What is Leukemia Basics

Leukemia or leukemia - is a general term describing a group of acute and chronic neoplastic diseases of the blood system. This disease is "white" blood, ie, leukocytes, before it was called leukemia.

Leukocytes perform a protective function in the body. All of them can be divided into two major groups: granulocytes (their function - phagocytosis, ie destroy bacteria and viruses by swallowing) and lymphocytes (they are in response to the invasion of bacteria and viruses produce a special substance antibodies that are glued together with disease-causing bacteria and viruses, and displays from the body). All types of leucocytes are produced by the bone marrow.

In leukemia, the white blood cells do not mature until the end, so they can not perform their inherent function of protecting the body against viruses and bacteria. The number of immature cells (blasts) literally fills the circulatory system and internal organs and is responsible for development of the main symptoms - anemia, bleeding, various infections, irritation, increase and dysfunction of affected organs.

Why it may be leukemia?

No one knows the true causes of the disease. However, it was observed that the leukemia often occurs after ionizing radiation, by exposure to some chemicals, viruses. Contributing factors are the genetic features of the structure of the body.

Types of leukemia

Leukemia can be acute or chronic. Acute leukemia is divided into acute lymphoblastic leukemia (ALL - if you grow blast cells) and acute myeloid leukemia (AML. - Grow blast granulocytes).

Chronic leukemia is divided into chronic lymphocytic leukemia (CLL), chronic myelogenous leukemia (CML) and hairy cell leukemia (mostly elderly sick man).

How does acute leukemia

Acute leukemia begins suddenly with high fever, sometimes with sore throat Angina - is it worth it to carry "on their feet"?   or with stomatitis Stomatitis - to breath fresh   symptomatic bleeding gums How to prevent bleeding gums: important rules . Appears as weakness, fatigue, loss of appetite, nausea, vomiting, pain in the bones. Increased liver, spleen, lymph nodes, there punctulate reddish-bluish rash, bruises, nosebleeds. Rapidly growing weight loss, there may be internal bleeding.

Against the background of the disease, typical changes in the blood - the emergence of a large number of immature white blood cells (blasts).

Manifestations of chronic leukemia

Chronic leukemia is slower, sometimes for several years. All symptoms smoother. The periods of exacerbation is usually followed by periods of remission (a temporary absence of symptoms).

The diagnosis is usually made by chance during a blood test.

Leukemia Treatment

Treatment of leukemia - is, above all, the suppression and destruction of breeding blasts, as even one or two of the remaining cells may lead to a new outbreak of the disease.

Inhibits the development of cell or with special drugs (cytostatic agents, such as vincristine) or by irradiation. Since both methods do not act selectively on the blasts, it could be affected and other full-blood cells, so this chemo- and radiotherapy carry heavy: general weakness, vomiting, drop all the hair and so on.

Since the period of intensive treatment the body is virtually defenseless against infection, the patient is isolated from any contact, he appointed prophylactic antibiotics Antibiotics - whether they will help you in the foreseeable future?   and antiviral drugs.

When bleeding transfusions of blood or blood components (eg, red cell mass or torombotsitarnoy).

The prognosis of leukemia

The prognosis depends on many factors, the most important of which - the type and stage of the leukemia patient's overall health, access to quality health care .  On average, 64 . 5% of men and 63 . 5% of women live at least one year after they have been diagnosed with leukemia .  Five-year survival is 44% for men and 44 . 4% for women, and ten-year survival rate - 32 . 9% for men and 33 . 6% for women .  Note that this is - the general data obtained by analyzing the records of patients aged 15 to 99 years old .  In the age group 15 to 39 years of the five-year survival rate is much higher (64%) than those aged 80 to 99 years old (19%) .  However, survival rates for leukemia are significantly worse than for many other types of cancer .  It is very much "spoils Statistics" acute leukemia: in 57% of cases it is detected when the patient has an urgent need of treatment, and therapy is much more effective when the disease is detected in its early stages .

Despite this, with 1970 annual survival rate for leukemia for both sexes and all age groups has increased almost two times, five-year survival rate - three times, and ten-year survival rate - almost four times.

As formed bilirubin

Bilirubin - a pigment that is found in the blood and excreted in the bile, so he called the bile pigments. Bilirubin is formed from hemoglobin - iron compounds to the protein that forms the basis of erythrocytes - red blood cells. In normal aging erythrocytes and disintegrate, thus of hemoglobin in spleen cells, bone marrow and liver is formed first the so-called indirect or unconjugated bilirubin. All indirect bilirubin is collected in the liver and it is captured by the cells of the blood (the bilirubin, which is formed in the other organs, transported to the liver with the blood combines with the liquid portion of blood proteins - plasma).

In the liver, indirect bilirubin by the enzyme glucuronyl connected with glucuronic acid to form a linked or direct bilirubin. Bilirubin, and a small amount of free bilirubin in the bile enter the intestine, where decay and under the influence of intestinal microflora are converted into new compounds, most of which is excreted in the feces (stercobilin), and a small portion - in the urine (urobilin).

Normally, the amount of bilirubin in the blood is from 8, 5 and 20, 5 mmol / liter, three-quarters of which is indirect bilirubin and a quarter - live.

Laboratory determination of bilirubin

For the diagnosis of various diseases using a number of methods for the determination of bilirubin in the blood, urine, and feces.

To determine the bilirubin and its fractions in the blood plasma of different methods, the most common of which is a method Endrashika-Grof. The method is based on the interaction of bilirubin with sulfanilic acid and sodium nitrate. This conjugated bilirubin gives quick response, so he gave the name of the direct and free - a slower reaction to accelerate which different substances (caffeine, ethanol, et al., Who first release bilirubin from protein complexes), and therefore it is called indirect.

Various methods for the detection of bilirubin in the urine based on his turning under the action of oxidizing agents in the other substances having a green or red color.

What do the tests

If the capture process is disrupted indirect bilirubin liver cells and its binding to glucuronic acid, the amount of indirect bilirubin in the blood increases. Violation of separation of direct bilirubin from the liver cells into the bile capillaries as a result of inflammation or liver cells dying off (necrosis) is the reverse current of bile in the blood and an increase in the blood levels of direct bilirubin. All these processes are characterized for destruction of liver cells due, for example, viral hepatitis Hepatitis - the scourge of our time   or tumor - so-called hepatocellular jaundice, which is characterized by an increase in both the indirect and direct bilirubin. And as a direct bilirubin is soluble in water, it flows freely to the kidneys and excreted in the urine, turning it dark. The amount of feces bilirubin and stercobilin reduced, it may be discolored.

Mechanical jaundice in the blockage of the extrahepatic biliary tract stone or squeezing their tumor. In this case violated the secretion of bile in the intestines and feces become discolored. Since the formation of direct bilirubin is not broken, then the amount in the blood (and hence in the urine) increases, the urine becomes dark.

With increased decay of erythrocytes with release of hemoglobin Hemoglobin: worse - low or high?   (a sign of hemolytic anemia Hemolytic anemia - when we did not have enough blood   and jaundice) the formation of a large number of indirect bilirubin, which does not manage to fully transform into a straight line. Indirect bilirubin can not fall into the urine, but there urobilin urine which enters it from the intestine.

In the long blockage of bile ducts, accompanied by mechanical jaundice Jaundice - if the eyes are shining suspiciously May impair the operation of the liver cells, and thus disrupted the process of catching and binding indirect bilirubin. This will increase its content in the blood along with the direct bilirubin.

Since the urine can be allocated only direct bilirubin, the color of urine becomes dark beer at the parenchymal and obstructive jaundice. By increasing the number of hemolytic jaundice, indirect bilirubin, which is insoluble in water and can not penetrate into the urine, so the color of urine in this disease is not changed.