Leukemia Sutta (CML)

Leukemia Sutta (CML)'s disease overview

Leukemia of the white blood cells (CML) is a disease of malignant chronic hypercondage syndrome, characterized by the proliferation of white blood cell cells that have been separate Chemistry mature, the consequence is that the number of white blood cells increases in peripheral blood with all stages of maturity of the granulocyte. Previously, the chronic phase of Leukemia disease, also known as leukemia, usually lasted 3-5 years, then quickly turned into acute Leukemia (with bad prognosis, more life time usually no more than 1 year). Currently, with the application of homosexual hematopoietic stem cell transplantation and targeted treatment with tyrosin kinase active inhibitors, the prognosis of Leukemia patients with granulocytes is significantly improved.

Causes of Leukemia Sutta (CML)'s disease

Leukemia The granulocyte is a disease, no family, non -genetic for the next generation.

Radioactive exposure can be a cause of disease. 

Philadelphia chromosomes and BCR-MLL combinations play the most important role in the pathogenesis of the disease.

Symptoms of Leukemia Sutta (CML)'s disease

  • Chronic phase:

  • The spleen is common in 85-90% of the patients. The liver is more than 50% of patients.
  • Fatigue, poor appetite, weight loss, night sweat. 
  • Mild or moderate anemia. 

    • Clogging (spleen embolism, limb embolism, penis veins, thorns, reduction or loss of vision on one side, hearing loss, ...).

  • Manifestations of gout due to hyperuricemiaememia in some patients. 
  • Acceleration:

  • Clinical manifestations (anemia, hemorrhage, infection).
  • Spleen does not respond to treatment.
  • Level Leukemia transfer phase: During this period, there are often clinical manifestations typical for acute Leukemia such as anemia, hemorrhage, infection coincidence, infection syndrome.

    • People at risk for Leukemia Sutta (CML)'s disease

    Risk factors that increase the likelihood of Leukemia disease is:

  • Radioactive exposure: Exposure to high doses (such as survival after an atomic bomb explosion or an accident of the nuclear reaction) increases the risk of Leukemia's disease. The granulocytes.
    • Age: The risk of Leukemia disease granulocytes increases with age Sex: The disease is often common in men than women

    In addition, according to many studies, other factors such as smoking, diet, inflammation, family history of people with leukemia diseases of the granulocyte, ... Not related to the risk of disease.

    Prevention of Leukemia Sutta (CML)'s disease

    Currently, many types of cancer can be prevented by changing lifestyle and avoiding certain risk factors. However, this is not true for most Leukemia patients with granulocytes.

    The only risk factor that can be avoided is high -dose radioactive exposure that can be applied in very few people.

    Diagnostic measures for Leukemia Sutta (CML)'s disease

    Chronic phase:

  • Peripheral blood test:

  • Colorful anemia, normal red blood cell size

    • Increased number of white blood cells

  • There are enough adult periods of peripheral blood cells
  • Ratio of blast cells or cell marrow and bone marrow under 15%
  • Increase the ratio of white blood cells and white blood cells to love base
  • The number of platelets increases in the range of 50-70% of cases.
  • Most map:

  • Cell -rich myeloma
  • Increasing granulocytes with adulthood of adults
  • Ratio of blast cells or cell marrow and bone marrow under 15%
  • Chromosomes Philadelphia and/or BCR-Ml gene: positive in about 95% of cases.
  • Blood uric acid concentration: Increases in 40-60% of cases.

    • Acceleration:

  • Peripheral blood test:

  • Increase the rate of blast cells or the marrow and marrow bone marrow but less than 20%
  • Reduce the number of red blood cells and concentrations of hemoglobin

    • The number of platelets may increase or decrease. 

  • Most map:

  • Reducing red blood cells and platelets
  • The trend of increased malignant cells (blast cells), in which the ratio of blast or oysterbachs and the bone marrow increases but less than 20%.

    • Level of Leukemia transfer:

  • Peripheral blood test:

  • Increase the ratio of blast cells or the marrow and the bone marrow ≥ 20%
  • Reduce the number of red blood cells and concentrations of hemoglobin
    • platelet reduction.
  • Most map:

  • Reducing red blood cells and platelets
  • proliferation of malignant cells (blast cells), in which the ratio of blast or cellal cells and the bone marrow is ≥ 20%.

    • Distinguish diagnosis:

  • The Leukemia reaction is encountered in severe infections.
  • Other diseases in malignant chronic hyperactive syndrome.

    • Leukemia Sutta (CML)'s disease treatments

    Treatment in chronic phase and acceleration

    treatment targeted with active inhibitors Tyrosin Kinase:

  • The first treatment option is the active inhibitors of the first and second generation tyrosin kinase, specifically:

  • Active inhibitors Tyrosin Kinase 1st generation: Imatinib. 
  • Active inhibitors of the 2nd generation Tyrosin Kinase: Nilotinib and Dasatinib. 
  • Monitoring response by testing:

  • Philadelphia chromosomes and tests after every 3 months from the beginning of treatment
  • Quantify the BCR-MLL gene with PCR technique from the diagnosis and every 3 months during the treatment process to assess the degree of infection at the molecular level.
  • Detects of the BCR-ML gene mutation when the patient does not respond to treatment with genetic sequence technique.

    • Other treatments:

  • hydroxyurea
  • Interferon

    • Hematoma stem cell transplantation:

    Hematopoietic stem cell transplant with humans suitable for HLA is a method that allows long -term retreat with the possibility of recovering. 

    Support treatment:

  • Blood transfusion: If the patient has anemia but it is necessary to limit the indication of blood transfusion when the number of white blood cells is still high to avoid increasing the risk of embolism.
  • Additional oral fluid supplement (2-3 liters of water daily), alkaline urine, forced diuretic to prevent tumor syndrome.
  • Allopurinol oral oral 300mg/day helps prevent and treat hyperuricemia.

    • White blood cells when the number of white blood cells. Treatment in the transformation phase of

    during the acute transfer phase of Leukemia disease, the granulocytic leukemia, need to be treated as for acute Leukemia disease (multi -chemotherapy and bronze marrow transplantation Type) Coordinate with treatment to target target with tyrosine kinase activated inhibitors. 

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