Internal Medicine

How do you recognize leukemia?

introduction

The concept of illness leukemia is generally understood as "blood cancer".
It is a systemic disease that affects the entire body. Various diseases of the hide behind the term leukemia hematopoietic system. The word origin of the collective term indicates a common one common ground of malignant new cell formations: in many cases there is a significantly increased number white blood cells in front.
in the Bone marrow develop from so-called pluripotents Stem cells not just white and red blood cells, but those too Platelets. On the way to functional white blood cells, imperfect control mechanisms can result in immature cells. she usually multiply faster and in this way disturb the Production of all other cells of Blood in the bone marrow. Immature white blood cells reduce those Immune defense. Infections are much more common. The lack of mature blood cells as well Platelets (Platelets) leads to Anemia (anemia) and an increased risk of bleeding.

A rough distinction is made between acute and chronic leukemia.
Acute leukemia is associated with rapid, severe disease that can result in death. Chronic leukemia, on the other hand, has a significantly slower and more inconspicuous course.

Depending on which progenitor cells of the white blood cells are affected, one speaks of myeloid or lymphatic leukemia. Myeloid leukemia arises from the preliminary stages of the granulocytes, while the lymphatic form arises from the lymphocytes. This results in four clinical pictures of leukemia:

Acute myeloid leukemia (AML)
Chronic myeloid leukemia (CML)
Acute lymphocytic leukemia (ALL)
Chronic lymphocytic leukemia (CLL)

There are also syndromes as precursors of leukemia and rarer forms such as hairy cell leukemia.

The annual number of illnesses in Germany is around 11,500. The majority of the sick are people over the age of 60. About 5% of those affected are children under the age of 15. In adults, chronic lymphocytic leukemia (CLL) is one of the most common forms. The acute course of lymphatic leukemia is more like leukemia in children.
The symptoms of the individual forms of leukemia are similar in their initial stages and are characterized by decreased performance, weight loss, fever and signs of anemia. If a hematopoietic disease is suspected, anamnesis, a physical examination and a precise blood count provide the first clues. In addition to a bone marrow puncture, a lymph node biopsy and imaging procedures are used to confirm the diagnosis.

Read more on the subject at: Lymph node biopsy

Symptoms

The symptoms of acute and chronic leukemia are mostly unspecific and are observed in connection with other diseases. However, there are various warnings that suggest leukemia and should be taken seriously.
The severity of the complaints varies depending on the form. While acute leukemia suddenly and suddenly occur, stay chronic leukemia Long undetected and are only discovered during routine medical examinations. Acute leukemia usually goes complete health ahead before seamlessly high fever and a clear feeling of illness with an increased tendency to Infections, otherwise in people with an intact immune system Not occur, occur. The course of the disease turns out to be significantly slower and more inconspicuous chronic leukemia Sick people usually experience only minor restrictions in daily life.
In general, those affected often feel tired and complain about decreased performance. Physical symptoms can take the form of the so-called B symptoms observed in cancer. The term encompasses the triad unwanted Weight loss, ongoing fever and night sweat together.

Faulty control mechanisms lead to the uncontrolled reproduction and production of immature white blood cells. The result is anemia (anemia), which is accompanied by the following symptoms: paleness, high heart rate, dizziness and increased shortness of breath.
In addition to mature white and red blood cells, fewer functional thrombocytes (blood platelets) are formed due to the displacement mechanism. As a result, those affected suffer more frequently from bleeding from the mucous membranes in the nose and mouth. Even slight trauma is enough to cause hematomas to develop under the skin. Also small punctiform bleeding on arms and legs, so-called Petechiae, are the result of a reduced ability to clot.
Other symptoms that can indicate leukemia are increased susceptibility to infections, skin rashes, swollen lymph nodes, painful bones and a palpably enlarged spleen or liver.

Read about that leukemia-related rash.

How do you recognize leukemia in young children and babies?

In Germany, about 600 Children and young people up to the age of 18 on one leukemia.
The symptoms of the onset of leukemia are unspecific similar to an adult. The children can do it more often tired and pale be and are general more prone to infection. fever, Night sweats and unwanted weight loss belong to the so-called B symptoms, which can occur with leukemia or other tumor diseases. The children can also use Bone pain complain faster and more often than usual blossomse.g. from the nose, or bruises (Hematomas) to get. As with adults, children and babies can swollen lymph nodes and a enlarged spleen or liver develop as part of leukemia. More general symptoms like Loss of appetite or malaise and Exhaustion can also occur.
Around 30% of all Cancers at this age account for malignant neoplasms of the blood-forming system. For children up to the age of 14, the acute lymphoblastic leukemia With 500 new cases per year, they account for the largest proportion by far. According to statistics, the majority of diseases are in children between one and five years. Adults are affected much less often. Thanks to modern therapy options, the chances are after 5 years disease free to be about 90%.
The acute lymphoblastic leukemia (ALL) is based on the production of degenerate Lymphocytes. Here will be different shapes distinguished. Depending on which precursor cells of B or T lymphocytes are affected, the course and prognosis can differ considerably. The exact subdivision into various sub-forms of ALLES is a helpful tool in choosing the right treatment. The causes of a ALLES have not yet been adequately clarified.
In the Disease genesis genetic and external factors seem like Viral infections and radioactive radiation to play a role. Children with congenital disorders of the Immune system and chromosomal abnormalities are also more likely to develop one leukemia.

When diagnosing a leukemia In addition to the anamnesis, the clinical examination are particularly precise Blood count analysis and a Bone marrow puncture displayed. There are also imaging procedures such as X-ray examinations, one Magnetic resonance imaging (MRI) and Computed Tomography (CT) are used.
With proven ALLES treatment takes place in a special facility for pediatric oncological cases. The central component of therapy for each sub-form is the chemotherapy with the help of so-called Cytostatics cell growth is inhibited.
Each therapy is tailored to the individual Tumor spread customized. In addition to cytostatic drugs, radiation therapy and possibly also a Stem cell transplant are used.
At the acute myeloid leukemia About 110 children and young people fall ill in Germany every year. At around 20%, it makes up the second largest proportion of leukemia. In terms of numbers, babies and toddlers up to the age of two are represented the most. Causes and diagnosis are with the ALLES comparable. Most important part of therapy one AML is the medicinal one chemotherapywhich is rarely supplemented by further measures. The Chance of recovery after 5 years 70%.

How do you recognize leukemia in the blood / blood count?

The various blood cells in the blood are examined.

If there is a suspicion of leukemia, the doctor initiates various examination steps. In addition to the medical history and physical exam, play an accurate Blood count and the Bone marrow puncture an important role. If the suspicion of a certain form of leukemia is confirmed, the results from the examinations of blood and Bone marrow decisive information for further treatment measures.
The blood count analysis is used to determine redden and white blood cells as well as the Platelets. In this way it is assessed whether and which subtype of white blood cells is subject to a malignant change.
In the so-called differential blood count, the morphology (Appearance) of the individual leukocyte subgroups, including their Share of the total of white blood cells. Granulocytes are part of our innate Immune system and can be divided into eosinophils, basophils and neutrophils. They do about 60% of the leukocytes out. Lymphocytes are the second most common and are among them acquired immune system. Monocytes are also called Phagocytes and only make up a few percentage points.

Doesn't always show that Blood count a marked increase in the number of white blood cells (Leukocytosis). Normal as well as lowered values (Leukopenia) are also not uncommon.
The various precursor cells of the Blood cells approach. Only at the end of their differentiation into functional cells are they released into the bloodstream. In malignant neoplasms of the bone marrow are found increased precursors in the blood. Often there is one sunk number red blood cells (anemia) and Platelets (Thrombocytopenia). This is related to the displacement by the malignant proliferation of the leukocytes. On the other hand, a leukemia can also be a Erythrocytosis or Thrombocytosis, which is an increased number of red blood cells and platelets.
Even if the Blood count analysis an important part in the diagnosis of Leukemias it is not always a reliable means. An inconspicuous one laboratory does not have to be an exclusion for leukemia. Conversely, not every abnormality definitely indicates leukemia. Other diseases are also associated with changes in the blood count.