What is leukemia?
People with leukemia (leukemia), commonly known as blood cancer, produce more white blood cells than they actually need, but most of them are abnormal; they live longer than normal cells, yet cannot fight infection as well as normal white blood cells. This unlimited proliferation of leukocytes affects the function of some vital organs and the production of normal blood cells. Clinical manifestations include anemia, bleeding, infection, and symptoms of infiltration of various organs.
Is leukemia only associated with white blood cells?
Leukemia is not exclusively associated with white blood cells. The hematopoietic system includes the erythroid lineage, granulocyte lineage, monocyte lineage, lymphocyte lineage, and megakaryocyte lineage. In addition to the leukocyte lineage (granulocyte, monocyte, and lymphocyte lineages), other non-leukocyte lineages, such as the megakaryocyte lineage and the erythroid lineage, can also develop leukemia. Regardless of which cell lineage develops leukemia, the leukemic cells inhibit the growth of other normal cell lines. As a result, varying degrees of anemia, bleeding, and infection will eventually occur clinically.
Can you be cured of leukemia?
Cures for leukemia are now common in clinical practice. The prognosis varies by type of leukemia. For example, in childhood acute lymphoblastic leukemia, chemotherapy results in long-term disease-free survival in 90% of patients. In addition, granulocytic leukemia and chronic granulocytic leukemia can be cured in more than 80% of patients with aggressive treatment.
Therefore, as a patient with leukemia, you must first have a correct understanding of leukemia, have a positive spirit of struggle, cooperate with your doctor to take appropriate treatment, do not give up, and believe that you can overcome the disease.
What are the treatments for leukemia?
- Chemotherapy: can bring the disease into remission, and then regular dosing can continue to kill the remaining cancer cells, leading to a cure;
- Radiation therapy: To prevent or treat CNS leukemia, cranial radiation therapy can be administered depending on the patient’s condition;
- Hematopoietic stem cell transplantation: This treatment offers hope for a cure for some patients with acute lymphoid leukemia who have failed chemotherapy, relapsed, or are at high risk.
- Targeted drug therapy: such as Imatinib Mesylate, which causes apoptosis of chronic granulocytic leukemia clones by inhibiting tyrosine kinase activity.
- Other: such as immunotherapy.
Why is a bone marrow biopsy performed in leukemia patients?
Because through bone marrow biopsy, doctors can learn about the proliferation of bone marrow hematopoiesis and whether there are changes in cell morphology, which is very important for guiding treatment and determining prognosis, and is also very beneficial for recovery from the disease.
Why should chemotherapy be continued after leukemia is in complete remission?
Because after complete remission of leukemia, if chemotherapy is not continued, over time, the number of leukemia cells will proliferate to the level before the induction of remission chemotherapy. Therefore, after complete remission of leukemia, further chemotherapy is still needed to continuously reduce the number of residual leukemia cells in the body with the aim of achieving a cure.
How does the treatment of acute leukemia differ from that of chronic leukemia?
In general, the treatment of acute leukemia is different from that of chronic leukemia.
In general, patients with acute leukemia should be given a full dose of combination chemotherapy as soon as possible from the time of diagnosis, with attention to the prevention of extramedullary leukemia.
For chronic leukemia, because of the relatively older age of onset and the generally slow progression of leukemia, physicians tend to use slow and gentle dosing, even stopping for a period of time for individual patients with extremely slow progression, but for patients who are eligible and suitable for hematopoietic stem cell transplantation, they should still be treated aggressively.
Why is chemotherapy for acute leukemia given in combination?
The combination of drugs can enhance the killing effect of the drugs on leukemic cells, which is more effective than single drugs and can reduce or offset the toxic side effects of the drugs.
Is there help after a relapse of leukemia?
Patients with relapsed leukemia are more difficult to treat than patients with initial treatment, but some still have a chance of achieving complete remission again or even long-term survival if they are treated aggressively and regularly in the early stages.
How is leukemia treated after relapse?
- Select a new chemotherapy regimen with drugs that are not cross-resistant;
- Increase the dose of conventional chemotherapy drugs;
- The selection of new anti-leukemic drugs with a different mechanism of action than conventional drugs;
- If a suitable hematopoietic stem cell donor is available, allogeneic hematopoietic stem cell transplantation should be strived for after remission.
What is a bone marrow transplant?
Bone marrow transplantation is the transplantation of another person’s or your own hematopoietic stem cells to take on hematopoietic function, which can maintain hematopoietic and immune function over time after a successful bone marrow transplant.
What are the adverse effects of chemotherapy for leukemia?
- Bone marrow suppression: manifested as a decrease in white blood cells, red blood cells, and platelets, thus leading to complications such as malaise, dizziness, bleeding, and infection;
- Gastrointestinal reactions: almost all anti-leukemic drugs can cause gastrointestinal symptoms of varying degrees, manifested as loss of appetite, nausea, vomiting, abdominal pain, diarrhea, and even blood in the stool;
- Immunosuppression: This is one of the reasons why patients are susceptible to infection after chemotherapy and the infection is not easily controlled;
- Other organ damage such as heart, kidney, liver, nervous system, lung and bladder;
- Localized phlebitis, or even embolism, due to chemotherapy drugs;
- Allergic reactions to chemotherapeutic drugs, etc.
What is the success rate of bone marrow transplantation?
The success rate of bone marrow transplantation is influenced by many factors, including patient age, disease type and condition, organ function, graft selection, pretreatment protocol, donor-recipient human leukocyte antigen (HLA) match, and the overall level of the transplant hospital. If we consider only the success of implantation and hematopoietic recovery, the current success rate can reach more than 95%. The success rate of transplantation in the strict sense (i.e., long-term survival after transplantation) is also related to factors such as post-transplantation complications and relapse.
Does bone marrow biopsy have an effect on the body?
Bone marrow biopsy is a simple and safe procedure that extracts only 1 cm of bone marrow tissue, which causes little damage, and the bone marrow is a highly regenerative tissue in the body that repairs quickly, so it has essentially no effect on health and causes no long-term damage, so patients do not need to worry. However, patients with severe coagulation factor deficiency diseases such as hemophilia cannot undergo bone marrow biopsy.
Why is aggressive and standardized chemotherapy important?
Aggressive and standardized chemotherapy is important for patients with leukemia. In recent years, academics specializing in the field of hematology have continued to exchange academic advances to guide clinical chemotherapy, leading to the gradual development of recommended standardized chemotherapy. Some types of leukemia are considered clinically curable, with a 5-year relapse-free survival rate of up to 90% if treated with standardized therapy. Most acute leukemias die from complications within six months if left untreated. If chemotherapy is administered randomly, either more chemotherapy-related deaths occur or poor remission treatment affects long-term survival without achieving the effects of standardized chemotherapy. Therefore, aggressive and standardized chemotherapy should be administered.
What is leukemia drug resistance?
Leukemia resistance is when leukemia cells are insensitive or resistant to the chemotherapy drugs used. When the percentage of white blood cells in the bone marrow of a patient does not decrease significantly after several courses of combination chemotherapy, or decreases momentarily, but then increases again to pre-chemotherapy levels soon after a short break in therapy, this is considered leukemia resistance. The development of drug resistance in leukemia cells is one of the main reasons for the failure of current leukemia therapy.
When should a patient with leukemia stop chemotherapy?
When a patient with leukemia should stop chemotherapy?
Chemotherapy should be discontinued after a patient with leukemia has achieved complete remission, after two years of aggressive intensive consolidation therapy, or after an allogeneic (or autologous) hematopoietic stem cell transplant, and when monitoring for minimal residual leukemia is negative.
For patients with leukemia not in remission, if life-threatening complications such as severe infection, bleeding, or serious injury to vital organs occur during treatment, chemotherapy may be considered suspended, but not discontinued.
What is a clinical cure for leukemia?
A patient with leukemia is considered clinically cured if he or she has not relapsed or has survived 10 years without disease after stopping chemotherapy for 5 years.
How should people with leukemia eat?
How should people with leukemia eat?
- Scientific supplementation of high protein: the consumption of protein in the organism of leukemia patients is much higher than that of normal people, and the function of the tissues and organs can only be maintained by supplementing with high quantity and quality of protein;
- Importance of vitamins: 70%-90% of malignant tumor patients have different degrees of vitamin deficiency in their bodies, so they should eat more vitamin-rich vegetables and fruits;
- Incorporate more iron-rich foods: one of the main manifestations of leukemia is anemia, so patients should be encouraged to eat iron-rich foods regularly, such as peas, black beans, green vegetables, dates, brown sugar, black fungus, sesame paste, egg yolk, etc.
- Eating less and more meals: Patients with leukemia, especially in the course of treatment, often have many reactions in the digestive system, such as nausea, vomiting, bloating, diarrhea and other symptoms, when they can adopt the eating method of eating less and more meals;
- A symptomatic diet according to the condition: if the patient has poor appetite and indigestion, he can be supplied with semi-liquid or soft rice, accompanied by foods that help digestion, such as hawthorn and radish.
How do patients with leukemia take care of their mouth?
Patients with leukemia have low resistance and chemotherapy drugs can damage the oral mucosa, which can lead to oral mucositis or ulcers. Oral mucositis is a major source of nosocomial infections and a major contributor to high antibiotic costs in patients with leukemia. Therefore, leukemia patients should perform oral care, which should be done as follows: teeth should be brushed with a soft sponge toothbrush as much as possible. Rinse with 20 ml of oral tide solution and 20 ml of 3% sodium bicarbonate solution for 5 minutes every morning, before three meals and at bedtime to remove food residues. Avoid eating raw, cold, hard and spicy foods.
Can people with leukemia exercise?
For patients with leukemia, especially those in complete remission, some exercise activities that are within their capabilities and appropriate should be performed to benefit both the treatment of the disease and the recovery of immune function. In contrast, patients with acute leukemia, bone marrow suppression, or combined infections, bleeding, and other complications should be bedridden.
How should leukemia patients exercise?
- Walking: This is a great activity for people with leukemia. It is easy to do and you can decide how much activity you want to do each day, but you should avoid crowded places;
- Simple localized body exercises, such as neck, shoulder and waist exercises;
- Lower-volume physical exercise is also possible, such as jogging, tai chi, table tennis, etc. Care should be taken to avoid intense, strenuous and injury-prone exercise.