Acute myeloid leukemia
Myeloid leukemia or acute leukemia, acute myeloid (Acute myelogenous leukemia) in children, is a disease and throw affects the tissue making blood bone marrow, where Ttsrtun primary cells that develop to produce cells lymph white blood cells, and appear in large numbers in the bone marrow and blood as cells cancer is able to move, and this is the type of leukemia is less common type of lymphoma, leukemia, and that alone was one of the most common tumors of blood in children, and the most common tumors among them.
And leukemia complex disease types and forest multiple, and different treatments and patients varies greatly depending on the type of the disease and the various factors for each person, and we will talk in this article for leukemia in general, with the allocation of talk about the type spinal when referring to the classifications and stages of treatment and some distinctive characteristics.
And we need at the outset, and to understand the variations of the disease, familiarity with some basic information about the circulatory system and lymphatic system.
Blood and lymphatic system
Bone marrow
Bone marrow is the spongy tissue soft, and called the spinal cord red, and located within the portion bones known bone spongy, and whose main function in the production of blood cells, and consists of an integrated network of blood vessels and tissue surrounded by fat and stem cells (Stem cells) that turn to blood cells of different stages of maturity of the final, as divided as the cells of origin of new, or grow and get bigger process Tnasagah naturally calculated to be blood cells, red blood cells (which carry oxygen and some of the materials vital to all body cells), and blood cells white (which defend the body against foreign objects and fight infection) and platelets (which Ttglt to prevent bleeding at the wound or cuttings), and present the bone marrow in each bone at about the babies, while Prior to puberty resides mostly in the bone flat, such as bone and skull bone ribs and shoulders and hips and rear.
Blood
Blood consists of plasma and different types of cells, plasma and consists largely of water and multiple chemical compounds, such as proteins, hormones and various minerals and vitamins, while blood cells include white blood cells and red and platelets.
Red blood cells
And are given a blood red color and is approximately half its size and contain the protein hemoglobin which carries oxygen from the lungs to various body tissues and carries carbon dioxide return, and a lack of red blood cells or hemoglobin leads to the emergence of anemia (anemia).
White blood cells
And is the basic tool in the body's immune system, as it defends the body and fight infection, attack foreign objects, such as bacteria or fungi, viruses or bacteria of different, or any foreign objects enter the body in addition to Almtsrtunh cells, and there are several types and classifications of cells white blood, and the three main types are:
Lymph cells (lymphocytes)
And is divided into three types: B cells (B lymphocytes), T cells (T lymphocytes), and cells are inherently genocidal (Natural Killer cells NK), and are integrated together as part is very important in the immune response, B cells help fight bacteria and some foreign organisms, and by producing Ddiat exotic particles (antibodies) or antibodies, which in turn serve as a guide or a feature of the objects targeted as stick proteins specific reside on their surfaces called antigens (antigens) Vtzmha and learn what attracts so species macrophages of the immune system cells , you swallow it, and attract the kind of blood proteins that destroy the bacteria causing holes in the wall of their cells.
While helping T cells in virus protection, where it can distinguish chemical specific, located on the outer surface of cells infected with the virus, whereupon destruction that secrete substances especially melt the outer membrane of these cells, and they secrete substances regulating the reactions of the immune system are called triggers cellular (cytokines), Tstnhi other types of cells, white blood cells to attack infected cells, and believed that T cells are attacking and destroying some types of cancer cells in the same way, in addition to attacking the cells of the transplanted tissue to the body, (so have patients who have had organ transplants , special drugs to thwart the reaction of T cells).
Granule cells (granulocytes)
And is divided into three sub-types, basal cells (Basophils) and oxyphil cell (Eosinophils) cells and neutral and also called neutrophilic (Alenetrovil neutrophils), and are differentiated by size and color of granules inside the phenomenon under the microscope, and these particles act as mainly in the fragmentation of chemicals cell organisms attacking the body, and of course going through the granule cells in several stages to grow and mature cells of the spinal primary to adult cells capable of defending, and are struggling, particularly bacterial infection and inflammation and symptoms of allergy, and the remaining fifty vessels for a relatively short period ranging from several hours to several days.
Single cells (monocytes)
And foreign objects are destroyed and transformed into the cells of omnivorous when needed, which in turn devour foreign organisms and help to distinguish lymphocytes and the production of exotic particles Ddiat.
Platelets
And actually consists of particles like cells resulting from the fragmentation of a type of bone marrow cells known as cell Anaqbih huge (megakaryocyte), and that turns into a bloody sheet, and are classified within the blood cells and is important in its function as part of the protection mechanisms in blood, and the main role in the formation of clots and protect various tissues from bleeding, Bertgaha and closed positions for cuts or cuttings in the body.
Lymphatic systemAnd the lymphatic system consists of lymph vessels that resemble blood vessels, and branching out into all parts of the body and passes through the lymphatic fluid, and is a colorless liquid secretions of cells carrying excess and waste products and immune system cells, and the network of blood accumulate in the lymph glands called the small organic lymph nodes, which in turn sets located in different parts of the body, such as the armpits, neck and abdominal cavity, (as is the spleen and tonsils and the thymus glands of the lymphatic system within the task), and stored in such a lymph gland cells (Lymphocytes) that are master cells in lymphoid tissue.
Please go to Page immunotherapy for more details on the lymphocytes and the lymphatic system.
What happens when the leukemia
Controls the bone marrow to produce blood cells, and the emergence of precancerous leukemia, out of the production process from its natural course, and begins in the bone marrow production of abnormal cells from one type of white blood cells, which lose some of these cells the mechanism that controls the format of its growth and maturity, Instead of being mature and become a great and able to perform its functions, remain immature and are increasing in great numbers and continuously and at the same degree of maturity inadequate reached, and do not die when the end of its life, and turn into the cells of a tumor abnormal, and then spread to the blood circulation and the lymphatic system, and can collect as well as in tissue lymphoma composed inflation cancerous, and the statements that try to rally these cancer cells in the spinal rod production of blood cells other, and thus lead to a shortage and lack of enumerated body which affects the functions of different and is known as white blood cells play a key role within the overall immune system, and is supposed to protect the body from infection and foreign objects, including the different types of cancer cells, and paradoxically, it is also susceptible to carcinogenesis in turn.
And when talking about the leukemia, use the expression (Blast Blast) any priorities, to refer briefly to the white blood cells abnormal, and there Plast naturally any cells of the newborn on the way to maturity by the mechanism of natural, and this is usually less than 5% of the total cells produced by the bone marrow, and usually do not appear circulatory, and Albulast Allokimy is abnormal is normal in newborn cells remains small, immature, and very non-stop growth at a certain point one of the phases of its growth, and increasing numbers of excessive increase and therefore deviate from the normal course, and can be found in large numbers in the blood circulation and can be distinguished under the microscope and categorized easily.
When you see the huge numbers of abnormal cells (Allokimah) spinal cord occur in succession and the effects of successive and different directions, which leads to their accumulation in the spinal tyranny on the rest of normal cells that are produced, and occupies a major place within the bone marrow, which impede and prevent the production of red blood cells and platelets and white blood cells, natural, and develop different symptoms on the child clearly indicate that normal blood cells are not produced in sufficient numbers, and thus a failure in the performance of its functions as a result of shortages, when decrease in the production of red blood cells, it becomes the blood (mild) which makes the child pale and tired constantly and feel weak, because the blood does not carry enough oxygen to the heart, lungs and muscles and various organs, and the child has symptoms of anemia, and when the lack of platelets exposed the child to bleed bloody and sometimes without clear justification and without cuts (bleeding from the nose or gums, for example) or the presence of bruising is justified, and show symptoms of deficiency of blood platelets, while at the lack of white blood cells very healthy, lose body immunity natural, where there is sufficient numbers of normal cells and competent anti-virus and bacteria and foreign objects, and the baby is exposed to various types of infections easily, which may cost him his life in a short time, and show a white blood cell deficiency symptoms.
And can be full of leukemia cells abnormal and spread from the bone marrow into the circulation and the lymphatic system, and shows the count of white blood cells high, and may be passed to members of other vital body such as lymph nodes and spleen, liver, and central nervous system and brain, to settle and grow and evolve there as they do in the bone, it can also start other types of cancer in these organs and then transmitted to the bone marrow, and, of course, is not such a transition of tumor cells within the marrow types of leukemia.
It should be noted that, and in rare cases the tumor may appear Allokima spinal CORME solid, so-called isolated tumor Algarni particleboard (Isolated granulocytic sarcoma) or Green leukemia (chloroma).
Types of leukemia in children
Leukemia, multiple species, as there is a carcinogenicity of each component of white blood cells and branches, and when one person does not affect only one type of these cells (rarely), and the most common types include:
Lymphatic leukemia (lymphocytic leukemia), (to Amvoblastic or Amphouid), where the lymph cell carcinogenesis arises (and is the most common precancerous B cells and T cells to a lesser extent).
And spinal leukemia (myelogenous leukemia) or lymph or granular (or Mileblastic Maylwid) carcinogenicity arises where stem cells that normally develop into neutral cells, one of the types of granule cells, or single cells arise, and in rare cases Ttsrtun stem cells turn into cells red blood cells and bone marrow that turn into platelets.
And compared to the maturity of most of the leukemia cells and body symmetry with normal cells, in addition to the speed of their reproduction and development (or aggressiveness), is classified into acute (Acute), and chronic (Chronic).
Where when acute leukemia cells are abnormal fall short of maturity, and remains extremely and continue to multiply and Crowding the spinal cord, and rush in the development of rapidly growing, without perish by the mechanism of natural life cycle of normal cells, either when leukemia chronic (rare in children), can be for these cells to mature, however, and despite her appearance, which is analogous to the appearance of normal cells the amount of it is not mature and not very full, and no functioning immune systems, as do the cells, white cells, and over-production and reproduction is not the main problem here (as opposed to acute leukemia), and the only problem is that the cells live longer than normal cells, leading to rally large numbers of adult stem cells, either granular or nodes, in addition to the slow push, and remains a bone of his part, able to produce a good number of normal blood cells for a long time, In this case, and for the period of time long evolution of chronic leukemia is a slowly less dangerous than the relatively sharp, and that the risk of change in the speed of evolution (depending on the stage) remains with the probability of transformation to acute type.
Leukemia, lymphoma sharp: (acute lymphocytic leukemia ALL) and is most common among children, with an increase of approximately 75 to 80% of all cases of leukemia, and usually affects children between two and eight years old, as they appear in adults, and for unknown reasons appear in males than females.
Acute myeloid leukemia: (acute myeloid leukemia AML), and appear often in people above the age of five and twenty, but they appear in children and adolescents, though less common and account for around 20% of the total cases.
Leukemia spinal chronic: (Chronic myelogenous leukemia CML) and is very rare in children, with an increase of less than 2% of all cases of leukemia, and what distinguishes it in some cases is the presence of a large number of cells neutral juveniles are underdeveloped, and that look able to maturity of more than primary cells, in addition to the presence of chromosome ill know Besbga Philadelphia (Philadelphia chromosome) at more than 90% of cases, and on the other hand changing the speed of development of this type significantly in some cases, and may turn sometimes to the type of acute .
Chronic lymphatic leukemia: (Chronic lymphocytic leukemia CLL) and is very rare in people under forty, and have no symptoms associated in its early stages and is not the usual address these phases, and if the patients remain under surveillance for fear of its development, and strange This type of medical statistics that indicate a risk ratio of 1: 4 for the injured first-degree relatives of patients.
It is worth mentioning that, and in rare cases Almtsrtunh cells are unmarked and difficult classification and is called in this case undifferentiated leukemia (undifferentiated), which appear when the patient all the advantages of spinal leukemia and lymphoma at the same time, and may show properties of spinal and nodes in the same cells Almtsrtunh, or carry some cells Almtsrtunh properties leukemia medullary and holds some of the other properties of leukemia, lymphoma, and is the classification of such cases difficult and controversial among medical schools, and was sometimes called the leukemia lymphoma acute indicators of medullary, or vice of any leukemia medullary acute indicators of lymph, or leukemia, called dual-mode (biphenotypic).
About the emergence of cancer
We need to understand how the emergence of cancer cells, knowledge of some basic information about the genetic characteristics and genes (genes), Valmorth is a part of the DNA Alrebonowi (deoxyribonucleic acid DNA) carries the characteristics of specific genetic and has a vital function specific, and an example set of genes color of the eyes and skin , or blood group, and this acid is a chemical that carries instructions for the system and the life cycle of cells, and the control of all its activities, and is the type of changes anomalies in the DNA of the genes influencing factor in determining the type of disease that may affect humans, and genes are parts of chromosomes (chromosomes), which can be likened to linear tape Mazfor of DNA, containing thousands of genes lined end to end, and the DNA is organized strictly in the 23 pairs of chromosomes, inherits half of each pair from one parent.
On the other hand may inherit one some of the changes the anomalous (or defects), DNA from his parents, which explains the appearance of some illnesses are common in some families, and called these changes Balthorat or changes the root of the structure (mutations), which also arise for reasons incomprehensible and unjustified imbalance just like the other images that affect this acid, which can be summarized in the following points:
Distraction of the chromosomes and the exchange sites (Translocation) between the two parts of the DNA, that is, a section of DNA Besbga a homeless HOS Besbga different and asymmetric with him, and this imbalance in particular is responsible for the emergence of some types of leukemia where it appears exchange Besbgaat different when each of them.
Reflection or the coup (inversion), which means that part of the chromosome is inverted, and overlay in reflected light it is still linked to the same chromosome.
Addendum (addition) of any part of the chromosome (chromosome or the whole) has doubled and many copies of it are located the cell, and is referred to with reference number chromosome positive (+7, for example).
Loss or erasure (deletion) of some of the clips DNA Besbga specific, and referred to as the chromosome number with a negative sign, eg -7 means that there is a missing part of chromosome VII.
And there are multiple types and so many of the genes, and each of them vital functions and characteristics of specific genetic, and contains some of the types of instructions and codes of genetic control in the mechanism of growth and division, and thus replication and reproduction for the production of new cells, and from these genes of certain urges and modify operations cell division, called idiomatically Btlieh gene tumor (Proto-oncogenes), and genes other slow and inhibit the division and reproduction, or give instructions to the annihilation of the self-cell, when needed, and called genes inhibiting the swelling (Tumor suppressor genes) .
And from here can Ttsrtun normal cells in the event of any of the mentioned types of imbalance structure of DNA, which in turn paid (directly or indirectly) to either run the forefront of uncontrolled tumor gene (which lose the ability to control cell growth and reproduction Turning gene and thus to throw (oncogene) is subject to stimulate an active tumor growth), or lead to frustrate the work of the inhibitory genes swelling, and end up with the emergence of a cancerous tumor.
It is important to know that, and except for genetic disorders that increase the level of risk for the emergence of some tumors (and it is not inevitable at all), do scientists know the real reasons and confirmed that lead to types of imbalance DNA, (or that trigger the trigger) and that lead to precancerous cells and the natural emergence of tumors.
In terms of leukemia can be argued that they arise from an acquired disorder and Viewer (ie, non-inherited) affects the DNA of a single cell bone marrow.
About risk factors for the emergence of leukemia
The term risk factors (Risk factors) to the factors and conditions predisposing to increase the likelihood of vulnerability to any disease, such as cancer, when any person, and there are risk factors for each type of tumor, and may include risk factors and genetic any associated characteristics of genes, in addition to factors related to the environment or lifestyle and living conditions, and although the factors on the pattern of living, such as smoking and poor nutrition or alcohol consumption or working conditions (such as constant exposure to chemicals), is one of the important factors in many of the tumors in adults, (and that does not mean that cancer is inevitable with the presence of these factors), but its impact is weak or absent when dealing with tumors of children.
And in the following paragraphs we are exposed to some risk factors for the emergence of leukemia:
Risk factors related to the environment
Means the risk factors of environmental all harmful influences in the environment, which affect the living conditions of natural (such as exposure to radiation or toxic chemicals or pollution), which increase the proportion of the risk of infections of different such as leukemia, and the following is a glimpse of some of these effects:
Radioactive contamination: Exposure to radioactive contamination and nuclear disasters one of the biggest risk factors for leukemia and is of the survivors of the atomic bomb in Japan clearest evidence of this, rates are higher in people with them (within 6 to 8 years after the explosion) to more than twenty-fold and especially the incidence of myeloid leukemia, and shows almost the same rate when exposed to radiation after the nuclear reactor accidents in previous decades, and the embryos subjected to intense radiation during the first months of pregnancy increases the risk is five times the risk of lymphatic leukemia.
Electromagnetic fields of high-tension: conflicting results of studies and inconsistent about the impact of exposure to EMF, high tension, such as housing near power lines, high voltage, and the mind within the main risk factors for leukemia, and suggest most of the studies published up to now is not to increase the proportion of the risk entirely , or the presence of a small percentage as a possibility exists, and to point out that medical statistics confirm that most cases of leukemia is associated with exposure to electromagnetic fields.
Chemicals: The constant exposure to chemicals (including gasoline), one of the risk factors in adults for the emergence of leukemia, acute myeloid, but he is not also and equally in children (except by a very small), and did not link any medical studies of leukemia, lymphoma and acute between any cancer-causing chemicals.
And has been disseminating the results of multiple studies on the various possible factors, without being binding and final and investigator between these factors and leukemia lymphoma, acute and of the factors covered by these studies are: age of mothers at the birth of children, and the use of maternal alcohol or smoking, or the use of contraceptives, in addition to areas of work of parents and the constant exposure to chemicals or solvents, chemical, and contamination of water wells with chemicals, and children's exposure to pesticides, and on the other hand there are studies suggesting that drinking alcohol in pregnant women increases the proportion of risk for the emergence of acute myeloid leukemia at birth.
Risk factors for tumor treatments
According to many medical studies for a direct relationship, and by the seriousness of small, between the treatment of cancer patients, whether adults or children chemotherapy and radiation therapy, and between the appearance of secondary tumors is the tumor the original processor (especially leukemia, acute myeloid) during the later periods of life, and these studies focus especially on the chemical class of drugs known as alkylating elements (Alkylating agents) such as real estate Saakulovosvamaid and linked the emergence of secondary tumors, and also suggest that leukemia usually appear in periods ranging from 5 to 8 years after the treatments, and are classified under the category of species intractable to treatment, and on the other hand the percentage of risk for the emergence of cancer, particularly tumors of the lymphatic system, (including leukemia, lymphoma acute, of course), when the cases were subjected to processor intensive to thwart the immune system (which is when the configuration of the transplant is Main).
Genetic risk factors and genetic ills
Found to scientists for decades, that man may inherit from parents on some changes and imbalances blades genetic DNA of the cells, which in turn cause disease spread in the family-specific, such as bug Naaourah (hemophilia), and sickle cell anemia (sickle cell anemia), and some of the These diseases lead to the birth of the child immune system is natural or is incapable, and thus increase the hazard ratio for the emergence of leukemia.
On the other hand higher rates of risk of some types of birth defects, which are defined Palmtlazmat (syndromes), and can be defined the syndrome as a set of concurrent symptoms and deformities or disabilities or anomalies other, which appears in most cases combined in the same the patient, such as Down syndrome or Mongolian (down's syndrome).
And the syndromes that increase the proportion of risk for the development of leukemia:
I Fraomena syndrome (Li-Fraumeni syndrome), which increase the hazard ratio for leukemia in addition to Algarnih tumors of bone and soft tissue tumors and breast cancer and brain tumors.
Mongolian or Down syndrome (down's syndrome), which increase the rate of risk for the emergence of leukemia, where at this syndrome, there are three copies of chromosome number 21 instead of having two copies of each chromosome, and for reasons poorly understood cause of this increase in mental retardation and similar distinctive appearance of the face in patients with this syndrome, and those who exceed their risk of leukemia fifteen times (whether spinal or lymph).
Syndrome Klinfeltr (Klinefelter's syndrome), and is the state resulting from the disruption of genes where there is the male chromosome plus a Class X (x chromosome), which leads to infertility, and prevents the natural development towards adulthood (such as the appearance of body hair and signs of puberty), and has been the link between this syndrome and increase the risk of the emergence of leukemia.
Add to the above, there are other imbalances genes such as those tumors nerve fiber (neurofibromatosis), and syndrome Wiskott-Aldrich (Wiscott-Aldrich Syndrome), and anemia, Fanconi (Fanconi's anemia), with a small percentage of risk for the emergence of leukemia, and is carrying the proportion of the largest of the emergence of lymphomas (especially Allahoddgkin) and some other tumors.
It is worth mentioning the other hand, the proportion of risk with the twin brother replication of a child with leukemia (either spinal or nodes), ranging from 20 to 25% during the first six years of age, while no more than 2 to 4% at Twin asymmetric or siblings others.
About the symptoms
Show most of the symptoms and signs of leukemia as a direct result of the lack of blood cell count to the body, and which is caused by confluence of cells Almtsrtunh bone marrow, which prevents the production of normal cells, and may show early symptoms are similar to symptoms of regular cold, or similar diseases, from courses fever endless and trembling, and feeling the pain of joints and bones, and repeated exposure to different types of infection, and may complain of the child beginning of the shortness of breath and feel the tiredness and fatigue, loss of appetite and weight, and it seems the color of the skin pale and yellow as a result of poverty blood and lack of red blood cells, in addition to the ease of bleeding or swelling lymph nodes.
On the other hand may coalesce cancer cells in the brain or spinal cord, and may show symptoms such as headache, severe and continuous, or impaired vision, or the inability to maintain a balance, or ease of fainting, and vomiting, and mental confusion, and lack of control over some muscle, or seizures, and may also accumulate in the testis, causing Ptdkhmha, and leukemia may affect sometimes the digestive tract or kidneys or any other part of the body.
And we review below the most usual symptoms:
Infection used to be subjected a child with leukemia to any infection easily, adding that such infections do not respond to antibiotics, and the child has high fever and exhaustion, physical, and is caused by decrease in cell count white blood corpuscles to the natural and especially the granule cells, Despite the high census of white cells in some cases, however, that the cells Almtsrtunh not combat infections as do normal cells, of course.
Easy bleeding and bruising may appear on the child's tiny red spots under the skin caused by bleeding from the capillaries, or appear bruised is justified (or a minimum of bruising) and colored dark blue or black, in addition to bleeding gums or amplified, or easy bleeding in any position , and prolonged bleeding wound to the lowest, and all this results in deficits in the production of platelets.
Fatigue and pallor of the skin: the patient may suffer from shortness of breath and feeling tired and lasting fatigue, and it seems the color of the skin and lips pale and return it to the lack of red blood cell count, and emergence of anemia.
Bone pain: About one third of child patients from bone pain and suffering is less than the pain of arthritis, and be due to a rally beneath the surface of leukemia cells in the bone or joints.
Abdominal cavity inflation: inflation caused leukemia spleen and liver in some cases, and this may seem like inflation, the stomach is full, and despite the lower ribs to cover these organs but the doctor can distinguish such inflation easily.
Swollen lymph nodes: Can leukemia cells to move to the lymph nodes, causing Ptdkhmha, and this may seem inflation evident when infected glands near the surface of the body (such as glands, both sides of the neck, underarms or near the collarbone), but it is difficult to distinguish inflation glands inside the cavity abdominal or chest without the use of imaging studies, such as CT or MRI.
Enlarged thymus gland (thymus thymus):
Than usual to affect carcinogenesis T cells directly on the thymus, leading to amplified, and this gallery is especially dangerous, as it added to the pressure of the gland swelling (or any gland lymph others) on the trachea, leading to shortness of breath and cough , and sometimes even to suffocation, pressing on the swollen thymus superior vena cava (which carries blood from the head and arms to the heart) to the emergence of bug superior vena cava (superior vena cava syndrome SVC) dangerous, and which require prompt treatment, and the emergence of symptoms swelling of the head and chest Baldhirain and the highest, with the change of color of the skin such placements to bluish red color, and may affect the brain and is also threatening the life of the child seriously.
Headaches, seizures and vomiting: can the leukemia cells to move out of the bone marrow in what is known to spread outside the core of the bone (extramedullary spread), and can be transmitted to the central nervous system of any brain and spinal cord, or to members of the vitality of others, including the testicles or ovaries, kidneys, lungs, heart or intestinal tract, and it was noted that at about 10 to 12% of cases of leukemia, acute myeloid appears to spread to the nervous system at diagnosis, while the figure is less than about half, when cases of leukemia, lymphoma, acute and indicators common to such Jump emergence of physical exhaustion and headaches, and seizures, and vomiting, and difficulty keeping balance and motor blurred vision, and drowsiness.
Rash: appear when some cases of acute myeloid leukemia is a rare symptom, such as inflation and gums bleed because of the transmission of tumor cells to it, and the appearance of small dark spots on the skin like a rash caused by transmission of tumor cells to the skin, and these cells may coalesce under the skin (or other placements), creating what is known as leukemia green (or green tumor chloroma) of the above.
And there opposed the last serious of leukemia acute myeloid, and if rarely, is the suffering of the patient's weakness and fatigue intense, the difficulty of pronunciation and the weight of the tongue, and is caused by the presence of large tumor cells with blood (which makes it thick) and it affects flows at the capillary blood vessels in the brain.
On diagnosis
Of course, requires a diagnosis of leukemia, an analysis of different blood and the bone marrow cells, since they may represent the early symptoms and clearly many other diseases, including anemia caused by other ailments, and infections and tonsillitis, and cases of rheumatism and inflammation of the meninges , in addition to other types of cancer, and it is important to determine which components of the white blood cells may be precancerous to determine the type of leukemia, since the treatment plans and the response is different in each type and when each case, and were often determine the type of leukemia from their appearance under the microscope, and sometimes may require a special analysis of the chromosomes and genetic biochemistry of the cells.
At the onset of symptoms can be attributed to leukemia, the doctor conducted a preliminary analysis of blood to the census of cells and examine the sample under the microscope, Changes in censuses blood cells are different and the appearance of microscopy is an indication that there is something wrong, and than usual to show the blood of patients large numbers of white blood cells with a lack of census red blood cells and platelets, in addition to most of the white blood cells are just cells, an initial (Plast), which is supposed to present the bone marrow and not circulatory, and despite these facts disturbing but it can not be confirmed and the presence of leukemia without examination of bone marrow cells microscopically, and the extracted sample by the extraction bone marrow, and examine it carefully under the microscope in order to detect the presence of tumor cells and the type and characteristics of vital, and the doctor may explore the cerebrospinal fluid surrounding the spinal cord and brain, to check the spread of cancer cells to the spinal cord and brain and that withdrawal of the said liquid sample, typically through the gaps between the bottom of the lumbar spine by a needle of poetry, and examined under a microscope.
And are made to explore the spinal or biopsy of bone marrow (Bone marrow biopsy) after the diagnosis, to determine the type of tumor and to determine the percentage of abnormal cells, and routinely during the sessions of treatment to determine the proportion of abnormal cells remaining and the response to the processors, so modify the treatment according to the developments, for example, The Show of exploration that the bone marrow contains less than 25% of tumor cells, the Panel recommends the processor to continue on the same chart therapeutic, but if showed that the bone is still thronged cells abnormal and prepare the child is slow to respond to the treatments, you may be required course of treatment more intense.
And is conducting this exploration, which is also known as the process of extraction of bone marrow (Bone marrow aspiration) usually after the end of each course of treatment, and is conducted to withdraw from the bone marrow biopsy sample, usually from the rear hip bone where the bone just under the skin and contains quantities large bone, and is the process of extracting the sample that lies the child lying on his face, and may be placed beneath a pillow suitable for raising the level of the body, and the doctor locate and draw appropriate and disinfected, and then the use of anesthesia appropriate, either topically or anesthesia short-term, then enters the needle withdrawal, which is not much different from the normal needle through the skin to the bone and the withdrawal of the sample which cylindrical diameter of 1.5 mm and length approximately 12.5 mm, and are examined under the microscope, and this process takes no more than five minutes.
On the other hand, and in some cases may be a biopsy of the lymph nodes position is to investigate, in addition to a series of radiological images of various x-rays X, and X-ray CT (Computed tomography scan) in addition to imaging MRI (Magnetic resonance imaging using magnetic waves to put multiple images of the body) and ultrasound, to determine the effect on other members of the body especially the liver and spleen and lymph nodes.
And the usual analyzes cellular especially in cases of leukemia, and are tests designed to study the changes DNA of the cells tumor, and the changes and exchanges in the types of chromosomes, genetic as well as to detect cancer cells using Ddiat exotic particles (Antibodies), making it possible to determine the type of Leukemia and planning different processors, and this analysis conducted on samples extracted cells from the bone marrow and cerebrospinal fluid, and lymph nodes and blood samples, in order to investigate whether abnormal changes in the size of these cells or their behavior or phenotypic characteristics under the microscope, and analysis of genes is the cellular (Cytogenetics) of the most important of these tests for identification of genetic changes in the chromosomes, as has been said since human cells contain 46 chromosomes natural (chromosomes, which are pieces of DNA and proteins that control the life cycle and cell metabolism), and in some types of leukemia, Part of one chromosome with part of chromosome is different, and an exchange of positions between the bonds of chromosomes (Translocation), and can usually finding such exchanges under a microscope, and of course help distinguish the exact type of cells Almtsrtunh and planning for treatment, and to predict therapeutic Palmrdod and assess the situation.
And in this regard it should be noted the presence of chromosomes than the normal number cell tumor in some cases, and noted that the leukemia cells lymph sharp shows the number of 50 chromosomes are more susceptible to chemotherapy, while those that contain fewer than 46 chromosomes, they are more resistant of chemical drugs, which requires the receipt of more intense doses.
And please go to a page that tests and laboratory tests for more details on these various tests, and tests.
Classification of acute myeloid leukemia
Classified as leukemia, acute myeloid depending on the type of cells Almtsrtunh and appearance microscopy, and the case of the disease (rather than the classification of the progress, as in solid tumors), and there are four main types of them according to the type of bone marrow cells Almtsrtunh, any stem cells that develop into blood cells:
Granule cells of leukemia:
And are the most common, and arise when priorities medullary carcinoma (myeloblasts), which turn in the final stages to neutral cells (neutrophils) and basal cells (Basophils) and oxyphilic cells (Eosinophils), and can be distinguished easily from the microscopic appearance, and is divided into three types:
Medullary leukemia without maturation (Myeloblastic without maturation) that is the predominant cells at diagnosis is a spinal tumor cells without the presence of normal cells on its way to maturity.
Then with the maturation of medullary leukemia (Myeloblastic with maturation) the presence of normal cells in the spinal cord on its way to maturity.
The third type, which is a special known as leukemia cells, spinal premature (Promyelocytic leukemia, and these cells are one of the initial stages of early development and growth of cells, neutral), and in this type stops the growth of tumor cells at a point similar to the appearance with the appearance of cells premature natural spinal cord, and Perhaps more accurately be said to be frozen at this point where it can be paid to maturity, and are processed in a special way for different types of acute myeloid leukemia.
Unilateral leukemia (monocytic leukemia): carcinogenesis and priorities arise when single (monoblasts) that turn into single cells (monocytes), and is more common among children below the age of two.
Ahumairat primary leukemia (erythroleukemia): and arise when the initial precancerous Ahumairat (erythroblasts) that turn into red blood cells, and this type is very rare in children.
Leukemia Anaqbiat huge (megakaryocytic leukemia):
And established priorities for precancerous cells Anaqbih huge (megakaryoblasts) that turn into platelets, and equal growth of cells significantly with the growth mode of platelets, which requires the use of special dyes to distinguish them under a microscope.
According to the classification system is commonly acute myeloid leukemia is classified into eight categories, each of which symbolizes a shortcut to the first letter of the word spinal (myeloid) with numbering starting from M0 and M7 so that each category and indicate the type of cells Almtsrtunh:
M0: and placed in this category of cases that can not be discriminated spinal leukemia cells under the microscope, the very similar between them and the lymphatic leukemia cells, and the distinction is made following an analysis of cellular phones.
M1 and M2: This category includes cases of leukemia Btafratha granule cells.
M3: includes leukemia cells spinal premature (Promyelocytic leukemia).
M4: respect to this classification a single forest leukemia and myeloid leukemia known as unilateral
(Myelomonocytic leukemia) is shown as carcinogenesis and single granule cells in the same time.
M5: and respect to this category unilateral leukemia (monocytic leukemia).
M6: This category includes Ahumairat primary leukemia (erythroleukemia) very rare in children.
M7: and respect to this category Anaqbiat huge leukemia (megakaryocytic leukemia).
On the other hand are classified as leukemia, spinal condition, rather than phased approach in the classification of solid tumors into the following categories:
Leukemia untreated (Untreated): this means the term that the child is Wizard of leukemia with the exception of addressing the primary symptoms associated with, which means that the white cell count is too large, both in the blood or bone marrow, and may show signs and symptoms of other acute-associated leukemia.
The state of stability and freedom, or lethargy (Remission): This term means and that the child had received the necessary treatments, and had returned and settled censuses of white blood cells and other blood cells to normal levels both in the blood or bone marrow, and tumor cells in the case of depression , and there are no signs and symptoms of leukemia.
If you revert or frequency (Recurrent): this means that the expression Allokima carcinogenesis has returned, and a back stage after the achievement of inertia, and also means the lack of freedom and lethargy after receiving initial treatments required by standard treatment programs.
On the treatment of acute myeloid leukemia
Is the most cases of leukemia are curable at high rates, and treatment is a complex and multifaceted and vary from one type to another and from one patient to another, and does not depend on the type, but on various aspects such as the behavior of abnormal cells and density of its presence and prevalence, as well to the child's age and general health condition and physical structure.
And of course it is very important to start treatment if diagnosis of acute leukemia, and without waiting, and targeting treatments to reach the stage of the siege of leukemia cells and eliminate them or stability (Remission induction) and is also known as phase to achieve freedom, then the stage of strengthening and stabilizing ( Consolidation), which also include operations to protect the central nervous system, followed by the stage of prevention and maintenance (Maintenance) in some cases, especially classification M3, and the other hand, the prospects for recovery depend on the standard combination of several factors, most importantly the child's age at diagnosis and blood cell counts white in the blood and the prevalence of disease and biological characteristics of the cells Allokimah, in addition to its response to the treatments received.
In this context, we need a reference to the factors that predict Palmrdod therapeutic or indicators of disease (prognostic factors), which is important for physicians identified from the outset through the data of various tests and analysis, to be able to arrange treatment plans appropriate in each case, and determine whether the situation requires sufficiency standard treatments, or treatments require extensive and more stringent.
And in this regard, cases of leukemia are classified into three categories:
Hazardous standard or moderate (standard risk), and the category of high risk (high risk), and the category of high-risk (very high risk), and of course require the last two categories treatments, intensive, and the cases of danger moderate to respond to treatments and check year cure rates higher standard than others.
In terms of acute myeloid leukemia is the following indicators of the directories and the task that should be calculated:
White blood cell count at diagnosis: is the child of high-risk category that exceeded the white blood cell count Balmellimitr 100.000 cubic cell at diagnosis.
Cellular analysis: According to medical studies for low cure rates at the standard cases of leukemia medullary syndrome associated with poor spinal growth (myelodysplastic syndrome with bone marrow produces too few blood cells, in addition to the death of these cells early stages before they mature, and also called the underlying leukemia) , and reduced rates when cases of infected defects of chromosomes known as mono-chromosome VII (Monosomy 7), which lacks this chromosome cell leukemia a Nschtah the two, and on the other hand is the chances are good to a great extent when there is exchange of chromosomes (translocation) cell leukemia between chromosome No. 15 and No. 17, and between Nos. 8 and 21, or when there is a reflection Babbga No. 16.
Respond to the treatments: low rates of recovery standard in children who respond slowly to chemotherapy, and the need for more than one session to achieve stability, while higher rates at cases that respond to and achieve stability after receiving the course of treatment first, and in this context is classified cases of leukemia, acute myeloid into three categories depending on the response to treatment standard, the category of weak response, Standard, or good.
Down syndrome (Down's syndrome) or Mongolian: high cure rates in children with standard compared to other Mongolian.
Morphology under the microscope is given the appearance of leukemia cells for microscopic evidence of good chances of recovery, for example, when the granules are formed within the cells of leukemia in the form of needle or bacillary (notes and a lot of cases when classification M2 and M3) are good chances of recovery.
About the types of treatments
The line chemotherapy for initial treatment of acute myeloid leukemia, and radiation therapy is used for certain cases, may also be a marrow transplant bone marrow in some cases.
Chemotherapy
Chemotherapy is the treatment using special drugs known drug chemical anti-cancer, the elimination of cancer cells and destroy them, and so disrupt and undermine the coordinated biological processes within them, and come the main advantage of this treatment of his ability to deal with tumors of mobile and deployed, whereas the radiation therapy or work on the surgical treatment of specific placements administration, confined tumors, its effectiveness and unique due to the fact that cancer cells, in a way, is more sensitive and more susceptible to chemicals than normal cells. And may be used as a treatment only in some cases, or part of a treatment program integrated includes several treatments in common, and decision-making by using this treatment, the balance between effectiveness and side effects and complications of the future, and between the seriousness of cancer, and of course Vamadaafath and its acceptable compared to the same disease, in addition to the positive therapeutic yield significantly.
And may be called the chemotherapy treatment systemically (systemic); due to movement of drugs, chemicals via the blood to all parts of the body, and its ability to destroy cancer cells wherever notified, and may be used before the direct surgeries when solid tumors to prepare them, and in order to facilitate; Bhzareth and shrink the tumor, what is known as chemotherapy Initial Assistant (Neoadjuvant), may also be used after surgery and eradication of tumors; to eliminate any cells of a tumor is characteristic may be outstanding, and to help prevent the return of cancer, what is known as chemotherapy additive (adjuvant) .
And be dealt with chemotherapy drugs in ways and different channels, some of which are taken orally in the form of tablets or capsules or liquids, and most of the body is injected, the injection of different ways: by intravenous injection, intramuscular injection, injection into an artery or a major injection topically directly under the skin, and if intravenous is the most widely used method, and may use other means to assist in the injection, such as catheters (catheters), which is implanted usually chest and can be used for long periods, and is injected drugs directly into the spinal fluid cerebrospinal surrounding the spinal cord and brain, known as the injection vaginalis, both to eliminate tumor cells, or to protect the central nervous system and brain, and is usually injected through the lumbar spine down the spine, or via a catheter especially planted under the scalp known as portfolio Omaya ( Ommaya reservoir).
And treatment programs consist of several repeated cycles separated by periods of convalescence, and the patient may receive during each session, a combination of several common chemical drugs, or are limited to one drug, by type of tumor and the planned therapeutic approach in each case. And in general is the use of chemotherapy during the time periods prolonged to reduce how much the cancer cells gradually, to the extent that enable the immune system control of any growth and throw, in addition to that space of time between doses are placed in order to achieve the greatest effect on cancer cells, and At the same time give sufficient time to allow cells and tissue normal to recover from the effect of drugs, chemicals, because of the types of drugs, the different effects of varying degrees on the cells and organs of natural sound, especially the cells and tissues rapid growth and heavy reproduction and a permanent replacement, such as bone marrow cells, and blood cells, and cells and tissues of the digestive system, in addition to some vital organs like the liver and kidneys, which in turn leads to complications side effects, which vary in intensity and quality of the drug to another and from one person to another, and of course of treatment to another even for the same person, and depend mainly on the type and dose of the drug user and the interaction of the body about it, and these effects are multiple; frustration include bone marrow (and thus decrease blood cell count), and complications of the mouth and gums (such as inflammation and ulceration and drought), and hair loss temporary, constipation, diarrhea, and fatigue, nausea, vomiting, loss of appetite, and feel the skin and skin, and usually take drugs to help and take some preventive measures and support; to avoid such effects and to prevent them and to alleviate it, before and during treatment sessions and after termination.
And in this regard it is useful to note that there are some leukemia cells changes genes making them resistant to chemotherapy, in particular, and show these changes Bmorth drug resistance multiplier (multiple drug resistance MDR), which allows cells Allokimah expulsion fast for some drugs the chemical from within the cells to abroad, which prevents from a pool of the drug inside the cell quantity necessary to eliminate them, and this gene is particularly important in the treatment of leukemia, acute myeloid, and for this reason are addressed leukemia using high doses of chemotherapy over a short period while treating leukemia, lymphoma acute low doses over a longer period.
It should also be noted that shows the incidence of leukemia and lymphoma viewer knows syndrome decomposition of the tumor (Tumor lysis syndrome) and is considered as one of the side effects of chemotherapy, and produces at the rapid degradation of the cells Allokimah and lymphatic tumor, which, when death released waste decay and some metals circulatory, (it appears that high rates of potassium and phosphate and uric acid, and low levels of calcium), which affects the kidneys, heart and nervous system, and this gallery is to avoid increasing rates of perfusion of the child and make sure drink plenty of fluids, and giving intravenous fluids in large quantities by adding bicarbonate to increase alkalinity of the urine, and the eating of certain medications such as real estate Alleuprenol (Allopurinol) and drug Yorikosem (uricozyme) to help the body get rid of this waste and reduce uric acid levels and to protect the kidneys.
(Please go to chemotherapy, to view more details about this treatment and methods of its management and its complications).
Radiation therapy
Radiation therapy is the treatment using the different applications of ionizing radiation (ionizing radiation), to destroy cancer cells and shrink tumors, both using the elements and isotopes, or by using a stream of radiation, revived and high-energy, x-rays, or radiation such as gamma rays, or stream of neutrons or protons, and the effectiveness of the radiation is concentrated in its ability to undermine and break up the DNA of tumor cells, and is a vital and fundamental article of the various cellular functions, leading to elimination.
Radiation therapy is topical treatment, and is divided into two types; internal (Internal), radioactive elements are grown directly into the tumor tissue, or close to it, either temporarily or permanently, and external (external), where the broadcast radiation from the radiation machine shed the positions of the tumors, and may be used both types in some cases.
And uses the external radiation when the leukemia in cases that require only that (especially address the leukemia cells located membranes meningitis, brain or testes, and in rare cases such as dealing with an emergency when there is pressure on the trachea), and of course, and to avoid the effects of radiation, is to take preventive measures During radiation therapy, to protect tissues and organs within the natural sound field processing.
And may be the use of radiation therapy alone, treatment only, or jointly with treatments other tumors, and may use a substitute for surgery as initial therapy, when some solid tumors, may also be used by the direct action surgical known as the treatment initial Assistant (neoadjuvant therapy), order to reduce the size of the tumor; to facilitate the eradication, or is used after excision surgery as a treatment additive (adjuvant therapy); in order to eliminate any tumor cells is characteristic may be outstanding.
And, of course, for the treatment of radiation complications and side effects associated with, linked to the overall locus of treatment, and result in general from affected cells and tissues rapidly growing and replacement, and from these effects: complications of skin and skin, and fatigue, and infections and dry mouth, and hair loss, nausea, gastrointestinal problems, and thwart the bone marrow, and is taking some preventive measures and support, and taking medication assistance; to avoid such effects and to alleviate it.
(Please go to radiation therapy, to view more details about this treatment and methods of administration).
Marrow transplant bone marrow (Bone marrow transplant)
As noted above Valenkhaa marrow is the spongy tissue soft and named spinal red, and located within the portion bones known bone spongy, and whose main function in the production of blood cells, and consists of cells mutant (turn into blood cells of any generator of the components of blood hematopoietic cells) , and fat cells, tissues and help the growth of blood cells.
And cells at the beginning of the configuration (initial) called cells Aboriginal or stem cells (Stem cells), and is the division's self-multiply, producing stem cells, new, or you through a series of divisions, cumulative, and the transformations successive production of blood cells of various (white blood cells and red and platelets), which continues to stages of growth and maturity within the bone marrow, and there is bone marrow in the bones almost all infants, while Prior to puberty, is concentrated mostly in the flat bones, such as skull bone, and shoulders, and ribs, and pelvic bones, and joints of the arms and legs.
And comes the need to perform marrow transplant bone marrow (Bone marrow transplant), or transplantation of stem cells (Stem cells transplant) when unable bone on the performance of its functions, and result in the deficit either by the effects of the cancer itself, which makes him either a product of cells of a tumor abnormal , or a product of small numbers of blood cells, or resulting from the effects of drugs, chemical and radiation therapy severe, it may be necessary to eliminate cancer cells, (especially when the tumors of blood and lymphatic tumors, and some types of solid tumors), follow the treatment programs is strong, dose intense frustration and lead to the destruction of the bone itself, and hence the target of transplantation, replacing the injured spinal cord stem cells, cancer, or frustrating treatments, cells intact and healthy, capable of growth and reproduction and the production of blood cells.
And possible sources of stem cells extracted and used for transplantation, including bone marrow and blood circulation, either from the patient himself or from a donor, and recently conducted studies to be drawn from the umbilical cords of newborns.
Divided transplantation into two types according to a source of stem cells, autotransplantation (Autologous) where extract these cells from blood or marrow the patient himself, and transplantation-sex or lineage (Allogeneic) where a pool of blood or marrow donor, and are selected donor appropriate following an analysis tissue special blood, known analysis antigens leukocytes (human leukocyte antigens HLA) and aims of this analysis, matching blades genetic protein antigens, produced by white blood cells, and are special proteins Highlight and attacking foreign objects as diverse as bacteria or viruses, and The success of agriculture over the tissue match between donor and recipient, and is a perfect fit, which brings together six groups of these proteins, and the donor twin brother is a perfect replication, followed by the brothers, then a parent, a donor or a non-kin of the patient.
And is the bone the main source of stem cells, and when the use of autotransplantation, is to draw the amount of marrow of the child, and is processed to eliminate any cancer cells, and then kept under the freeze, and are giving the child high doses of drugs, chemicals, with radiation therapy with or without , and to destroy the entire spinal balance, and then implants the bone processor, and when using the implant gay, is to draw the amount of marrow donor, after the tests and analyzes different; to make sure that his general health and free from infectious diseases, and is the selection and collection stem cells separately, and after the stages of creating a patient for transplantation, by giving high doses of chemical drugs with or without radiation therapy in order to thwart the immune system and for the destruction of the infected bone marrow, stem cell transplant is selected.
And is extracted stem cells from blood circulation and is known in this case the cell periphery or periodic (peripheral stem cells) and the quantity is usually sufficient to collect, and thus become used to implant the self-practice, when there is the possibility to urge the bone marrow in the patient, the excretion in the session blood in sufficient quantities for transplantation, but when gay culture, will be gathered from the circulation of the donor; the blood passes through the filter of the machine, the separation of these cells separately.
And, of course, involve the transplantation of different complexities and complications, such as difficulty in finding the corresponding donor, and complications associated with the process, the effects of chemotherapy and radiation treatments, and the risk of transplant rejection, and failure of cells cultured in the stability and reproduction.
(Please go to Page marrow transplant bone marrow to view more details about the transplantation).
About the stages of treatment
Supportive care
Normally, the sick children at a critical moment when diagnosed with leukemia (and also while receiving treatments) deficiency in the rate of white blood cells normal may lead to exposure to infection, dangerous and deadly, and may be exposed to severe bleeding as a result of decrease in the rates of blood platelets, in addition to the risk of poverty blood as a result of the shortage in the rates of red blood cells and that the most serious relapse heart as a result of deficiency of oxygen nourishing the muscles, and from here comes the need for supportive care consistently, which include receiving antibiotics and medication support, and drugs known stimuli growth components of the blood (hematopoietic growth factors ), and transfusions of blood and its components of platelets and red cells, and in order to address and avoid some of these risks.
Treatment plans
Treatment plans based on the classification of the child within the diagnostic categories and groups mentioned above, and especially the classification by degree of risk, and initially treated the child is usually the standard plans that have proven effective.
In general there are three stages of treatment for this type of leukemia, starting phase stability and suppression of tumor cells and then phase stability and phase to maintain and which are used when certain situations only.
Phase stability or freedom (Remission Induction)
And targeting of treatment at this stage seeking to put down what might be called the flurry of cancer cells of leukemia, using chemotherapy to eliminate as many as possible and to enter the process of freedom from the cancer, as the body of the patient at diagnosis is approximately 1 trillion a tumor cell to Okimah, and necessary eliminate 99% of that number to consider the disease in the case of the stability and subsidence, however, and left about 10 billion cells, and throw the necessary elimination of turn, and for this reason be required to receive intensive treatment, both in this stage or the stage of stability the following, which requires hospital stay , and the time medical care over time in anticipation of any complications that may arise, and are this phase successful at making sure the end of the symptoms of leukemia and that samples of blood and bone marrow and cerebrospinal fluid of the tumor cells, and the return of the bone marrow to normal, in addition to the return censuses of blood to normal levels.
Leukemia and is processed using the spinal various combinations of chemical drugs, include drugs commonly used real estate Donomaysan (daunomycin), and Saitozen arabinoside (cytosine arabinoside), known Bassaetharaben (cytarabine), and sometimes a real estate Taeogoanin (6 thioguanine) and Aitoboseid (etoposide), and are given the drug Donomaysan for 3 days and drug Saetharaben for 7 days, and that the doctors saw that the leukemia may not respond to these drugs but are usually added drug Aitoboseid, and are repeated treatment with these medicines every four weeks until the monitor is free marrow of leukemia, it which usually occurs after two to three treatment cycles.
And than usual when most of the cases during this stage the use of injection-Ghamdi, injecting drugs directly into the cerebrospinal fluid surrounding the spinal cord and brain, or the use of high doses of chemotherapy, systemic, or the use of radiation therapy, known as the process of prevention the central nervous system (CNS Prophylaxis ) in order to eliminate any cancer cells that may be present within its environment, or to prevent its spread to the brain and spinal cord, even if the two monitors, and may be used drug Matotricksat
(Methotrexate) alone at the injection vaginalis to situations of risk standard and high, or use a combination joint known as the injection triple (Triple intrathecal) injection of a combination of drugs Matotricksat and Hyderokortazon (Hydrocortisone) and Saetharaben, and it is customary to use radiation therapy to the brain, where the ratio is risk for the emergence of leukemia, brain or spinal fluid low in children myeloid leukemia patients.
On the other hand, different treatment plans for acute leukemia promyelocytic (Acute Promyelocytic Leukemia) classification (M3) for the rest of the processors, and was named as well as cell growth Allokimah stands at a level similar to the medullary cells with premature bone marrow (promyelocytes one of the early stages the evolution of cells neutral natural), and it was noted that when all cases arising carcinogenesis at the time of the exchange sites between the chromosomes numbers 15 and 17, leading to disruption of operations also vitamin A Bonueh cells, and have scientists discovered that by using acid, vitamin A, average (all-trans retinoic acid ATRA), can fix this imbalance and premature Almtsrtunh pay the cells to mature into the cells of mutant neutral, and although the possibility of achieving stability using this acid alone only to be used in parallel with chemical drugs to achieve the best results, (where the back Allokimah cells to grow again in a short time), and from the habitual use of antibiotics Ddah Alantraschaelin tumors of the class as a first option.
And side effects recorded when using this acid, the emergence of the illness known as vitamin acid syndrome (a) (retinoic acid syndrome) and by the emergence of symptoms of respiratory complications as a result of the accumulation of fluid lungs, and low blood pressure in addition to severe fluid retention and kidney damage, and than usual the other hand, the emergence of complications related to blood clots in cases of this category, and are traditionally treated with drugs for inhibiting blood clotting (anticoagulant).
Phase of consolidation and installation (Consolidation)
And the next stage and intensive chemotherapy, which begins immediately after the stabilization, and it is very important to eliminate cancer cells and the remaining potential, using similar doses of the same drugs used previously or higher doses or adding new drugs, and are usually the use of high doses of the drug Saetharaben (Cytarabine) and may be added Donomaysan drug (Daunomycin) and in one or two sessions of treatment-related, as may be to recommend stem cell transplantation in some cases.
On the other hand to continue operations and protect the central nervous system in this stage, the use of NA injection at the start and then every month or two throughout the period of consolidation.
Stage to maintain (Maintenance)
Other than therapeutic levels of acute lymphatic leukemia, children do not need acute myeloid leukemia patients to stage the province, except in cases of leukemia cells spinal premature classification (M3), which continues to use vitamin acid (a) average (ATRA) for almost a year.
Phase or frequency reference (Recurrent)
As noted above means a reference to, or frequency that carcinogenesis Allokima have returned and have emerged following the achievement of stability and inertia, any sense of rolling a relapse of the patient (relapse), also means failure to achieve the inertia and freedom after receiving treatments, and is collected in children when a relapse, or failure to achieve stability, weak overall, and has been used several different drugs and combinations, without any of them to achieve success in the full record, and remains the hope for another period of stability (which happens when a lot of cases) and then a bone marrow transplant or stem cells, and some doctors recommended a transplant, without waiting for stability and freedom, and this method has given good results in some cases, and on the other hand recommends some medical schools need to transplant stem cells immediately after stability and freedom, while most of the school recommends the need to implant stability is achieved, the second, ie, in the event of relapse after the success of the first phase of stabilization and receive treatments once again, and once again achieve the stability.
It should be noted that it is usual to show signs of the return of leukemia relapse and treatment received during the period or after six months of completion, while the unusual cases when the high risk category (either leukemia or lymphoma spinal) and the return of a relapse of cancer that did not show signs of and signs of disease after two years from the cessation of treatment.
After the treatments
Necessary to conduct tests periodically comprehensive last for several years after the end of treatments, in order to investigate any signs of the return of leukemia as well as control of complications and side effects of treatments received, whether immediate or delayed, which may appear years later (please go to a page of late complications of treatments for tumors to view fuller details), and include these tests in addition to careful clinical examination, laboratory tests and imaging studies of different, and are made to schedule a time downward, where it is a month during the first year from the cessation of treatment, then every two months in the second year, then every three months in the third year, then every six months until the fifth year, and then made an average of once a year, and it is very important, of course, notify the medical team in case of any symptoms or complications may appear, the action may be taken the necessary medical and achieve effective treatment without delay , both of the complications of treatment or relapse.
