Acute myeloblastic leukemia
Acute leukemia is a disease of the systemhemopoiesis, which is based on unlimited proliferation of tumor cells, which are its morphological substrate. Acute myeloblastic leukemia according to the FAB classification is divided into seven variants. The classification is based on the level of differentiation of cells representing the substrate of leukemia. Tumor clone of myeloblasts comes from stem cells that are capable of giving rise to colonies of myeloid cells, megakaryocytes, erythrocytes, macrophages.
The most frequently observed variants of M0-M3. At the heart of the first two are cells without differentiation. Option M2 is differentiated cell. The M3-promyelocytic variant is characterized by abnormal cells with giant granules. M4 and M5 are myelomonoblast and monoblast leukemia. M6 - erythromyelosis, with enhanced proliferation of erythroid cells. M7 is megakaryoblastic leukemia. Of all the variants with acute myeloblastic leukemia, the prognosis is most favorable for M0-M2.
Etiopathogenesis of leukemia
What is acute myeloblastic leukemia? At the heart of the disease - the increased ability of cells to mutations, which occurs under the influence of external factors (radiation, viruses, chemicals) and predisposition to genetic instability of the genome. As a result, there are tumor cells capable of unrestricted division. They form a clone, which, in turn, by means of repeated mutations gives rise to subclones.
Tumor cells are continuously formed in the bonebrain, damaging and displacing the normal germ of hematopoiesis. Gradually, they exit into the peripheral blood and metastasize to the organs, forming additional foci of pathological hemopoiesis. Myeloblastic leukemia develops with a characteristic clinical picture.
Clinic of acute myelogenous leukemia
Because of a violation of normal hematopoiesispatients develop anemia, the number of mature neutrophils and platelets decreases dramatically. Dizziness worries. weakness. There are signs of bleeding: hemorrhages on the skin and mucous membranes, increased bleeding during menstruation, nosebleeds. There are pains in the bones, an increase in the lymph nodes of various groups. The spleen and liver are enlarged. Because of the violation of the function of leukocytes, the decrease of immunity acute myeloblastic leukemia flows with the attachment of infections. Often it manifests with severe angina.
In later stages, signs of renal insufficiency and neurological symptoms can be attached.
In my current acute myeloblastic leukemiathere are stages of developed manifestations, remissions, relapses. In case of ineffective treatment, it ends with the terminal stage. The stages of the disease are characterized by clinical manifestations and a certain pattern of blood and bone marrow.
Diagnosis of leukemia
Acute myeloblastic leukemia is based oncytochemical studies of cells representing its substrate, and immunophenotyping - the determination of myeloid cell markers. Morphological methods for detecting blast cells in determining the type of leukemia are given an approximate value, although they continue to be used.
Sometimes a genotypic method is used, based on the polymerase chain reaction. They use it to determine the residual manifestations of the disease in patients in a state of remission.
The prognosis of acute myeloblastic leukemia is less thanfavorable than the prognosis for acute lymphocytic leukemia. Up to 75% of patients with adequate treatment reach remission. There are data on the cure of 20% of those who reached remission while continuing intensive treatment. Promising results are provided by bone marrow transplantation.