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Definition of Blood Cancer

Acute Lymphocytic Leukemia

Even if there are chronic leukemias acute leukemia, in all cases, this disease that affects the bloodstream, resulting primarily from the infiltration of tumor cells in the bone marrow and blood.

Bone marrow (called "red", not to be confused with the spinal cord) is in the flat bones: skull, ilium (hip bone), ribs, sternum and spine. In the marrow are produced the three different types of blood cells: red blood cells, white blood cells and platelets. All cells are produced from stem cells in a complex process called "hematopoiesis", which allows their differentiation.

Depending on the type of blood cell affected, but also depending on the stage of hematopoiesis affected by the disease, leukemia can take various forms. Their symptoms, their evolution and their treatments are different as well.

Definition of acute leukemia

We talk about acute leukemia when hematopoiesis is blocked at an early stage of the production of blood cells. Malignant cells that proliferate are so immature (called cells "blast"). They correspond to rapidly changing forms of involving patients' lives in the short term (as opposed to chronic forms).

From acute leukemia, we differentiate acute lymphoblastic leukemia, affecting cell lineage (a type of white blood cell involved in the immune system), acute myeloid leukemia, which may affect the precursors of all other cells produced by the bone marrow bone (red cells, platelets, some other white blood cells such as neutrophils).

Symptoms of acute leukemia

The most common acute leukemia begins abruptly in a few days, without signs, with a rapid deterioration of the general condition and a combination of symptoms. They often reflect the inability of the bone marrow to produce blood cells normally, due to the proliferation of leukemic cells.

Thus, the decrease in production of red blood cells causes anemia whose main clinical signs are pallor, shortness of breath, fatigue, rapid heartbeat ... The decrease in platelet exposed to bleeding, bruising, bleeding gum or skin.

Finally, the reduction in the number of white blood cells (neutrophils) may cause infectious problems.

The number of cases of acute leukemia

In 2005, according to figures from the National Institute of Health Surveillance, over 3000 cases of acute leukemia were diagnosed.

They are ranked 18th in cancer cases in men and 18th in women.

Diagnosis of the disease

The diagnosis of acute leukemia can not be established after a single blood test. It is essential to make a cytological examination of bone marrow cells. This examination consists of the morphological analysis of marrow cells after removal of these cells by bone marrow aspiration. The myelogram is performed under local anesthesia by puncture of the sternum or iliac spine.

Morphological analysis of these cells allows to define the subset of acute leukemia: acute lymphoblastic leukemia or acute myelogenous leukemia. Other laboratory tests allow additional data to better characterize the cells of the disease. Study of cellular proteins (phenotype), and study of cell chromosomes by karyotype can also refine the diagnosis and prognosis.

Treatment of acute lymphocytic leukemia

The treatment consists of administering chemotherapy, namely the use of a combination of several drugs. A first phase of induction chemotherapy is performed. This treatment can be performed in a protected area. According to prognostic factors and quality of the response to the first treatment, bone marrow transplantation may then be necessary for optimal treatment of the disease. If this is not the case, a maintenance phase is performed.

There is a significant risk that the leukemic cells cross the meningeal barrier to attack the central nervous system. Also, lumbar punctures are they systematically and regularly carried out to analyze the cerebrospinal fluid, even in the absence of any symptoms. They can at once detect the presence of abnormal cells, treating them as preventive as curatively by the local administration of drugs (cortisone, methotrexate). In parallel, we perform a prophylactic irradiation of the skull base.


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