. .Many people always equate anemia, weakness, and degeneration as they think this is a normal phenomenon. However, if the elderly have the above symptoms, it is a problem that cannot be ignored, because it may be a precursor of blood cancer-the condition manifested by myelodysplastic syndrome!  . . .What is myelodysplastic syndrome? . .Myelodysplastic syndrome is a common blood disease. Most patients are diagnosed with anemia because of discomfort in the beginning. Disease, which is also known as the predecessor of blood cancer (leukemia), has symptoms related to anemia that cannot be improved for a long time. Although it is not cancer, due to the abnormal function of bone marrow hematopoietic cells, hematopoietic stem cells cannot differentiate into mature normal blood cells. They often deteriorate into acute leukemia. In severe cases, there is a risk of death within 1 to 2 years.  . . .Aspiration of stocks does not hurt the bones during examination . .Because of myelodysplastic syndromes, bone marrow must be drawn for examination. Many people believe that bone marrow puncture will damage the body, and they are often unwilling to do bone marrow puncture. The opportunity for early diagnosis was lost and treatment was delayed. In fact, the amount of bone marrow extracted by bone marrow aspiration is very small. Normally it is 0.2～0.3g, and the weight of normal adult bone marrow tissue is 1600～3700g. Therefore, the amount of bone marrow extracted by bone marrow puncture is insignificant compared with the total amount of human bone marrow, and it will not harm the body. Moreover, the human body also pays every day. There is a lot of blood cell regeneration. The operation of bone marrow puncture is simple, except for a slight soreness at the moment the bone marrow is extracted, the patient basically feels no pain. He was worried that the syringe would damage the peripheral nerves during the examination, causing paralysis of the lower half of the body, and refused further examinations, making the disease unable to be controlled as soon as possible and delaying the prime time for treatment.  . . In fact, the bone marrow is collected from the hip bone without the nervous system. Not only will it not cause paralysis, but the pain is not very severe during the sampling process. Please don’t worry.  . . .Not necessarily terminal illness . .Because the failure of the bone marrow to produce mature healthy cells is a gradual process, myelodysplastic syndrome is not necessarily terminal illness. However, some patients do die from the direct effects of these diseases due to bone marrow failure and blood cell reduction. In addition, for approximately 30% of patients diagnosed with myelodysplastic syndrome, this type of bone marrow failure syndrome will further develop into acute myeloid leukemia (AML).
Chemotherapy is not unfamiliar for every leukemia patient, because many leukemia patients will receive chemotherapy during the treatment process. To put it bluntly, chemotherapy actually refers to the treatment of patients based on organic chemicals. Everyone may also have heard that leukemia patients may experience bone marrow suppression after receiving chemotherapy and radiotherapy. So what is bone marrow suppression? Bone marrow suppression is actually a side effect of chemotherapy drugs. The specificity of red blood cells is reduced.  . .Because bone marrow suppression is caused by the toxic and side effects of organic chemicals on red blood cells, and because organic chemicals have led to the reduction of red blood cells or the specificity of red blood cells in leukemia patients who have received radiotherapy and chemotherapy Therefore, we can see that the main manifestations of bone marrow suppression are also related to the reduction of red blood cells.  . .The main manifestation of bone marrow suppression is that the patient will have symptoms of anemia, and the patient’s white blood cell count and its platelets will be reduced to a certain extent; and the patient looks pale and often sleepy; and more serious bone marrow Inhibition may also cause infection. The patient may bleed or become severely anemia after infection. At this time, it is necessary to consider giving the patient a whitening needle; continue the instillation for 2 to 6 days until the infection is controlled. Naturally, it is necessary to seek the advice of a doctor based on their own medical conditions, and everyone cannot decide for themselves.  . .In fact, the damage caused by radiotherapy and chemotherapy to the patient’s human body is relatively large. The damage caused by radiotherapy and chemotherapy is far more than just bone marrow suppression. Therefore, it is recommended that leukemia patients choose as little side effects as possible when choosing treatment methods. The treatment method can reduce the pain. In the end, a series of diseases and complications caused by radiotherapy and chemotherapy are also very serious.
Leukemia patients almost always experience bone marrow suppression after receiving chemotherapy. Normally, it will continue for 7-14 days and then return to normal, mainly manifested by pancytopenia. For different patients with leukemia, the degree of myelosuppression is also different. Some patients can restore myelosuppression normally, but some patients have not improved, even for half a month, a month, or even longer. . The leukemia chemotherapy inhibition period has passed, why the blood picture has not risen so long? It is mainly divided into two reasons: on the one hand, the bone marrow picture of the disease has been relieved, but the hematology has not recovered normally, which belongs to the poor quality of relief (it may also be due to the high toxicity of the chemotherapy drugs in this course of treatment, which prolongs the inhibition time). On the other hand, the disease itself has not been relieved, and the original malignant leukemia cells are still in a pathologically proliferating state, which in turn affects the normal hematopoietic function, causing the blood picture to be delayed and unable to recover. In response to this, there is a need for potentiation and attenuation therapy for drug toxicity, as well as killing therapy for the proportion of primitive cells (high-intensity multi-drug combination). It is necessary to evaluate the situation of bone marrow suppression clinically, and conduct targeted remission treatment. For leukemia patients with severe bone marrow suppression (grade ≥5), support and maintenance treatment should be taken in time to avoid the risk of low blood cells. Finally, it is emphasized that chemotherapy is a course of treatment, during which it is necessary to pay attention to recheck blood routine, liver function and other indicators to meet the next treatment. In daily life, care should be taken to reduce the impact of complications on the bone marrow. To learn more about “disease knowledge” or “leukemia friend group exchange” and other WeChat search public number: dxbby120
September 08, 2020 Medical News-Imbruvica (ibrutinib, ibrutinib) combined with rituximab (rituximab) first-line treatment of adult patients with chronic lymphocytic leukemia (CLL) has been approved! Chronic lymphocytic leukemia (CLL) is usually a slowly growing white blood cell cancer. In Europe, the total incidence of CLL is about 4.92 cases per 100,000 people per year, and the incidence of men is about 1.5 times that of women. CLL is mainly a disease of the elderly, with a median age of 72 years at the time of diagnosis. What kind of medicine is this? Imbruvica is a pioneering Bruton’s tyrosine kinase (BTK) inhibitor that is taken orally once a day and exerts anticancer effects by blocking Bruton’s tyrosine kinase (BTK), which is required for cancer cell proliferation and metastasis. ——BTK is a key signal molecule in the B cell receptor signaling complex, which plays an important role in the survival and metastasis of malignant B cells and other serious debilitating diseases. Imbruvica can block the signaling pathways that mediate the uncontrolled proliferation and spread of B cells, help kill and reduce the number of cancer cells, and delay the progression of cancer. In clinical trials, single-drug and combination therapies have shown strong efficacy against a wide range of hematological malignancies. Imbruvica+Rituximab (IR) is a non-chemotherapy combination treatment plan, which will provide an important new choice for the first-line treatment of chronic lymphocytic leukemia! To learn more about “disease knowledge” or “leukemia friend group exchange” and other WeChat search public number: dxbby120
The high-risk myelodysplastic syndrome develops quickly and has a high probability of transforming into acute leukemia. It usually occurs in middle-aged and elderly people. Patients with peripheral blood or bone marrow blasts have more than 10%. Further laboratory examinations revealed complicated changes in chromosomes or abnormalities in chromosome 7. According to high-risk patients with different conditions, they are divided into those who require blood transfusion and those who do not require blood transfusion. The significance of high-risk MDS chemotherapy first talk about the current treatment of myelodysplastic syndromes. At present, for these high-risk patients, modern medicine always follows the treatment of leukemia. When the blast cell is high, it is chemotherapy. The chemotherapy itself is not wrong, but we To understand the meaning of chemotherapy. Our goal is to restore the high-risk MDS peripheral blood picture and allow the patient to obtain complete remission, but myelodysplastic syndrome is different from leukemia. After the decline of bone marrow blasts, many patients’ peripheral blood does not recover. This is the difference between myelodysplastic syndrome and leukemia. Different, so the treatment strategy is also different. The need for blood transfusion and the need for blood transfusion. So to sum up, for patients who do not need blood transfusion, they do not need to be hospitalized. They can be treated with oral medicine or Chinese medicine outpatient treatment, so that patients can maintain a certain quality of life, especially those who cannot withstand chemotherapy. A combination of Chinese and Western treatment is necessary. For patients who need blood transfusion, because they have begun to deal with the hospital, their quality of life has declined, and the risk of bleeding is significantly increased with the decline in platelets. Because before we considered that chemotherapy is risky, and currently there are risks without chemotherapy, and the risk of platelet decline is getting closer and closer to the risk of chemotherapy. Among them, some patients who want to pursue therapeutic effects can start chemotherapy, while others are still Hesitating patients can continue to wait for observation.
Aplastic anemia, myelodysplastic syndrome, myeloma, various types of leukemia and a series of blood system incurable diseases, not only difficult to treat, once some “death” manifestations appear, it is also very likely to be life-threatening and requires patients to improve as soon as possible alert! These “deadly” manifestations mainly include the following: infection-according to US data, about 60,000 cancer patients are admitted to the hospital each year due to low white blood cell counts and low resistance to serious infections. The mortality rate of this part of patients About 1/14. According to statistics from domestic scholars, the most common site of infection in cancer patients is lower respiratory tract infection, which accounts for about 35.14%; the second is urinary system infection, which accounts for about 14.63%; the third is bacteremia, which accounts for about 13.41%. The high infection rate of patients is related to repeated radiotherapy, chemotherapy, intravenous intubation, and indwelling catheter. Clinically, urinary tract infections in patients with blood diseases are common and frequently-occurring diseases. Due to the long hospital stay of blood disease patients, the body’s immune function is reduced, so they are more susceptible to urinary tract infections. gastrointestinal dysfunction, failure- acute gastric bleeding is very dangerous, the death rate was as high as 50%-70% in the past, although medicine and treatment methods have improved, the death rate is still as high as 40%-50%. Cirrhosis accounts for most of the causes of stomach bleeding. Hyperuricemia—— normal people excrete 300-500mg of uric acid in the urine every day due to the metabolic decomposition of nucleic acid. Leukemia patients can increase the excretion of uric acid dozens of times due to the nucleic acid decomposition of a large number of leukemia cells. Hyperuricemia occurs when the patient receives chemotherapy, radiotherapy and other treatments. The application of corticosteroids can increase hyperuricemia. High concentrations of uric acid are quickly supersaturated and precipitated, causing extensive damage to the kidneys and uric acid stones, which can lead to Oliguria and anuria. Therefore, patients with acute leukemia must supplement with adequate fluids to ensure a certain amount of urine and take allopurinol. If renal failure occurs, they must limit the amount of fluid replacement and undergo dialysis treatment. bleeding——Bleeding is a common clinical manifestation and harm in patients with hematological diseases, especially those with thrombocytopenia and abnormal blood coagulation. When patients have bleeding, they should actively stop the bleeding to avoid visceral bleeding, and even intracranial hemorrhage is life-threatening. Electrolyte imbalance—— During the treatment of leukemia, excessive potassium excretion is often caused by excessive destruction of leukemia cells or due to chemotherapeutic kidney damage. Also due to chemotherapy caused poor appetite for eating, digestive system dysfunction, insufficient intake and hypokalemia. Or due to the destruction of leukemia cells, the release of phosphorus increases, leading to low calcium. Therefore, pay attention to the electrolyte concentration of potassium, calcium, and sodium during the treatment. DIC—— is disseminated intravascular coagulation, which is a serious bleeding syndrome, which is common in patients with M3 leukemia. Be vigilant!
Take lymphatic leukemia as an example-this disease can be divided into acute and chronic according to the severity of the disease. The lesion involves surrounding blood, lymph nodes and organs throughout the body. The acute type is common in children, and the chronic type is more common in middle-aged and elderly patients. How many times do you need chemotherapy for acute and chronic leukemia? In terms of treatment, it often involves the formulation of chemotherapy regimens. The first step is to kill malignant cells to control the progression of the disease. How many chemotherapy is needed for this? ——Acute Lymphoblastic Leukemia Acute Lymphoblastic Leukemia is a hematological malignant tumor and requires standardized chemotherapy. After induction of remission, 7-8 courses are consolidated, followed by oral chemotherapy drugs every month, and consolidation and intensive treatment every 3-6 months. The specific chemotherapy regimen depends on the prognosis stratification. Induction of remission-hospitalization is required for 3 to 6 weeks, and subsequent chemotherapy can be given in the form of an outpatient treatment. If the white blood cell count is extremely low, it is necessary to pay attention to hygiene and avoid contact with infectious pathogens. Chemotherapy consists of a combination of 3 to 8 representative drugs. These drugs include: prednisone, vincristine, daunorubicin, methotrexate, 6-mercaptopurine and cyclophosphamide. Give blood products supportive treatment when necessary. Patients who develop any secondary infections need to receive anti-infective treatment. -Chronic lymphocytic leukemia may not be treated in the A phase of chemotherapy. In phases B and C, drugs such as cyclophosphamide and chlorambucil (CLB) can be selected according to the clinical situation, which involves 3-6 courses of treatment, and combined chemotherapy can also be used. The current treatment of lymphocytic leukemia is mainly through chemotherapy hospitalization or oral administration. The effect of chemotherapy is different for each patient. Moreover, the recurrence rate of this type of leukemia is also relatively high. Generally, systemic chemotherapy must be considered. It is necessary to combine Chinese and Western medicine and follow-up transplantation intervention to prevent subsequent recurrence and increase the success rate. To learn more about “disease knowledge” or “leukemia group exchange” and other WeChat search public number: dxbby120
At present, it has been recognized that leukemia involves at least dozens of fusion genes. In most leukemias, there are chromosomal structural aberrations, including: ①deletion .②repetition ③inversion ④translocation…These conditions can lead to the original Structural mutations of oncogenes and tumor suppressor genes, activation of proto-oncogenes or inactivation of tumor suppressor genes, produce new fusion genes encoding fusion proteins. Some genes are transcription factors that regulate cell proliferation, differentiation, and apoptosis. When genes are mutated, they directly affect downstream signal transmission pathways, leading to enhanced cell proliferation, apoptosis barriers, and differentiation barriers, resulting in leukemia phenotypes. Some typical leukemia fusion genes are specific molecular diagnostic markers for certain leukemias. For example, the BCR-ABL fusion gene can appear in more than 95% of chronic myeloid leukemia (CML). The prognostic effect of patients is related to the type of fusion gene. For example, the PML-RARa fusion gene unique to acute promyelocytic leukemia is expected to achieve considerable results with all-trans retinoic acid inducing remission for APL patients. Some genes, such as MLL-related fusion genes, have a poor prognosis and a high BS rate. So the question is, what should I do if the leukemia fusion gene has not reached the standard? Staged treatment failure is not disease progression, at this time the condition is still in the chronic phase. If it does not turn negative for a long time, measures should be taken in time to adjust the treatment plan (such as switching to other drugs or increasing the dose). Generally speaking, there are still many patients who will achieve good results. Even if there is no effect, don’t be pessimistic, still have to actively treat, actively adjust the treatment plan, and strive to obtain a better treatment effect. For patients whose fusion gene has not reached the standard or even after changing the drug, the multi-drug combination therapy can be carried out as appropriate to strengthen the treatment intensity. Or prepare for transplantation. Finally, it is emphasized that for this part of the diseased population, clinically by detecting the expression level of the fusion gene, the disease progression and recurrence can be predicted earlier. According to the expression level of the fusion gene, it is helpful to evaluate the effect of drug treatment, whether it is drug resistance, and guide the clinical change of treatment plan accordingly. To learn more about “disease knowledge” or “leukemia group exchange” and other WeChat search public number: dxbby120
. . . . . . . . Bleeding gums is a common thing for most people. But I would like to remind everyone here that bleeding gums should not be ignored, because bleeding gums may be related to leukemia. Let’s take a look at what is going on? . . . . . .Bleeding gums ? It turns out that it may be a sign of leukemia . . . . . . . . It turns out that the oral cavity shows that there are some cases of bleeding gums in the elderly, which are characterized by mild swelling of the entire mouth gums and the edges of the gums. Hemorrhage, accompanied by general fatigue, loss of appetite, and some elderly people have bruising on the skin, which is confirmed by laboratory blood tests as leukemia.  . . . . . . . .Why is this? In fact, after entering old age, people’s gums begin to shrink, the fibrous tissue in the gums is degenerated, and the number of blood vessels decreases.  . . . . . . . . Therefore, although there is gum inflammation in the elderly, gum bleeding is generally rare. In recent years, the incidence of leukemia in the elderly has increased, and many patients have the earliest The symptom is bleeding gums.  . . . . . . . . Therefore, if the elderly have bleeding gums inexplicably, especially the chronic bleeding of the whole mouth gums, they must go to the hospital for examination and treatment, especially with skin Hematology tests are required for bruising. Generally, after a simple laboratory examination, the cause can be found out, so that the correct treatment can be obtained early.  . . . . . . . .Of course, gum bleeding is not only related to leukemia, but also the following possibilities! . . . . . . . . .  . . . . . . . . . . . . . . . . . . . . .One, local factors① periodontal disease  . . . . . . . .Due to the tissue lesions around the teeth, gum edema, capillary dilation and hyperemia, once chewing hard food or brushing teeth improperly, it often causes gum bleeding. ② Dental calculus irritation . . . . . . . .Because the calculi attached to the neck of the tooth have rough edges and contain a variety of bacteria, it can stimulate the gums and cause the gums to become swollen and inflamed, causing bleeding . ③Caries in the neck of the tooth . . . . . . . .If the cavity in the neck of the tooth is not filled in time, it is allowed to develop below the gingival margin. Because the edge of the cavity is irregular and sharp, It often irritates the gums, causing inflammation, ulceration and bleeding of the gums.  . . . . . . . . The above-mentioned common local lesions cause gum bleeding, as long as the local lesions are treated in time, the bleeding can be stopped after anti-inflammatory.  . . . . . . . . . . . . .&
Leukemia, a malignant tumor of hematopoietic stem cells, is often referred to as “blood cancer”. In recent years, as the incidence of leukemia has increased year by year, more and more people have begun to pay attention to this type of disease. In fact, leukemia is not so terrible. As long as the treatment is done in time and the later care is in place, there is still great hope for the recovery of leukemia patients. So how should patients be cared for?  . .1. Leukemia is a serious blood disease. After the illness, many patients will lose confidence in treatment. Therefore, family members must psychologically dredge the patient to help patients build confidence in treating the disease and help improve the patient’s treatment Quality of life. If the mood is poor for a long time, it will not only affect the immune ability, but also easily affect the endocrine function, which will have certain side effects on the treatment and rehabilitation. The patient can also do some things that make the body and mind pleasurable in daily life, which will help the recovery of the disease.  . .2 For patients with leukopenia, special attention should be paid to food hygiene. The dishes and utensils used should be blanched with boiling water before use, and mouthwash should be carried out after meals. Do not eat raw or cold dishes, do not eat leftovers, and not much fruit. Eat, for patients with thrombocytopenia, do not eat hard foods, so as not to scratch the esophagus and cause gastrointestinal bleeding. At the same time, avoid exerting force and keep the stool unobstructed. If the stool is dry and clumpy, use some anti-intestinal drugs.  . .3. During the treatment of patients, avoid activities of leukemia patients in densely populated public places, because dense populations can easily breed bacteria, which can make the patient catch a cold and cause the condition to deteriorate again. Remember to wear a mask when you go out. The air contains a lot of fine dust and toxic substances, and a large number of bacteria, viruses and microorganisms are attached. When the body’s immunity is low, inhaling these toxic substances may aggravate the infection and cause the disease to relapse. .  . .4. The living environment is also very important. Leukemia patients should often open windows for ventilation to remove carbon dioxide in the room. A large amount of fresh oxygen enters to keep the patient’s breathing unblocked, which is beneficial to strengthen the patient’s immunity and help the patient’s condition Get better.  . .5. Closely observe the vital signs of the patient. After treatment, patients with leukemia should also closely observe various vital signs, observe whether there are symptoms of fever, infection, observe urine output, the number and color of urine and stool, and accurately determine the recovery of the condition. When any When abnormal, seek medical treatment as soon as possible.  . . Although leukemia is a relatively serious disease, as long as they are treated properly and receive the correct care, most patients can gradually recover. Therefore, both the patient and the patient’s family must master the correct nursing method. Pay attention to the intervention of living habits and diet in daily life, which will help improve the quality of life of leukemia patients.
In daily life, facing various life pressures, people’s bodies gradually become weakened. When everyone is negligent, there are many fatal bad factors that threaten our health. Many of these factors are sufficient to induce leukemia. Here is an introduction to which factors can induce leukemia. 1. Many people will have some small illnesses that are difficult to tell, or they are side-by-side diseases that cannot be eradicated because of the ineffectiveness of Changzhi. Due to the eagerness to cure these small diseases, most people are reluctant to proceed step by step. Or after the treatment, there is no patience, and I started to use some so-called folk remedies, using illegal drugs to treat psoriasis and rheumatoid history: many so-called “ancestral secret recipes” for the treatment of psoriasis and rheumatism contain a large amount of acetimine and oxytocin Morpholines, they are the main culprits in inducing leukemia. 2. Radiation has now become a topic for the whole people. How to prevent radiation has also become a problem that every ordinary person has to face. In fact, we are affected by radiation every day in our lives. Some people who have been exposed to radiation are particularly serious: After exposure to X-rays or gamma rays, leukemia can be induced due to large amounts of radioactive elements. 3. Environmental pollution has moved from the classroom to people’s attention, especially the pollution discharged by some chemical plants. There are also building materials decoration, a large amount of decoration pollution gas is inhaled, various boards, latex paint and new furniture, etc., all contain chemical synthesis substances, which can gradually release toxic gases. This is also the reason why leukemia is prone to occur in the newly decorated environment for a long time. 4. Sometimes small objects that are inseparable from us in our lives can also be one of the important causes of leukemia, such as gasoline. People who have been in contact with gasoline for a long time, car drivers have long-term contact with gasoline containing benzene, and the risk of developing leukemia is very high. Therefore, people who drive for a long time should go to the hospital for blood test routines. If the blood routines were normal in the past, and the white blood cell decreased after driving, it is not caused by virus infection or other reasons, which means that they are very sensitive to benzene and must be extra careful. So as not to contract leukemia. In general, there are many causes of leukemia, and there are many unavoidable factors in life. We can only try our best to eat and drink regularly, stay away from pollution, live a healthy life, and try to understand the etiology and clinical symptoms of leukemia. Once discovered For abnormal phenomena, it is necessary to go to the hospital for examination, to achieve early detection and early treatment, so as to avoid the trouble of leukemia.
Many patients who have just been diagnosed with chronic myelogenous leukemia will feel confused, anxious, and even a little scared. Don’t be afraid, the following article will give you some suggestions for the newly diagnosed CML “Xiaobai”, and take you to face CML leukemia correctly! What should I do if I don’t know anything when I just diagnosed CML? ●First of all, the newly diagnosed patients with chronic myelitis undergo a series of related examinations. After the condition is confirmed, treatment should be started immediately to prevent delay in the condition. ●Secondly, people with chronic granular disease should quickly adjust their mentality and eliminate negative emotions. In fact, slow granular particles are not “terminally ill.” Early diagnosis and early treatment can provide deep relief to most patients, and some patients can even stop the drug. ●Finally, you can check more relevant information and join the patient association to fully understand the condition. You can also learn more about the precautions of patients with chronic particles in their daily life, take care of them, and help them recover. Only by understanding the condition can we improve treatment compliance and better cooperate with treatment. In addition, you can also share experiences and experience with your patients, and at the same time encourage each other to build confidence in treatment. Although chronic myeloid belongs to leukemia, its course is relatively slow, and the patient is actively treated, and its life span is no different from that of ordinary people. Therefore, it is most important for the newly diagnosed CML patients to develop a good treatment mentality. For more patient communication and help, please follow the WeChat public account [Chronic Myelopathy Association]mbxb120
Leukemia can be divided into acute and chronic according to the incidence. Among acute leukemias, it can be divided into acute lymphocytic leukemia and acute non-lymphocytic leukemia, among which acute myeloid leukemia (acute non-lymphatic) is more common. Leukemia refractory-is acute marrow (M4) difficult to treat? Acute myeloid leukemia M4 is also called acute myelomonocytic leukemia, and it is generally more malignant than other types. Patients are prone to fever, anemia, and bleeding. It is indeed difficult to treat, but it is not without a cure. Regarding the treatment of this disease-you can do both preparations! In addition to targeted support and maintenance treatment, high-intensity treatment is required for the condition of the M4 subject in the early stage (to kill the leukemia cells in the body first), but at the same time, the patient’s tolerance (large side effects) should be taken into account. In addition, it is possible to decide whether to prepare for subsequent transplantation according to whether the patient has adverse prognostic factors (gene chromosome abnormalities that can affect the prognosis). Supplement-Patients with M4 leukemia also need to maintain a good personal mood and mentality. A good positive attitude is also a lot of help to the disease. To learn more about “disease knowledge” or “leukemia group exchange” and other WeChat search public number: dxbby120
There are several reasons for repeated bone penetration in patients with leukemia: (1) Confirmation of diagnosis For patients with morphologically confirmed leukemia, it is necessary to conduct further examinations of bone marrow cytochemistry, immunology and cytogenetics to determine the subtype of leukemia. Determine the prognosis. (2) Observation of curative effect For patients with leukemia who have not yet resolved, usually 10-14 days after chemotherapy, bone puncture is required to understand the response of the last chemotherapy and help doctors determine further treatment plans and medication choices. If a patient, after a course of combined chemotherapy, the percentage of leukemia cells in the bone marrow drops significantly or less than 40% compared to before the boil, it indicates that the patient may be insensitive to the boil, and should be added for further treatment Large drug doses, or change the treatment plan, choose other drugs. (3) Judging the prognosis If the patient has undergone multiple regimens combined with chemotherapy, but the percentage of autohematological cells in the bone marrow does not decrease significantly, or once decreased but rises to the level before treatment in a short period of time, it indicates that the patient has leukemia cells Primary drug resistance is difficult to treat and the prognosis is poor. (4) Monitoring the changes of the condition For patients who have achieved complete remission by chemotherapy, although the bone marrow picture is nearly normal, they should still be reviewed regularly. The purpose is to detect changes in the condition as soon as possible and give timely and effective treatment.
The main symptom of leukemia patients is infection and fever, and the number of white blood cells in the blood of most patients is very high. Although there are a lot of white blood cells, they are all immature and naive cells, just like some “baby soldiers”. They have no ability to resist the enemy. Therefore, patients with leukemia are easily infected, such as the mouth, throat, ears, nose, anus, and skin. Some inflammatory changes may occur if the place is violated. Bacteria are highly virulent and can become life-threatening when entering the bloodstream. Because leukemia patients produce a large number of immature white blood cells in the bone marrow, the megakaryocytes that produce platelets are significantly reduced. Therefore, leukemia patients may have skin and mucous membranes, bleeding in multiple tissues and organs, and severe intracranial hemorrhage may occur. Leukemia cells invaded other tissues can be manifested as bone pain, periosteum tumors (tapechromoma), skin nodules, gingival swelling, liver and spleen lymph nodes, etc., can also be manifested as meningeal leukemia, testicular leukemia, etc. Leukemia patients are often accompanied by anemia, and the anemia is aggravated by bleeding.
Many people with chronic myeloid leukemia once had the idea of giving up treatment after they learned that they had leukemia, but with a deep understanding of the condition, they realized that chronic myeloid leukemia is not a “terminal disease.” Can slow particles be cured? ——Experts say that continuous remission without treatment, that is, “cure” chronic myelogenous leukemia, is our ultimate goal. This result is achieved step by step, and complete hematological, cytogenetic, and molecular responses, and try to get a higher level of molecular response through standardized targeted drug therapy to obtain the possibility of drug withdrawal! Before that, we need to achieve a primary goal in the process of treating slow particles. What is the primary goal of treating slow particles? ——The primary goal: control slow granule in the chronic phase and prolong life! The application of tyrosine kinase inhibitors represented by imatinib has successfully reversed the natural course of CML. On the basis of prolonging the survival period, improving the quality of life and living like normal people have become the demands of chronic granule patients. In the case of good communication between doctors and patients, select the appropriate TKI according to the patient’s basic disease and drug tolerance, adjust the dosage according to the patient’s tolerance and treatment response, and minimize adverse drug reactions on the basis of ensuring the efficacy . Clinically, this goal has been basically achieved. As long as patients can actively treat, standardize medication, and monitor their condition, they can achieve long-term disease survival, and even normal life and work effects. With the advancement of medicine, CML can now be treated as a “chronic disease”, and early diagnosis and treatment of some CML patients can even achieve the purpose of stopping the drug. Therefore, patients who have been diagnosed must establish confidence in treatment and strive for a speedy recovery! For more patient communication and help, please follow the WeChat public account [Chronic Myelopathy Association]mbxb120
Chronic myelogenous leukemia can be seen at any age, but the peak incidence is around 40 years old. Ph1 chromosome can be detected in 90% of patients with this disease, and abnormalities in the corresponding gene structure can also be found in the remaining 10% of patients through molecular biology methods. The onset of this disease is insidious, with mild early symptoms, including low-grade fever, night sweats, weight loss, etc. Splenomegaly is clearly characteristic of the disease. Peripheral blood leukocytes increase, mostly granulocytes below the myelomyelocytic stage. Platelets do not decrease or even increase in the early stage. Bone marrow hyperplasia is extremely active, the ratio of mid-myelomyelocytic and late-myelomyelocytic cells is increased, megakaryocytes are more common, and bone marrow fibrosis may be present in varying degrees. The natural course of chronic myelogenous leukemia can be divided into three stages: (1) the chronic phase has mild symptoms, about 3-4 years. (2) more symptoms and hematological changes in the accelerated phase, and the patient may die due to infection or bleeding . (3) The symptoms and hematological changes in the blast phase are similar to acute leukemia.
Xiebielu Studio WeChat add369456 article source: transferred from WeChat public account [Xiebielu Studio] Myelodysplastic Syndrome (MDS) has another name: pre-leukemia. After the diagnosis of the disease, most patients are very consistent in worrying that they will eventually turn into leukemia. In fact, MDS has a relatively high risk of transforming into acute leukemia (AML), but not all patients with MDS will develop leukemia. So, are those MDS patients who have not transformed into leukemia, are all cured? MDS, myelodysplastic syndrome, as the name implies, is a group of bone marrow hematopoietic stem cells damaged by certain factors, one or more lines in the peripheral blood Blood cell reduction, abnormal morphology, immune function, and hemostatic dysfunction are the main blood diseases. Whether MDS patients eventually transform into leukemia depends on the development of the specific disease. There are four common possibilities: First, turn white. Some patients will “turn white” within two years, and some patients will gradually turn into leukemia after the disease lasts for many years. . Secondly, they have been in a state of myelodysplastic syndrome for a long time and will not develop into leukemia, and patients need continuous treatment and medication to maintain. Third, some patients have not “turned white”, but the condition is still getting worse, especially caused by bone marrow failure The reduction of blood cells in the patient leads to serious infections, bleeding and other complications and life-threatening. Finally, after some patients have undergone treatment, the clinical symptoms disappear, blood and bone marrow images have basically returned to normal, achieving the goal of basic cure. In short, no matter whether the condition of MDS patients turns white or not, they must be actively treated, especially for patients with severe bone marrow failure and extremely low blood cells, and timely and reasonable diagnosis and treatment, whether it is Western medicine or traditional Chinese medicine dialectical treatment, To help patients get a better quality of life!
Essential thrombocythemia (ET) is a type of clonal pluripotent stem cell disease, which is a myeloproliferative disease. The peripheral blood platelet count is mostly (1000—3000) X10^9/L, and the megakaryocytes in the bone marrow increase significantly, and there are The formation of a large number of platelets, combined with splenomegaly, bleeding or thrombosis, can diagnose the disease. The annual incidence of this disease is about 0.1 per 100,000 people. It is a rare case with a slow onset. ET transforms into acute leukemia (AML) is extremely rare, accounting for about 1%-4.5% of all ET patients. Some scholars divide the disease into a low-risk group and a high-risk group. Most scholars believe that the high-risk group should be treated, but now that PLT>1000X10*/L needs treatment. Patients <60 years old, PLT≤1500X10^9/L, no typical clinical manifestations, belong to the low-risk group t2, only 3a transformed into myelodysplastic syndrome (MDS), and then transformed into erythroleukemia (M6) after 1a, Whether the cause is related to receiving chemotherapy such as alkylating agents or hydroxyurea or spontaneous conversion is still uncertain. However, recent relevant data indicate that the probability of ET patients who have not received treatment and will transform into acute leukemia is small. Receiving 32P, alkylating agents or hydroxyurea can increase the probability of transforming into acute leukemia, so we must be cautious when giving chemotherapy to this patient. In this case, ET first transformed into myelodysplastic syndrome with myelofibrosis (myelofibrosis syndrome), and then into erythroleukemia (M6) with myelofibrosis. This case has not been reported in China. In the past, it was thought that the bone marrow puncture stem would disappear when myelofibrosis was transformed into AML, but this case is different, and it may be related to this case of erythroleukemia with myelofibrosis. The patient was not sensitive to chemotherapy after transforming into erythroleukemia, suggesting that this transformation may be the terminal stage of ET and the prognosis is poor.
Overview] Leukemia-like reaction is a response of the hematopoietic system after the body is stimulated. It is manifested as a significant increase in the number of peripheral blood white blood cells and the appearance of immature cells, similar to leukemia. 【Diagnosis】 1. Medical history and symptoms ⑴ Medical history question: Note: ① Whether there are bacterial, fungal and parasitic infections. ② Whether you have autoimmune diseases . (rheumatoid arthritis, sarcoidosis, etc.) and tumor diseases (kidney tumors, leukemia, etc.). ③Whether to use glucocorticoids, adrenaline, lithium chloride and other drugs. ④ Whether there is severe burn, crush injury, electric shock injury, poisoning, acute hemolysis or massive blood loss, whether it is in the recovery period of bone marrow suppression, etc. ⑵Clinical symptoms: Depending on the original disease, corresponding clinical symptoms appear. 2. Physical examination found: is mainly the corresponding signs of the primary disease. 3. Auxiliary blood test: red blood cells and hemoglobin are normal (except acute hemolysis, massive blood loss and leukemia), and platelet count is normal. The number of white blood cells is significantly increased> 25×109/L, up to 200×109/L, and there are different types of leukemia-like reactions depending on the body’s stimulating factors, which can be granulocytes, monocytes, lymphocytes or eosinophils The proportion of granulocytes increased. Classification shows immature cells. Toxic granules and vacuoles often appear in the cytoplasm of neutrophils. 2. Bone marrow phenomenon: hyperplasia is active or obviously active, most of the original cells are not significantly increased, and there is no abnormal cell morphology of leukemia. The erythroid and megakaryocyte cell lines are normal. 3. Cytochemical staining: neutrophil alkaline phosphatase score was significantly increased. 4. . Genetic examination: no Ph1 chromosome. Four. Differential diagnosis Leukemia reactions usually have clear incentives, but when the primary disease is relatively hidden, attention should be paid to distinguish it from leukemia. 【Therapeutic measures】 The leukemia reaction itself does not require treatment, and it can recover quickly after the original cause is removed. Therefore, the primary disease should be carefully searched and treated actively.