clinical work, this test is often refused by patients or their families, thus affecting the timely diagnosis and treatment of the disease. Because they are worried that bone marrow aspiration is the essence of the human body, which will greatly damage the vitality and have adverse effects on human health, or even cause serious injuries. Some people misinterpret bone puncture as lumbar puncture and think that the puncture may have an effect on the brain. These are false claims without scientific basis. This is mainly a misunderstanding caused by the patient’s lack of necessary understanding of bone puncture.
The site of bone puncture is mostly chosen in the patient’s anterior superior iliac spine, posterior superior iliac spine or sternal stalk, which will not cause any damage to important organs at all. Since the puncture is performed under local anesthesia, the pain experienced by the patient is similar to that of a normal intramuscular injection. Bone marrow is an important part of blood production in adults and is constantly being renewed every day. 0.2 to 5 ml is taken for the test, which has no effect on the human body and does not cause any damage at all.
Of course, bone aspiration is not suitable for all patients, and there are contraindications. Bone puncture is contraindicated in patients with hemophilia, where coagulation factor deficiency can cause local hematoma after puncture. If the puncture site has local septic infection, be sure to choose another non-infected site for puncture, or wait for the local infection to be completely controlled before performing bone puncture.
10.What should patients pay attention to after bone puncture?
After bone puncture, patients may experience mild pain at the puncture site, and local bleeding may occur in patients with hematologic disorders and abnormal coagulation mechanism, patients and their families need not be nervous, and the bleeding can be stopped by giving pressure to stop bleeding for 5 – 20 minutes, and the local distension and discomfort can gradually disappear in 3 to 4 days. Patients are reminded to pay special attention to keep the puncture site clean and not to get wet for 3 days to prevent local infection. Patients without special circumstances can walk away after surgery and do not need to be sedentary.