chronic myeloid leukemiaChronic myeloid leukemia (myeloid leukemia, CML) can occur at any age, but most often appears in middle-aged and older, rarely - in children.

Malignant disease develops very slowly. Many people do not need treatment for months or even years. However, in some cases it is needed right away.

It is proved that early detection of cancers of the blood facilitates compilation adequate therapeutic protocol which is able to heal the disease with the least damage to the organism.

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In people with chronic myeloid leukemia in the blood there is an excessive amount of white blood cells - granulocytes (granular leukocytes), so the disease is sometimes called chronic granulocytic leukemia. When examined under the microscope it can be seen that the granulocytes are not fully developed (immature). Since they accumulate in the spleen, resulting in an increase of its volume over time. It is located on the left side of the abdomen, under the ribs. This body produces a small number of lymphocytes, keeps blood cells and destroys the old, damaged.

Granulocytes also fill the bone marrow, reducing the number of healthy white blood cells, red blood cells and platelets.

To better understand what is chronic myeloid leukemia and its treatment, it is helpful to know a bit more about the person's blood.

The blood in the human body

Blood consists of cells that are in the plasma fluid.

Blood cells are produced in the bone marrow, the spongy material that fills the interior, the central part of the bones, especially in the area of ​​the pelvis and spine. Typically, millions of new blood cells are synthesized on a daily basis, to replace the old and worn out.

All blood cells originate from stem. There are two types of them:

  1. The lymphoid stem cells, which are lymphocytes.
  2. Myeloid stem cells, on which there are all other types - red blood cells, platelets and granulocytes.

New blood cells are immature and are called blasts. They can not perform its function. To maturity, they reside in the bone marrow. Where stem cells divide and grow until fully developed form (mature) red blood cells, platelets and leukocytes.

Then they are released into the bloodstream to perform various functions:

  1. Red blood cells contain hemoglobin that carries oxygen from the lungs to all cells of the body.
  2. Platelets - cells are very small in size, contributing to the process of clotting and prevent bleeding and bruising.
  3. White blood cells prevents the development of infections and fight with them. There are several types of white blood cells, the two most important of them - it neutrophils and lymphocytes. The levels of these cells is measured in a total blood analysis.

How is chronic myeloid leukemia?

All cells have a certain "set of instructions", what to do and when. It is stored within them in the genes. Each gene controls some aspect of cell behavior. For example, some define vacation time, others - the growth, the time of transformation into a mature cell. The genes are organized in chromosomes or structure.

The disease occurs when an error is transferred from one gene to another chromosome during cell division. They are united. This abnormal fusion stops the ripening process of blasts. These cells are leukemia or blast.

Philadelphia chromosome

Most of the people with the disease (95 of 100) in the diseased cells have the Philadelphia chromosome.

The main part of the cells contains 23 pairs of chromosomes. The Philadelphia chromosome is formed when the ABL gene on chromosome 9 mistakenly transferred to the chromosome 22 and is attached to the gene BCR. This results in a new gene called BCR-ABL. It synthesizes a protein, which is called tyrosine kinase. The excess of this protein leads to abnormal cell behavior and changes in the blood and bone marrow. New methods of treatment of chronic myeloid leukemia are aimed at blocking tyrosine kinase activities. Despite the fact that the disease is genetic, it is not hereditary.

Causes of chronic myeloid leukemia

There are several factors that can increase the risk of developing the disease, but most people do not know why it arises.

  • Age. The probability of occurrence of the disease increases with age.
  • Irradiation. Exposure to very high levels of radiation may promote the development of myeloid leukemia.
  • Chemical substances. Certain chemicals used in industry, as well as pesticides can slightly increase the risk of CML.

In recent years, it exaggerated information that living near nuclear power plants may have a certain impact. Research is still going on, but so far there is no evidence.

Also not found between CML and likely exposure to electromagnetic fields and residential radon.

Symptoms of chronic myeloid leukemia

Symptoms of the disease develop slowly, many people have no symptoms in the early stages. Most often myeloid leukemia detected by chance when blood tests make for a different reason, for example, before surgery or during regular medical examinations.

If the symptoms in the early stages of the disease still occur, that develop slowly and are usually mild in nature. They are non-specific, and can be easily confused with symptoms of other common diseases such as influenza.

Clinical manifestations of chronic myelogenous leukemia may include:

  1. The feeling of fatigue and malaise.
  2. Loss of weight and appetite.
  3. Discomfort in the abdomen, and sometimes a feeling of fullness in the left side due to enlarged spleen.
  4. Bleeding and bruising due to platelet deficiency.
  5. Frequent infections caused by deficiency of white blood cells. The disease can be more severe, the healing process takes longer.
  6. Pallor, fatigue and shortness of breath causes anemia, which arose due to the red blood cell deficiency.
  7. Pain in the bones appear in connection with the accumulation of a large number of white blood cells in the bone marrow.
  8. Enlarged lymph nodes due to the concentration in their leukemic cells. they usually do not cause pain.
  9. Small swelling on the skin.
  10. Itching.
  11. Blurred vision and headaches caused by congestion of blast cells in the tiny blood vessels.

If there are any of these symptoms, it is worth remembering that they are typical of many other diseases.

Diagnosis of chronic myeloid leukemia in Israel

In connection with minor disease symptoms usually detected by accident. A blood test showed a high number of white blood cells - the immature granulocyte.

Diagnosis and treatment of diseases of a team of doctors in an Israeli hospital.

Initially hematologist collects history, examines the patient, checks whether the enlarged lymph nodes, spleen or liver. Performed several blood tests. If the results show the presence of leukemic cells, conducted additional tests to help identify the type of leukemia, the degree of development of the disease. It helps to plan treatment in Israel.

Bone marrow biopsy

A small sample of bone marrow is taken from the rear of the femur, or sometimes of the sternum. She studied under a microscope for the presence of abnormal cells. After hematologist determine their view, he can be called a type of leukemia. Other tests help confirm the diagnosis and determine the treatment plan - cytogenetic and molecular tests (PCR) that detect abnormal gene fusion.

Sometimes holding trepanobipsii required when the bone fragment is removed together with the liquid.

further tests

The Israeli clinics may be employed and medical imaging techniques:

  • Chest X-ray to check the status of the heart and lungs.
  • US operate at the increased size of the liver and spleen.

Cytogenetic test examines the blood and bone marrow samples to detect the Philadelphia chromosome. Its results help physicians choose the best treatment option for chronic myeloid leukemia.

PCR

PCR (polymerase chain reaction) examines blood for the presence of abnormal gene BCR-ABL. This is a very sensitive test that helps detect signs of leukemia, while other studies did not find them. It is used to confirm the diagnosis - chronic myeloid leukemia and monitoring the body's response to treatment.

Stage chronic myeloid leukemia

Allocate not step, and phase CML: chronic, accelerated (acceleration phase) and the final (terminal).

chronic phase

The disease develops very slowly and often stable for a long time. May be absent any symptoms, most people lead a normal life.

During this period, patients rarely need to visit the clinic. chronic myelogenous leukemia treatment is done on an outpatient basis and does not cause many side effects. Perform regular blood tests to check how well the body responds to therapy.

The majority of patients who are beginning to treat myeloid leukemia in the chronic phase of the disease is well controlled, without causing symptoms. If therapy is constantly going on, the disease can be kept under control for many years and possibly decades.

Some people with CML responds poorly to treatment. And for about five years after diagnosis of the disease can progress, moving from the chronic phase to more advanced.

Accelerated phase (acceleration)

A small number of people chronic myeloid leukemia can gradually move to this stage. The disease develops faster, bigger blast cells present in the blood and bone marrow. Sometimes these changes can be seen with the help of blood tests, using the microscope. If the patient is unwell or discovers any new symptoms, it is imperative for them to tell the doctor.

The final phase

After some time in the accelerated phase (usually a month), the disease becomes terminal, getting acute myeloid leukemia symptoms. At this stage, a large number of blast cells fill the bone marrow, their high level is present in the blood.

Sometimes the disease is not responding to treatment. Then she passes the accelerated phase and immediately goes into the final phase or blast crisis.

Remission

When remission normal state of the blood and bone marrow after treatment. Distinguish its different levels.

Israel clinics can provide accurate and rapid diagnosis of chronic myeloid leukemia, find the most suitable treatment to achieve the best results. If you need assistance, please contact us.