Leukemia symptoms in children analysis. Causes and methods of treatment of acute leukemia in children

Leukemia is a serious disease that can appear even in infancy. Such a diagnosis comes as a big shock to parents. However, it is important to remember that when timely treatment doctors give favorable prognosis for recovery.

The most common form of acute leukemia is lymphoblastic. The non-lymphoblastic form is diagnosed much less frequently. In the acute course of the disease, in just a few weeks or months the disease can progress greatly and lead to death.

Thanks to timely diagnosis You can achieve significant improvements in your health. In the chronic form, the child’s condition is so stable that he can go without treatment for months or even years.

However, this is fraught with danger, since there is a risk of developing a blast crisis, an exacerbation that can no longer be treated. Therefore, in any case, the child needs careful diagnosis, treatment, as well as sensitive care from parents and doctors.

Leukemia is a disease in which the formation of new blood cells in the bone marrow is disrupted. Stem cells produce red blood cells, platelets and white blood cells. They are included in the blood in a certain ratio.

In leukemia, white blood cells are affected. They are produced by the body in normal quantity, but are malformed and do not perform their function.

Such pathological cells do not die in due time, but accumulate in tissues and organs. Because of this, healthy white blood cells cannot form. These malignant cells are called blasts.

They spread throughout the body in the blood and gradually accumulate in the central nervous system, liver, spleen, bones, and brain. Because of this, the affected organs cannot function properly. So all systems fail and the disease progresses quickly.

This pathology, also called blood cancer, is the most common among cancer diseases in children. The danger lies in the fact that in most cases the child’s body is affected by the acute lymphoblastic form of the disease.

It leaves very little time for treatment. The chronic form practically does not occur in children. With timely diagnosis, this disease can be significantly slowed down. Therefore, it is very important not to ignore warning signs. They will be discussed further.

You can learn more about the disease from this video:

Manifestations

In the early stages, signs of cancer are confused with other less dangerous diseases. Therefore, the doctor can prescribe an in-depth diagnosis even if alarming symptoms.

And yet the following violations in the child’s health cannot be ignored. The first signs of the disease begin to appear after two months. The predominance of certain symptoms depends on the location of the leukemic tissue.

In an adult, the spinal cord is located in certain bone tissue. In a child, it is present in all bones. Therefore, hematopoietic disorders can occur at any location. But the blood carries cancer cells to all organs, tissues and systems.

Intoxication

Due to the fact that there are very few healthy leukocytes in the blood, and those that exist do not perform their function, the body cannot protect itself from the invasion of infections.

Also, intoxication syndrome is provoked by the accumulation of immature, oncological, leukocytes in the tissues. Intoxication of the body is expressed in the following:

Fever. It may be low, but when an infection occurs, it increases significantly and does not normalize after taking antibiotics. This occurs due to an insufficient number of healthy white blood cells in the blood;
Weakness and fatigue which occur due to poor blood flow to small vessels. Leukemia blood is too thick due to excessive production of white blood cells.
Decreased appetite;
Pale skin;
Insomnia;
Depression, apathy;
Increase lymph nodes;
Gum damage and rash due to accumulation of blast cells under the skin.

All of these symptoms indicate that there is an inflammatory process in the body. It is dangerous to the child's life. In combination with malfunction immune system may develop severe viral and infectious diseases. Even death from complications is possible. To avoid this, the child is placed in conditions close to sterile.

Cardiovascular disorders

Blood pathology quickly affects the functioning of the heart, disrupting its rhythm and structure. The following diseases develop:

Tachycardia;
Expansion of the boundaries of the heart, which occurs mainly due to changes in the size of the ventricles;
Arrhythmia;
A decrease in the ejection fraction, that is, a decrease in the volume of blood that the left ventricle ejects into the lumen of the aorta at the time of contraction;
Diffuse changes in the myocardium.

In turn, these diseases make themselves felt by the following symptoms:

Nausea;
Rapid heartbeat or dull rhythm;
Fainting;
Shortness of breath;
Dizziness;
Chest pain.

Some of the symptoms listed are not separate diseases, such as diffuse change myocardium. But based on laboratory research and the combination of signs, the doctor can say with confidence what explains certain symptoms.

Hemorrhagic syndrome

This symptom is characterized by the following manifestations:

Hemorrhages into internal organs and cavities;
Bleeding on mucous membranes;
Frequent nosebleeds;
Tendency to bruises;
Long healing of small cuts and wounds;
Vomiting with bloody discharge;
Petechiae and ecchymoses on the skin due to rupture of small vessels.

Because of low content platelets in the blood, the coagulation function is impaired, uncontrolled bleeding occurs. They are dangerous because they can affect any organs and systems.

Possible appearance uterine bleeding, hemorrhages on the retina, in the brain, in the organs of the digestive tract.

Leukemic lymph node hyperplasia

Enlarged lymph nodes in leukemia occur not only due to inflammatory process as with a normal illness. Hyperplasia is uncontrolled cell division that leads to the formation of excess tissue, in other words, a tumor.

An increase in the amount of lymphoid tissue is separate symptom blood cancer Blast cells and metastases are retained in the lymph nodes.

All groups of lymph nodes in the child’s body enlarge. They are found in the armpits, in the abdominal cavity, near the collarbone, in the groin, on the neck, in thymus gland. This gland is often affected by blood cancer. Symptoms of leukemic hyperplasia:

Visual enlargement of lymph nodes;
Skin rash that resembles herpes;
Pain in the area of some lymph nodes;
Damage to the thymus gland causes coughing and difficulty breathing, and compression of the superior vena cava;
Compression of the superior vena cava causes disruption of blood circulation in the head and upper extremities, and cyanosis is noticed.

Other signs

Features of the course of the disease vary greatly depending on the location of the pathology. Other symptoms that are common with leukemia include:

Increased belly size due to the accumulation of pathological leukocytes in the spleen and liver;
Against the background of suppressed immunity, various viral diseases which occur in a severe form. Among these diseases are pneumonia, sepsis, fungal infections, urethritis, candidal stomatitis and other;
Pain in bones and joints. Blast leukocytes accumulate in the joints, causing painful sensations. Also, the calcium content in the bones decreases and they become brittle. Lesions affect the skull bones, long bones, ribs, spine and pelvic bones;
Increase salivary, parotid, submandibular and lacrimal glands;
Ulcerative-necrotic injuries mucous membrane, skin, walls of the gastrointestinal tract;
Nausea, vomiting, dizziness, difficulty coordinating, headache. Such symptoms appear when the central nervous system, which can cause serious complications, including coma.

In order to put accurate diagnosis collection of tests is scheduled. The first thing that is needed is a peripheral blood test from a finger prick. In the presence of pathology in such blood there will be too few platelets and red blood cells with an excess of leukocytes.

Other deviations are also noticeable. But in 10% of children, such an analysis does not show any abnormalities, even if the disease is present. Therefore, other tests and puncture are prescribed spinal cord.

Blood cancer is a serious disease that requires anti-leukemia therapy, special conditions maintenance of the patient, supportive therapy, as well as other measures that are used in combination.

Treatment requires a lot of effort and time. However, with his help can be achieved complete remission diseases. Doctors put forward a favorable or unfavorable prognosis depending on many factors in the condition of the sick child.

It takes into account how enlarged the spleen and liver are, how many blast cells are in the body and how successful the treatment is. These factors are directly influenced by how quickly treatment was started.

It is very important to notice even minor symptoms diseases. In this case, there is every chance of defeating the disease and maintaining the child’s health.

In this video, the patient tells the story of her child’s illness:

Leukemia is a dangerous oncological disease, which is also called blood cancer, leukemia, leukemia, bone marrow tumor. With this pathology, healthy blood cells are replaced by immature ones, resulting in an imbalance in the number of different cells. In this case, leukocytes - cells that perform protective functions - stop “working”. Blood cancer is dangerous because any infection can be fatal for the patient, since the body is left without protection. As a rule, leukemia in children appears between the ages of 2 and 5 years. It is necessary to notice the development of the disease in time, since it is treated only at the first stage, and it is not always possible to do this. At the second stage, there is no chance of recovery at all. Despite the powerful development of medicine, leukemia has not yet completely conquered it.

Blood cancer can occur in the following forms:

Spicy. This is special dangerous condition, in which the child does not live long. Unfortunately, it can be lost within 0.5-5 months. Red blood cells do not develop at all, which is why the blood is filled only with white cells - leukocytes. The disease appears unexpectedly and develops quickly with the following symptoms:

angina;
poor appetite;
catastrophic weight loss;
general weakness of the body;
nosebleeds;
causeless bruises on the body;
pale skin;
headache;
enlarged lymph nodes and liver;
moodiness;
dyspnea;
tachycardia;
V difficult cases– tissue necrosis and sepsis.

Acute leukemia is the most common cancer pathology among children - every third child with cancer suffers from it.

Chronic. This form of leukemia lasts longer - for 1-2 years. Pathological processes occur more slowly than in the acute form. Sometimes it is discovered completely by accident - during examination for other diseases. Usually adults suffer from this form of blood cancer, but there are also victims of this disease among children (3% of total number children with leukemia). As a result of a violation of the blood composition, general immunity is reduced, which is why infections and viruses are able to develop quietly in the child’s body. Acute periods of the disease are followed by periods of remission, when leukemia ceases to manifest itself. But it only seems - the disease does not go away without proper treatment. Symptoms of chronic form of leukemia:

weight loss;
frequent infectious diseases;
weakness;
lack of appetite;
increased body temperature;
high level of sweating.

Signs of leukemia in children

With the pathological proliferation of useless cells in the blood, you can see following symptoms development of the disease:

Acute leukemia in children

The acute form of leukemia develops rapidly, the number of leukocytes increases catastrophically. This pathology occurs in children in the form of lymphoblastic leukemia - altered blood cells are found in the lymph nodes or bone marrow. The second type of acute form is granulocytic leukemia, which most often affects adults.

The reasons for the development of the disease are not fully understood, but there is an opinion that this is facilitated by:

immune system disorders;
genetic abnormalities;
influence of some chemical substances and radiation.

Signs of acute leukemia:

During their maturation, all blood cells go through certain stages, the first of which is blast. However, lymphocytes cannot fully develop if there is a tumor in the bone marrow. Due to damage, lymphocytes do not acquire the necessary protective functions.

Symptoms of pathology:

fever;
aching bones;
swollen lymph nodes;
tachycardia;
sudden weight loss;
pallor;
it is possible to increase the size of the testicles in boys.

Acute lymphoblastic leukemia in children

This form of blood cancer is the most common. Boys are at greater risk of getting the disease than girls. People who have previously been treated with chemotherapy or radiation are also more susceptible to lymphoblastic leukemia.

The acute form is preceded by a pre-leukemic period of pathology, which does not reveal itself in any way. What follows, in fact, is acute stage with all the signs of blood cancer. As a result of treatment, remission occurs - a calm course of the disease with occasional relapses. Once completely cured, relapses stop.

Signs of acute lymphoblastic leukemia may vary from child to child, so accurate diagnosis you need to undergo a multifaceted examination.

If, thanks to treatment, a five-year remission is observed, we can talk about a complete cure for the child. With repeated illness, the chances of recovery become much less. Acute blood cancer can be cured completely unpredictably, even if doctors and relatives of the patient prepared for the worst.

Tests for leukemia

The primary examination of the child is carried out by a pediatrician; if leukemia is suspected, a referral to an oncohematologist is given. To diagnose the disease, bone marrow and blood examinations are used, as well as additional methods:

Treatment of leukemia in children

The main thing in the treatment of leukemia is the destruction of all pathological cells. The following methods are used:

The acute form of the disease requires complex therapy, which often leads to complications in the form of stomatitis, otitis. The child becomes completely open to all infections. Therefore, he must be placed in a separate room and wear a bandage covering the respiratory organs. The treatment is very complex and long-term. It is important for parents to be patient and establish relationships with medical personnel. It is very important to put every effort into achieving lasting remission.

Antibiotic treatment kills not only diseased cells, but also healthy cells. To improve your child’s condition, you need to follow simple rules:

The chronic form also requires complex treatment. The disease often becomes acute, which complicates therapy and can lead to disastrous results. Chemical and chemical agents are used to destroy cancer cells. radiation therapy, which keep healthy cells alive. Correct treatment helps put leukemia into remission. Bone marrow transplanted from a donor can also be life-saving for the patient.

If the disease has passed from chronic stage in acute cases, polychemotherapy is used. Vincristine and Prednisolone are used in combination. These drugs help most children go into remission within six months. During the period of remission, therapy does not stop - Mercaptopurine and Methotrexate are prescribed.

Forecast

The prospects for the development of pathology depend on several factors:

at what age did the disease develop? Children aged 2 to 10 years are more likely to be cured.
gender of the child. Girls are cured more often than boys;
at what stage was the diagnosis made;
number of chromosomes;
a form of blood cancer. In acute cases there is a greater chance of recovery than in chronic cases;
response to therapeutic measures;
leukocyte count;
the rate of disappearance of blast cells from the child’s blood. The faster this happens, the more effective the treatment;

If left untreated, there is a 100% chance of death. In 60-80% of children with blood cancer, the disease progresses without recurrence for about 5 years - thanks to chemotherapy. If there has been no relapse for 5-7 years, then we can say that the disease has been defeated! To avoid problems, it is not recommended to change the climate zone of your residence. Vaccinations are given on an individual basis.

To avoid the development of such dangerous disease Seek medical advice at the slightest suspicion of leukemia. Remember that your child’s life depends on you and the professionalism of the attending physician.

Cancer is one of the most mysterious diseases, and one of the most dangerous. Despite the achievements modern medicine and the development of high technology, a cure for cancer has not yet been found. The only way, which allows, if not cure, then at least prolong the life of the patient, there remains an aggressive effect on the human body through chemotherapy and radiation therapy.

Is one of the most dangerous forms cancer, which in most cases is fatal. But the worst thing is that this particular form of cancer affects very young children. Babies can only be saved if we start at the earliest stage of the disease.

How to recognize signs of leukemia in children, what signals it sends children's body adults calling for help, and what factors contribute to the development of this disease? At the same time, every parent of a child with blood cancer is faced with the question of whether blood leukemia can be cured or not, and whether there is hope that their child will again begin to enjoy life as before.

Features of leukemia in children

The name "blood cancer" is usually applied to some form of leukemia (leukemia). However, in medical practice, malignant blood diseases are called hemoblastoses, which represent a group malignant tumors affecting the hematopoietic system.

A tumor arises as a result of the appearance of just one cell, which for some reason has undergone mutation. A mutant cell has the ability to multiply uncontrollably, suppressing the activity of healthy cells, and over time completely destroying them.

Leukemias are those in which cancer cells affect the bone marrow. Due to the fact that a significant number of immature leukocytes, that is, white cells, appear in the patient’s blood, this disease was previously called leukemia. However this feature The disease is not typical for all types of leukemia.

The incidence of leukemia among children is 4-5 people per 100 thousand. In this case, blood leukemia most often occurs in. Most favorable time The age of development of the disease is from 2 to 5 years. Pediatricians are especially concerned about the trend towards an increase in the number of children becoming ill and the high mortality rate.

Causes of leukemia

Why childhood leukemia develops is not known to science. However, there are certain factors that significantly increase the likelihood of developing blood cancer. These include:

chemotherapy;
radiotherapy;
radiation therapy;
exposure to chemicals;
viral diseases;

violations psycho-emotional state child;
maternal smoking during pregnancy;
poor ecology in the region of residence;
genetic predisposition.

It should be noted that the causes of leukemia in children remain unclear in 65% of cases. Therefore, the main version of the occurrence of this disease is considered to be mutations in the DNA of blood cells, in which their functions are disrupted and the ability to mature is lost.

Immature cells are called blast cells. Normally, their content in the bone marrow does not exceed 1-3%. However, by mutating, these cells multiply very quickly, creating many clones that suppress healthy hematopoiesis.

Once in the blood, they, along with its current, spread to all tissues and organs, infecting them and causing the development of metastases. If blast cells penetrate the protective barrier surrounding the brain, they infect its membranes and substances, contributing to the development of neuroleukemia.

It has been noted that blood cancer most often occurs in children with Down syndrome.

Types and forms of leukemia in children

Based on the type of course, two forms of the disease are distinguished. These include:

acute leukemia develops from blasts - immature cells;
chronic leukemia occurs against the background of mutation of maturing and mature cells.

Acute leukemia in children is characterized fast current. In this form of the disease, the hematopoietic system stops producing red cells, and white cells take their place. This form of the disease is the most dangerous, since it characteristic feature is the low life expectancy of a child. Depending on the stage of the disease and the treatment provided, children can live no more than one and a half months.

Chronic blood cancer is milder because white cells gradually replace red ones.

Therefore, the life expectancy of such patients increases to 1-2 years.

It should be noted that the acute form of leukemia never turns into chronic, and the chronic form never turns into acute. And they began to call them that solely for the sake of convenience. However, in the chronic form of leukemia, stages of exacerbation occur, during which the overall blood picture becomes similar to acute leukemia.

Types of acute leukemia

There are two types of acute leukemia:

non-lymphoblastic.

In the first case, cancer cells develop from lymphoblasts. In this case, the initial site of dislocation of malignant cells is the red bone marrow. As the disease progresses, they spread, forming metastases in the spleen, lymph nodes and nervous system. This type The disease occurs most often in children after 1 year. Moreover, it mainly affects boys.

The main category of patients with non-lymphoblastic leukemia includes children aged 2 to 3 years. This type of leukemia scientific language called myeloid because cancer cells attack the myeloid blood process.

Although this type of disease is quite rare, childhood leukemia in this form is characterized by rapid development and is characterized by the almost instantaneous division of white blood cells, which penetrate the bone marrow and prevent the growth of red cells.

Blood cancer is believed to be curable. However, treatment tactics and further prognosis are directly dependent on the stage of the disease. These include:

the first or acute stage lasts from the moment the first signs appear until the child’s condition improves and the results of examinations performed after treatment;
the second stage occurs at the moment of complete (when the bone marrow contains no more than 5% of blast cells) or incomplete remission (if the content of blast cells does not exceed 20%);
the third stage is characterized by the development of relapse of the disease, when cancer cells are found in the internal organs of the child.

It should be noted that the third stage of leukemia is practically untreatable. Its outcome, as a rule, is death.

Signs of the disease

From all of the above, we can conclude that it is possible to cure blood cancer only if early diagnosis. Unfortunately, in most cases, a sad diagnosis can only be made when the disease takes an aggressive form. Symptoms of leukemia in children are nonspecific, and therefore, when they appear, parents rarely consult a doctor, citing a cold or overwork of the child.

When reaching a critical age, parents need to pay attention to the following manifestations:

increased fatigue;
causeless loss of appetite;
sleep quality disturbance;
pain in bones and joints;
causeless increase in body temperature;
bleeding gums, nosebleeds;
nausea, vomiting, abdominal pain and other signs of intoxication.

Other symptoms in children include paleness of the skin and mucous membranes. Since leukemia causes an enlargement of the liver and spleen, the skin may become jaundiced. With leukemia, infection of the mucous membranes occurs, so the child’s mucous membranes very often become inflamed oral cavity, gums and throat. Leukemia also causes enlargement of the lymph nodes and salivary glands.

Signs of blood cancer in children, characterized by deterioration in blood clotting quality, are of particular concern. As a result, bruising may occur on the skin, indicating internal hemorrhage. And since cancer cells inhibit the growth of red blood cells, sick children develop anemia, the severity of which depends on the degree of spread of blast cells.

But the most dangerous cancer is the one that infects the brain - neuroleukemia. This condition is characterized by the following manifestations:

headaches;
dizziness;
impaired visual perception;
nausea;
loss of elasticity of the neck muscles.

If metastases spread to the substance of the spinal cord, sensitivity decreases in children lower limbs or paralysis of the legs develops.

Diagnosis and treatment

The final diagnosis is made after the following diagnostic measures:

laboratory blood test, including general and biochemical analysis;
Ultrasound of internal organs, allowing to assess their condition;
X-ray examination of the chest;
computed tomography;
red bone marrow puncture.

Treatment of blood cancer is carried out in a hospital setting. In this case, sick children are placed in separate rooms in which conditions are as close as possible to sterile. This makes it possible to exclude the addition of bacterial and viral infections to leukemia.

This disease is treated by chemotherapy, the main goal of which is the complete destruction of mutating cells. Deciding how to treat, namely which chemicals use for destruction malignant neoplasms, is applied based on the results of the examination and determination of the type and form of the disease.

Conclusion

It is important to understand that the prevention of this terrible disease does not exist. Basic preventive actions consist of regular visits to a pediatrician, which will allow you to catch the disease at the earliest stage of development. Only in this case the answer to the question of whether leukemia can be cured will be positive.

It should also be remembered that it will be possible to talk about a complete cure only after 6-7 years after the end of treatment, if during this time no relapse occurs.

Leukemia (syn. – leukemia) is an oncological disease that occurs in the bone marrow due to mutations in stem cells. The result of such mutations is the loss of the ability of blood cells to develop to mature forms. Like any malignant disease, leukemia has a morphological substrate - blast cells. The uncontrolled growth of blast cells, their inability to fully perform their functions and the displacement of normal hematopoietic centers cause the symptoms of the disease.

There are acute and chronic leukemias. It is important to note that acute leukemia cannot become chronic, and chronic leukemia cannot worsen. The terms acute and chronic do not denote the nature of the process, but absolutely various diseases. Depending on which bone marrow cells are affected, leukemia is divided into lymphoblastic and myeloid forms. In turn, lymphoid leukemia can be T and B cell. In the first case, blast cells are immature precursors of T lymphocytes, in the second - B lymphocytes. Acute myeloid leukemia can be of several types: from the precursors of red blood cells, platelets, neutrophils, etc. Unlike acute myeloid leukemia, in the chronic form, more mature blood cells predominate. The most common and favorable is acute lymphoblastic leukemia. Chronic lymphoblastic leukemia does not occur in children.

Among childhood cancers, leukemia ranks first, accounting for about 35%. Children aged 2 to 5 years are most often affected. The risk of developing leukemia is statistically slightly higher in boys.

Causes of leukemia in children.

To date, scientists have not yet been able to definitively establish the cause of leukemia in children, but a number of convincing theories have been developed, confirmed by modern scientific research. One of the most common theories is genetic. According to it, as a result of random changes in chromosomes that occur in utero in the fetus, abnormal genes are formed. They trigger the production of abnormal substances that block the normal maturation of blood cells.

The second, no less common theory is viral. Very often in practice, a doctor is faced with a situation where leukemia in a child develops against the background of a recent viral infection. As a rule, this is infectious mononucleosis, chickenpox, adenoviral infection. Most likely, viruses lead to the occurrence of leukemia by integrating into the cellular genome and causing various breakdowns in it. In addition, a viral infection leads to overly active division of immune cells, which can also be considered a risk factor. In many leukemia cells, the genome of a particular virus can be detected, which is convincing confirmation of this theory.

Immunodeficiency theory. Everyone knows that the immune system human body performs one of the most important functions - the destruction of foreign microorganisms and substances that have entered our body. However, in addition to fighting agents that come from outside, the immune system is aimed at destroying our own pathologically altered cells, including malignant ones. With a decrease in immunity, this function is not carried out in in full, which creates favorable conditions for the uncontrolled growth of blast cells.

Secondary development of leukemia. Modern schemes Radiation and chemotherapy have made significant progress in curing children from cancer. But there are long-term consequences on the other side of the coin. similar treatment. It's about about the development of secondary tumors, including leukemia.

Radiation of the mother during pregnancy (X-ray, computed tomography), alcohol consumption, narcotic substances and smoking is also a risk factor in the development of leukemia in children. There is also an increased risk of developing leukemia in children with existing genetic diseases such as Down syndrome.

Symptoms of leukemia.

During the course of leukemia, there are several stages. Each has its own characteristics.

1. Pre-leukemic period. This period is characterized by the absence of bright, specific symptoms. This fact is the reason late diagnosis. The main signs of the disease that parents in the pre-leukemic period can note are: weakness, fatigue of the child at school or kindergarten. Decreased appetite, low mood. The child prefers sleep and rest to active games. Also possible various violations stool, from constipation to diarrhea syndrome. It is often possible to record an increase in body temperature to 37-37.5 C. As a rule, such nonspecific symptoms are interpreted by parents and doctors as the onset of ARVI.

2. The acute period is different vivid symptoms. Body temperature can rise to 38 degrees and above. The child loses weight even with a high-calorie diet. General health worsens. One of characteristic symptoms with leukemia there is anemia (anemia), which is manifested by pale skin. Due to a decrease in the number of platelets in the blood, bleeding often develops. As a rule, this is a pinpoint rash on the skin and mucous membranes of the mouth. Nosebleeds are possible, as well as more serious symptoms such as kidney and gastrointestinal bleeding. The child may complain of pain in bones and joints, sweating at night, and itchy skin. Very often the lymph nodes in the neck, above the collarbones, and in the groin become enlarged. Unlike inflammatory enlargement of the lymph nodes, with leukemia they are painless, the skin over them is not changed. In more than half of young patients, the liver and spleen increase in size. Only a doctor can reliably determine this, but if these organs are significantly enlarged, the child’s abdomen will be enlarged and deformed, which attentive parents will immediately notice.

3. After the start of treatment, the acute period is replaced by a remission phase. The child's condition stabilizes, the liver, spleen and lymph nodes decrease in size. The bone marrow begins to produce sufficient quantity full cells, which ensures the normal well-being of the child.

4. After completing the entire course of treatment, as a rule, the child can be considered completely healthy, but in some cases a relapse is possible. This phase manifests itself similar symptoms with an acute period.

Diseases that can be confused with leukemia.

In the early stages of the disease, it is very difficult to distinguish leukemia from viral infections, such as Infectious mononucleosis, adenovirus infection and a banal ARVI. All of them can occur with enlarged lymph nodes, weakness, and increased body temperature. Pale skin can occur with anemia of another nature: iron deficiency, B12 deficiency, aplastic. Bleeding often occurs in diseases such as hemophilia and thrombocytopenic purpura. Pain syndrome in bones and joints can develop in rheumatological diseases - juvenile rheumatoid arthritis, systemic lupus erythematosus. Considering the fact that leukemia can masquerade as a variety of diseases, it is necessary to immediately contact medical care and do not self-medicate.

If a child has such complaints, you should contact your local pediatrician. The doctor, in turn, will determine whether there is a need to consult a more specialized specialist - a pediatric oncologist/hematologist.

Diagnosis of leukemia.

If leukemia is suspected, the child must be hospitalized in an oncohematology hospital. Staying at home with such a disease or suspicion is strictly contraindicated! Within a few days, specialists will take all the necessary tests and perform all instrumental studies.

First of all they take General and biochemical blood test. In the general analysis for leukemia, anemia (reduced number of red blood cells and hemoglobin), thrombocytopenia (decreased number of platelets) is often noted; the number of leukocytes can be either reduced or increased. Sometimes blast cells can be found in the blood.

Definitely take it bone marrow and cerebrospinal fluid. Bone marrow analysis is the most important; it is on its basis that the diagnosis of leukemia is established or removed. Cerebrospinal fluid is a mirror of the state of the central nervous system. If blast cells are detected in it, more intensive treatment regimens are used.

All other studies, such as ultrasound, CT scan, radiography are additional and necessary to assess the extent of the process.

Unlike other malignant diseases, leukemia does not have stages. In this case, we operate with the concept risk group. The intensity of treatment will depend on which group the child falls into. For example, in acute lymphoblastic leukemia there are three groups: standard, medium and high risk. Allocation is based on the patient's age and bone marrow examination. If the patient's age is from 1 to 6 years, the white blood cell count at the time of diagnosis is less than 20 thousand and there are no most significant chromosomal mutations in blast cells, then the child is classified and treated according to the standard risk protocol. If found genetic mutations, the so-called Philadelphia chromosome, the child will automatically be included in the group high risk and receives more intensive chemotherapy regardless of age and other indicators. If the age is under 1 year or older than 6 years and/or the white blood cell count is more than 20 thousand, the patient belongs to the average risk group. Depending on the risk group, the doctor chooses one or another treatment regimen. Depending on the response to treatment, the risk group may change, but only for the worse. With good results in the initial stages of treatment, the patient still remains in his original group.

Treatment of leukemia in children.

Pediatric oncology has advanced significantly over the past few decades. If in the middle of the last century more than 90% of patients died from leukemia, today survival is about 80%. In other words, 8 out of 10 children can be considered completely cured with timely treatment options.

Unlike other areas of medicine, where a doctor, relying on his wealth of experience, can adjust treatment tactics and replace one drug with another, in pediatric oncology the situation is different. There are approved protocols for the treatment of each malignant disease, in particular leukemia, from which the doctor has no right to deviate except in cases of drug intolerance or tumor resistance.

In the treatment regimen for leukemia, several phases are distinguished: induction, consolidation, reinduction and maintenance. During all periods, hormonal and antitumor drugs are used. Some drugs are given in tablet form, but most administered intravenously using special devices, infusion pumps. These devices allow you to set the speed with high accuracy intravenous infusions, That is an important condition therapy of leukemia in children.

For high-risk patients, as well as for patients with brain damage, radiation therapy is used.

As a rule, the entire period of treatment in a hospital takes up to 3-4 months. Maintenance therapy medications are taken on an outpatient basis. In case of severe disease, early relapses, tumor insensitivity to treatment, the child is referred for stem cell transplantation from related donors. This method allows in most cases to achieve stable remission.

An important component is accompanying therapy. It includes antibacterial, antifungal drugs, since during the treatment period the child’s immunity is significantly reduced, blood products, such as erythrocyte and platelet suspensions, are used for the purpose of replacement. Continuous infusion of glucose solution, saline solution, solutions of potassium ions, maintain ionic balance and promote detoxification.

Treatment of leukemia in children refers to high-tech care; the compulsory medical insurance policy does not cover all costs, but some of them are covered charities. It is also possible to obtain quotas for treatment from the Department of Health. To do this, you need documents confirming the presence of the disease (discharge summary from the medical history, test results). The attending physician also deals with this issue with the parents.

Disability. When a diagnosis of acute leukemia is established, the child is sent for a medical and social examination. Disability group 1 is determined when the diagnosis is initially established, as well as in case of exacerbation of leukemia. Group 2 is determined by stable remission for at least a year with continued specific therapy. Group 3 is defined as complete, stable remission after completion of specific treatment.

Forecast.

Without treatment, the prognosis is extremely unfavorable. In more than 90% of cases, the patient dies.

With early recognition and timely treatment the chance of achieving stable complete remission reaches 80%! According to statistical data, the most favorable prognosis is observed in children from 1 to 6 years of age with acute B-cell and lymphoblastic leukemia. Intermediate prognosis for acute myeloid leukemias and less favorable in chronic myeloid leukemia. Another unfavorable factor is the age of the child under 1 year and over 6 years. However, these statistics are quite arbitrary; sometimes a good response to treatment occurs in acute and chronic myeloid leukemia.

It is very difficult to say reliably what affects the prognosis and outcome of the disease. Most likely, this depends not only on the type of tumor and the age of the child, but also on the nature of the changes in the genome of the blast cell.

Pediatrician Zhuravel E.A.

The collective name for a tumor of hematopoietic cells is leukemia. Symptoms in children with pathology, which can develop with fulminant metastasis to vital organs, on initial stages wear atypical, general character. Signs of leukemia in children, against the background of the body’s low ability to resist the ongoing process, at first do not give cause for particular concern and are regarded as a general malaise. Symptoms of leukemia in children begin to appear quite quickly as soon as immunity decreases and cancer cells enter all organs.

There are acute and chronic forms of the disease, but acute leukemia in children is predominant, while an adult organism with a more developed immune system and ability to resist is more often susceptible to a chronic process. Of all leukemias, acute lymphoblastic leukemia in children is characterized by a sharp onset, lightning-fast development and expected death. This type of pathology affects every 4 children out of 100 thousand. Susceptibility to this terrible disease age group children 2–5 years old makes it a particularly pressing task to identify the first uncharacteristic symptoms of leukemia in children at a stage when there is still a possibility of a favorable prognosis.

The course of the disease is approximately the same in children and adults, but the development of a fulminant scenario is more typical for children. A chronic process that can be observed in adulthood is rare in children. The age at which the first signs of leukemia most often develop is characterized by the absence of immunity transferred to intrauterine development, And insufficient production its own ability to resist. For parents who are not aware of what blood cell cancer is, external symptoms before the onset of the active stage look like signs of general ailments. The baby’s complaints are attributed to cold symptoms, fatigue, overwork, and food intoxication.

The first signs of leukemia are indeed not very diagnosable unless laboratory and instrumental tests have been done. Meanwhile, the child’s body begins to develop fatal disease, which in modern medicine is classified according to structural change leukocytes, and whether it can be influenced is not always known. The destructive effect exerted by blasts on blood cells determines:

lymphoblastic, or leukocytic, leukemia;
myeloid, with damage to granulocytes in the leukocyte fraction;
erythroblastic.

All - acute lymphoblastic leukemia - is the most common form of the disease in the age group from 2 to 5, but in acute form it is observed up to 15 years of age. Lymphoblasts that contribute to the emergence and development pathological process, - groups of heterogeneous malignant formations that manifest themselves due to the presence of certain immunophenotypic and genetic characteristics and gradually replace healthy blood cells, preventing them from maturing due to the attacks carried out. The disease itself manifests itself only at the stage when the number of blasts prevails over the presence of healthy leukocytes. Treatment of acute leukemia is still possible at an early stage, but the detection of acute leukemia, unfortunately, often occurs in cases where the pathological process has become irreversible.

Symptoms at an early stage of the disease

Despite the fact that acute leukemia in children occurs approximately 3 times less frequently than in adults, the initial symptoms, stages of development of the disease, and especially its early manifestations, may look approximately the same. Leukemia in children initial stage The pathological process looks like a manifestation of a harmless ailment, the etiology of which often remains unclear until the development of a threatening scenario. How to find out what leukemia is, which manifests itself as follows:

sleep disorders and increased sweating at night time;
seemingly causeless jumps in low-grade fever;
lack of appetite, accompanied by nausea or vomiting for no reason;
frequent headaches;
pain and swelling of the joints;
increased fatigue.

The initial signs of leukemia in children with such a typical picture can only be seen subject matter specialist, and even then, guided by the uneven enlargement of lymph nodes, which is not observed in every specific case. The time at which leukemia manifests itself, symptoms in children with vague signs, pathological proliferation and the prevalence of lymphoblasts reaches the bone marrow tissue.

Childhood leukemia at an early stage is very difficult to diagnose due to the vagueness of external signs.

Late symptoms and stages of disease development

The answer to the questions of how possible treatment is and whether leukemia in children is curable is possible in a positive sense if therapy began at the earliest stages, when lymphoblasts have not yet become predominant. When intoxication and hemorrhagic syndromes are accompanied by threatening symptoms of an impending disaster, treatment of leukemia in children involves only minor measures to improve the quality of life. During this period, the symptoms of the disease are visible with alarming clarity:

tumor intoxication leads to frequent nausea and vomiting, trembling eyeballs, severe headache;
developing anemia is possible, murmurs appear in the heart when listening;
comes sudden weight loss accompanied by apathy and lethargy;
hyperplastic syndrome can occur in enlarged lymph nodes and internal organs;
hemorrhagic syndrome may be accompanied by stomach and nosebleeds;
child's exposure infectious diseases reaches its maximum against the background of a depleted immune system;
With combined pathologies, more atypical symptoms also appear.

At total defeat childhood leukemia, the symptoms of which were subtle and hardly noticeable, is simply a terrible picture. In modern oncology, several options are distinguished: the scenario develops at lightning speed; the disease goes through three stages (remission and relapse after treatment) and in some cases the disease is cured. Parents always have hope for a successful outcome, but it is not always possible to achieve it.

Causes of the disease

The etiology of its occurrence, like any tumor pathology, has not yet been clarified. It is assumed that leukemia in newborns is a consequence of previous diseases or negative impacts in the prenatal period. However, the possibility that the newborn was affected by factors at the genetic level cannot be ruled out either. What provoked the mechanism of development of oncological pathology before one year of age: the same perinatal factors, pathology at the gene level, or a pathological influence already acquired during the period after childbirth external conditions appearance - can only be said with a certain degree of probability. The most common versions include:

radiation exposure;
congenital genetic abnormalities;
exposure to certain chemicals;
the impact of frequent infections that affect children with weak immune systems;
intrauterine developmental anomalies.

The remaining, untraceable causes of occurrence remain idiopathic for modern medicine, and it is not yet possible to reliably establish the causes of leukemia in children. It was possible to establish as accurately as possible that the process can develop during the treatment of other oncopathologies, and that leukemia is not transmitted as an infectious disease.

Treatment of leukemia in children

The main method of treating leukemia in children is polychemotherapy. Prescribed according to the protocol, it can be variable, but often the treatment of acute lymphoblastic leukemia in children is carried out to induce remission with parallel destruction of blast cells. There are several possible options therapy to eliminate symptoms in children by carefully eliminating concurrent triggers while determining a dose of drugs that will not cause harm to health. Leukemia in children, which is treated with parallel chemotherapy, usually leads to remission. At the same time, the immune system is stimulated, because one of the reasons why children suffer from leukemia is a weakened immune system, which is normally capable of suppressing aggressive cells.

Symptomatic therapy is determined by direct observation of the patient. Associated infection requires antibacterial and antiviral drugs, blood transfusions are performed, hemorrhagic syndrome is treated with hemostatic agents. Leukemia in a child requires mandatory detoxification, rational nutrition, vitamins, sterile and warm food, exclusion of any probiotics from the diet. Blood leukemia in remission leads to consolidation, during which they try to destroy the slightest manifestations of the disease, eliminate possible reasons occurrence of relapse and, upon achieving a favorable result, begin maintenance therapy. This stage of treatment can last several years. Childhood leukemia that has been cured requires constant monitoring of the condition to exclude possible relapses. Sometimes tumor remnants linger in the blood of children or bone marrow, and they are not visible during hardware analyses. To date, their possible elimination is predicted only with the help of molecular genetics, which is not yet available to the attending physician.

Forecasts and overall results

The overall results of the fight against the disease are disappointing. Sometimes the treatment process is completed successfully, but in percentage terms, the emerging disorder wins more often than medicine and the child’s body. Until the possible, but real reasons leukemia in children and it is not the symptoms that arise after the lesion that will be eliminated, but the mechanism that gives rise to their occurrence, significant success in the fight against leukemia in children, the causes of which are unknown, is unlikely to be achieved.

Every day new drugs are tested, innovative effects of long-known components are discovered, hundreds of people are cured with their help, but it is unknown what provokes the emergence of the mechanism and when a breakthrough will be made that will help cure leukemia. Constant research, medications, modern chemistry, therapy, pediatrics, oncology still do not know what the distinctive symptoms of the pathology are at an early stage and carry out treatment when the disease becomes irreversible. But their tireless work gives us hope that soon it will be possible to be cured, just as cholera and plague were cured in their time.