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The process of hematopoiesis (hematopoiesis) occurs in the red bone marrow. First, blast cells are formed there, and then the red blood cells, leukocytes and platelets themselves. Not everyone knows what leukemia is, symptoms in children and possible reasons development of the disease.

Leukemia is malignant disease blood (cancer), in which there is an excess production of immature cells (blasts). This is a type of systemic hemoblastosis. The incidence rate among children reaches 4-5 cases per 100,000 people. Most often, leukemia is detected at 2-5 years of age. Today there is an increase in incidence.

Why do children get leukemia?

The main causes of leukemia in children include:

Exposure to radiation (ionizing radiation). This is possible when carrying out radiation therapy and with frequent exposure of the child to x-rays.
Exposure to chemicals (toluene, pesticides, paints, arsenic).
Uncontrolled use of medications (chloramphenicol, antibiotics).
Infection of the body with oncogenic viruses.
Hereditary predisposition.
Hormonal and immune disorders.
Gene mutations.
Congenital defects development and syndromes (Klinefelter syndrome,).
Smoking.
. Common reason the occurrence of leukemia.
Collagenoses.
Primary thrombocytopenia.

In case of leukemia in children, the cause may lie in other hemoblastoses (myeloma, lymphogranulomatosis and non-Hodgkin's lymphomas). Children often suffer from leukemia due to inhalation of various carcinogenic compounds.

Classification

Leukemia in children can be acute (lasting less than 2 years) and chronic (lasting more than 2 years). Almost always, children are diagnosed with an acute form of the disease. This pathology characterized by rapid progression and possible metastasis (spread cancer cells throughout the body).

Children's leukemias are lymphoblastic (develop as a result of uncontrolled division of lymphoblasts) and non-lymphoblastic (develop from other cells). The second group includes erythromyelosis, megakaryocytic, undifferentiated, myeloblastic, promyelocytic, myelomonoblastic, eosinophilic and monoblastic leukemia. The symptoms and treatment of each form of blood cancer have their own characteristics.

How does the disease manifest itself?

Signs of leukemia in children are determined by its form (acute or chronic). For acute cancer blood the following symptoms are characteristic:

Increased body temperature.
General malaise.
Sweating.
Weight loss or slow weight gain (in young children).
Pain in muscles and bones.
Sore throat.
The presence of ulcers on the oral mucosa (develops ulcerative stomatitis).
Bleeding and sore gums.
Signs of anemia in the form of pale skin, weakness, dizziness, palpitations, shortness of breath, brittle nails, dullness and hair loss, dry skin, pale visible mucous membranes and increased fatigue.
Decreased children's ability to learn. Reason - oxygen deficiency fabrics.
Hemorrhagic manifestations. Symptoms of leukemia in children include bruising and bleeding various localizations(nasal, gingival, gastrointestinal). There may be a change in the color of urine due to hematuria (blood in the urine). Older girls often experience uterine bleeding. Common sign leukemia - bruises and petechial rashes on the body.
Nausea and vomiting.
Hypotrophy.
Enlarged liver and spleen.
Increase in individual groups lymph nodes.
Sleep disturbance.
Decreased appetite.

Blood leukemia in children manifests itself with signs of damage to the brain, kidneys, heart, genitals and other organs. The reason is the formation of infiltrates (accumulations of cells in tissues).

If the symptoms of leukemia in children are left unattended, it is possible dangerous complications. One of them is neuroleukemia. It is characterized by damage to the brain and brainstem. This pathology manifests itself meningeal symptoms, vomiting, nausea, severe headache, eye symptoms(double vision), impaired sensitivity and dysfunction of the pelvic organs.

Chronic leukemia occurs with phases of exacerbation and remission. In the preclinical stage, the first signs of the disease are observed in the form of low-grade fever, pain in the left hypochondrium, weakness and sweating. In the advanced stage, symptoms characteristic of acute leukemia appear. In children of the first year of life clinical picture may be erased. Leukemia in newborns is manifested by respiratory failure, enlarged spleen and liver, rashes, fever and hemorrhages.

In the terminal stage of leukemia in children, crises are possible. They are characterized by skin damage, severe bleeding and increased signs of intoxication of the body. Rupture of the spleen is often observed. Often a secondary (bacterial) infection joins this stage.

Diagnostics

If you suspect childhood leukemia, you should contact a pediatrician or hematologist. To make a diagnosis you will need:

Interview with the patient and his parents. Risk factors for blood cancer and duration of symptoms are established.
General analysis blood. Detects a decrease in the level of platelets and red blood cells, acceleration of ESR, decrease in hemoglobin, predominance of blast (immature) cells, reticulocytopenia (lack of reticulocytes in the blood), absence of eosinophils, basophils and leukocytosis (increase in white blood cells). A valuable diagnostic feature is the absence of intermediate cell forms (segmented, young, rod).
Biochemical analysis blood. Leukemia in a child leads to damage to the liver and kidneys. In this case, the level of transaminases, bilirubin, uric acid, creatinine, urea and LDH (lactate dehydrogenase) increases. The concentration of protein, sugar and fibrinogen also decreases.
Sternal puncture (a puncture of the breastbone to obtain a sample bone marrow).
Myelogram. Most informative for acute leukemia. The acute form of leukemia is characterized by a content of more than 30% blast cells and a decrease in leukocytes, platelets and erythrocytes. At chronic myeloid leukemia there is an increase in immature granulocytes, and with chronic lymphocytic leukemia- lymphocytic metaplasia.
Trephine biopsy (removal of material from the ilium). Carried out in doubtful cases.
Cytogenetic study.
Coagulogram.
Ultrasound, CT and MRI. Required to assess the condition of organs.
Neurological examination.

Features of treatment

Is leukemia treatable in children? Everyone knows experienced doctor. Patients are subject to mandatory hospitalization in the hematology department. It is not always possible to cure the disease. The main aspects of treating leukemia in children are:

Use of chemotherapy drugs. They help destroy pathological cells and normalize hematopoiesis. The most commonly used are Mileran (prescribed for chronic myeloid leukemia), Mercaptopurine, Puri-Netol, Leukeran, Fluorouracil and Cyclophosphamide. Most often, several drugs are used at once. Maintenance therapy with low doses of medications is mandatory.
Transfusions (transfusion of blood components).
Application restoratives(immunomodulators, iron supplements).
Usage hormonal drugs(Prednisolone) and antibiotics (in case of secondary infection).
Infusion therapy.
Blood purification using plasmapheresis.
Bone marrow and stem cell transplantation.
Irradiation of the spleen. Required when it is greatly increased.
Balanced, good nutrition.
Radiation (radiotherapy). Effective if identified chronic leukemia in children. X-ray therapy is also performed for infiltration of the lymph nodes, mediastinal organs, testicles and pharynx.

Recovery prognosis

If children have leukemia, it is possible to be cured. The most favorable prognosis is observed when:

timely consultation with a doctor;
lack of self-medication;
properly selected laughter therapy;
absence of lymphadenopathy, damage to the nervous system and liver;
acute lymphoblastic leukemia type 1;
child's age from 2 to 10 years.

In boys, the disease in most cases is more severe than in girls. If acute leukemia in children is detected at 2-10 years of age, there are signs of damage internal organs and brain, the prognosis worsens. In the absence of chemotherapy, radiation or radical treatment The mortality rate for leukemia in a child is close to 100%.

In 60-80% of cases, polychemotherapy using cytostatics allows achieving stable and long-term remission. About 20% of children recover completely. Acute lymphoblastic forms of the disease have a more favorable health prognosis. With chronic lymphoid blood cancer, the life expectancy of patients varies from 2-3 years (with severe forms diseases) up to 20-30 years (with favorable course leukemia).

One of the most difficult to cure pathologies in children today is leukemia. The disease is characterized by a disruption of the process of hematopoiesis in bone marrow cells and replacement healthy cells immature blasts (sick cells) from a number of leukocyte cells. Percentage Children with cancer (leukemia, leukemia) make up about 35%. Oncological lesion blood most often occurs in children under five years of age and older than two. Currently, there is a trend towards an increase in the number of children developing blood cancer.

In children weak immunity, and they are more susceptible to negative factors:

toxic chemicals, such as formaldehyde, found in furniture varnishes;
radiation exposure;
electromagnetic radiation, for example, during prolonged stay near computers or computer devices;
frequent relapses infectious diseases, capable of causing mutational changes in the child’s body;
genetic disorders, including Down's disease;
potent drugs, provoking changes in the condition of bone tissue in children.

These are the main suspected causes of leukemia in children. A mutation that occurs in the bone marrow causes cancer cells called blasts to develop and divide. Then a repeated mutation of the cells may occur, causing irreversible development tumor cells and malignant neoplasms.

The rapid division of pathological cells affects the state of leukocytes, and a person’s immunity sharply decreases. Cancer cells enter all lymph nodes and organs, which causes changes normal condition health.

Types and degrees of leukemia

According to the form of the disease in a child, acute and chronic courses are distinguished. pathological process. The acute process very quickly exhausts children, and their condition worsens sharply. Chronic course The disease can last for several years, and this form of the disease is more often characteristic of adults.

Based on changes in the structure of leukocytes, they are distinguished: lymphoblastic (leukocyte) leukemia, in which leukocytes are directly affected, myeloid leukemia, characterized by changes in granulocytes (leukocyte fraction) and erythroblastic.

Blood diagram of a healthy child and a patient with leukemia

In some rare cases it happens congenital disease. Children under 15 years of age are most often affected.

According to the course of the disease, there are three stages, according to which the treatment regimen is built:

complete or incomplete remission;
relapse of the disease in a child.

Rarely, secondary leukemia occurs due to the use of potent drugs, chemotherapy or radiation.

Symptoms

Healthy white blood cells are replaced by altered cells, immunity decreases, the body weakens and cannot fight infections. The lifespan of blast cells increases, and leukocytes practically cease to function.

In children, leukemia manifests itself with nonspecific symptoms:

fatigue;
disruption of normal sleep;
decreased appetite, up to absence;
unreasonable temperature fluctuations;
headaches often (small children cannot tell and cry constantly);
less often, nausea and vomiting for no reason;
uneven enlargement of nodes of the lymphatic system;
severe sweating of the baby at night;
swelling of the joints and aching pain in them.

In rare cases, the first symptoms of leukemia in children manifest themselves as intoxication or hemorrhagic syndrome.

Symptoms of leukemia in a child

Other signs of the disease include the following symptoms:

tonsillitis (inflammation of the pharyngeal tonsils);
stomatitis (more about stomatitis);
pallor of the skin and mucous membranes;
gingivitis;
yellowish or grayish skin color;
splenomegaly (enlarged spleen);
hepatopathy (pain in the liver and increase in size);
lymphadenopathy.

Similar manifestations in children with acute leukemia:

hemorrhages (in the form of stars) in the skin or mucous membranes;
hematuria (blood in the urine);
accumulations of blood can penetrate into the joint cavities;
bleeding in the stomach, uterus, lungs, nose.

Diagnostic procedures

When a child shows the first signs of illness, parents often confuse them with colds or they blame it on the child’s fatigue after playing or studying. Such conditions of children cannot be ignored; you should immediately contact a pediatrician.

To find out the cause of the child’s unhealthy condition, it is recommended to undergo a preventive examination:

examination by a pediatrician;
taking an anamnesis (history of development pathological condition person);
ECG (electrocardiography);
Ultrasound ( ultrasound examination) organs abdominal cavity;
clinical blood test with a detailed leukocyte formula;
in severe cases that are difficult to diagnose, a bone marrow puncture is prescribed;
blood test for sugar;
clinical urine analysis;
stool analysis for worm eggs (about worms).

This is necessary to differentiate the diagnosis. Very often, the symptoms of leukemia are similar to the condition of anemia. In advanced cases, they are prescribed additional research or repeated to monitor the dynamics of the disease.

To correctly and timely assign treatment course, it is very important to establish what the cause of the disease is.

You cannot ignore the slightest changes in the baby’s health condition; you should immediately seek advice from a pediatrician if you discover even isolated mild symptoms. With this pathology, an early diagnosis is important. The disease progresses rapidly.

Therapeutic measures

When children are diagnosed initial signs leukemia, first of all, a diagnostic examination is prescribed and symptomatic treatment. After production accurate diagnosis treatment is carried out in a specialized children's hospital.

For treatment, the following are used: chemotherapy, radiotherapeutic methods, bone marrow transplantation; very rarely, medicine is injected into the canal with cerebrospinal fluid. Drug treatment prescribed according to the degree and type of damage circulatory system, and also use hormonal therapy to stimulate the immune system.

Leukemia in children with timely detection can be cured in 85% of cases. Every year, new technologies and treatment methods make it possible to heal more patients and prevent the relapse of the disease.

The most severe disease of the hematopoietic system is leukemia in children: symptoms identified on initial stage process help prevent the development of complications. The disease has characteristic features, there is fulminant metastasis to vital organs:

spleen;
liver;
brain;
bone tissue.

The likelihood of the child developing acute liver failure and neuroleukemia increases.

The initial symptoms of leukemia in children do not appear immediately, but later certain time, necessary for the accumulation of cancer cells in bone marrow tissue.

Rapid progression of the disease leads to an unfavorable outcome if therapy with cytostatic drugs is not started in time. A hematologist determines the cause of a sharp exacerbation chronic tonsillitis, influenza, because the ailments may be based on problems with the composition of the blood.

It is dangerous to self-medicate: in relation to a child, this is a crime that worsens the patient’s condition, leading to neglect oncological process.

Childhood leukemia occurs often before the age of 5 years and is divided into types such as:

myeloid;
lymphoblastic.

Causes of blood cancer

There are several factors influencing the development of blood pathology:

the effect of harmful chemicals on the patient’s body;
genetic changes;
radiomagnetic radiation;
viral illness;
electromagnetic influence.

Childhood leukemia is characterized by the formation of special blast cells that replace leukocytes. Tumor cells are mutated, quickly divide, but do not complete the full cycle of their development. IN large quantities they destroy normal blood cells. With the blood flow, blasts metastasize to the brain, lymph nodes, and spleen.

There are several stages of disease development:

The acute process is characterized by a rapid course.
A chronic illness in children lasts up to two years: the symptoms are more pronounced, and the disease is constantly progressing.
During the period of remission, the patient's blood test data improves, and the number of cancer cells decreases by up to 20%.
Relapse of the disease is characterized by the appearance of new lesions, although tests indicate stabilization of hematological parameters.

Children with Down syndrome often develop leukemia. primary immunodeficiencies, polycythemia. After use intensive care During an organ transplant, the risk of developing leukemia in a child increases.

Initial manifestations of the disease

Important to remember: early detection disease helps improve the child’s quality of life.

The first signs of illness should be a reason to visit a hematologist.

Children aged 2-4 years appear increased fatigue, bone pain, appetite changes, sleep worsens, appears low-grade fever bodies. At sudden development illness, the child suffers from intoxication, hemorrhages occur on the skin and mucous membranes. The baby has yellowish skin with an earthy tint. The lymph nodes are significantly enlarged, and the lacrimal and salivary glands infiltrated. The child's face is puffy. Blood is released from the gums and nasal cavity, and inflammation of the tongue mucosa develops.

The baby may complain of palpitations, and dull heart sounds and functional murmurs are heard on auscultation.

In the first months of the development of the disease, the formation of neuroleukemia in a child is observed: headache, attacks of nausea and vomiting, dizziness, blurred vision. Often the baby experiences extreme thirst, indomitable cravings for food, diencephalic syndrome develops. Bone pain is prolonged, masquerading as a manifestation of polyarthritis.

Symptoms of a dangerous disease

The disease is manifested by such characteristic symptoms as:

hyperplasia of lymph nodes;
intoxication;
anemia;
the appearance of many hemorrhages.

Intoxication is accompanied by fever, decreased appetite, sweating and weakness. Toxic substances—metabolites, tryptophan and tyrosine—accumulate in the child’s body, and the body’s protective functions are weakened.

With leukemia, the baby develops hypochromic anemia. The child may not make specific complaints: he experiences constant fatigue, enlarged lymph nodes in the axillary region, groin. The spleen changes in size, the heartbeat quickens, the child loses weight sharply and consumes little food.

Due to the location of the lymph nodes in the chest, a cough occurs without sputum production, and shortness of breath increases. In some cases, the disease picture resembles ARVI, occurring with symptoms such as:

hyperthermia;
vomit;
headache.

The gait is disturbed, and the baby loses balance. The child develops dental problems: swelling and loosening of the gums, hyperemia of the tongue with the presence of cracks or aphthous rashes, necrotic ulcerations on the tonsils.

Blood test indicators during the development of leukemia in a child

General study blood in childhood cancer indicates the presence of young bone marrow cells.

The analysis indicates the complete absence of eosinophils and basophils in the blood. In megakaryoblastic leukemia, the platelet count is much higher than normal. Malignant cells are completely absent during the development of the leukemic type of disease.

Remission is characterized by stabilization general indicators blood test, and the content of blast cells in the bone marrow tissue is 5%.

The terminal phase of leukemia is characterized by an increase in immature basophils and eosinophils and a significant decrease in the number of neutrophils. Biochemical research blood determines changes in the content of uric acid, bilirubin, AST, globulins and allows the doctor to predict functionality liver and kidneys.

As a result of the development of anemia, the number of red blood cells is 1-1.5.10¹²/l. ESR increases significantly. Different phases of the disease are characterized by a certain value of leukocytes: from 0.1.10⁹/l to 100-300.10⁹/l. The granulocyte count is 1.5.10⁹/l. It is characterized by a decrease in the number of monocytes.

Treatment regimen for leukemia in children

The nature of the development of the disease depends on the form of the oncological process. The acute form of the disease is severe and has a variety of symptoms. Chronic leukemia develops over several years and is accompanied by a period of remission with the complete disappearance of clinical symptoms.

There is a possibility that the chronic form of the disease will transition into an acute phase, ending in a blast crisis that is difficult to treat with drugs.

Spicy myeloid leukemia affects children from 0 to 2 years, and the life expectancy of a sick child does not exceed 5 years and depends on the effectiveness of therapy and prognostic findings.

For the course of the disease great value has the patient's age and initial white blood cell count. A favorable prognosis of the disease is observed in children from 1 to 9 years of age, and infants belong to high group risk. Children with more than 50,000 mm³ of leukocyte cells need intensive treatment. Girls are more likely to be cured than boys. The number of chromosomes in tumor cells affects the child’s recovery.

Children with concomitant diseases have a poor prognosis and little chance of cure.

Therapy for leukemia in children

Treatment of the disease is aimed at stopping the development of tumor cells and their partial destruction.

Therapy is carried out in a hospital with a course of chemotherapy drugs. Treatment consists of several phases. With induction therapy, the specific goal is to achieve remission.

In the consolidation phase, they strive to reduce the number of cancer cells. During maintenance treatment, the patient is prescribed drugs that prolong the remission stage.

Intrathecal treatment can destroy cancer cells that affect nervous system, using drugs injected into the brain through lumbar puncture. The duration of therapy varies: the first stage lasts more than 6 months, and maintenance treatment takes about two years. In many cases, therapy allows you to completely get rid of the disease.

Children under 12 months of age have the lowest chance of recovery. Radiotherapy is used to treat a sick child, prescription cytostatic agents, suppressing the growth and development of cancer cells. Immune correction is carried out using glucocorticoid drugs.

Early diagnosis of a dangerous disease allows you to gain confidence in complete victory over cancer.

Oncological diseases, including leukemia, in children always cause real horror among parents. Each of the neoplasms has its own clinical features, which means it is treated differently.

What is it?

Leukemia in children is a neoplasm that forms in the hematopoietic system. These diseases are quite dangerous. Some of them lead to fatal outcome. Every day, scientists around the world conduct numerous studies and develop new drugs that would treat these diseases.

With leukemia, normally functioning cells are replaced with diseased ones. Ultimately, this contributes to the disruption of proper hematopoiesis in the baby. Since these diseases are oncological, treatment is carried out by pediatric oncologists. Typically, a baby with leukemia is observed in cancer center throughout your entire life.

More and more new cases of disease are recorded every year. Scientists note with regret that the incidence of various forms leukemia in children increases every year several times. Typically, the first signs of the disease are found in children aged 1.5 to 5 years. Not only children, but also adults can get sick. Their peak incidence occurs at the age of 30-40 years.

Some medical specialists leukemia is called "leukemia". Translated, this means new blood formation. In some ways, this interpretation of the disease is correct. In leukemia, the production of healthy cells is disrupted hematopoietic system. Atypical cells appear that are unable to perform their basic functions.

The body cannot control the formation of “low-quality” cellular elements in any way. They form independently. It is often quite difficult to influence this process from the outside. This disease is characterized by the appearance of numerous immature cells that are found in the bone marrow. This organ is responsible for hematopoiesis in the body.

The name “leukemia” was proposed by Ellerman at the beginning of the 20th century. Later there were numerous scientific research, who gave an interpretation of the disease taking into account impaired physiology. Every year, large financial resources are allocated all over the world to search for drugs that would save children with leukemia. It must be said that there are significant positive developments in this area.

Of all types of leukemia, the acute form is most common in children. This classic version diseases. According to statistics, in the structure of cancer incidence of leukemia, every tenth person is a child. Currently, scientists around the world emphasize the importance of studying and finding new drugs for leukemia. This is due to high mortality and increased incidence of blood tumors in children.

Causes

Today there is no single factor that contributes to the development of this dangerous disease in kids. Scientists put forward only new theories to explain the causes of the disease. Thus, they proved that exposure to ionizing radiation can lead to the development of blood tumors. It has destructive effect to the hematopoietic organs.

The relationship between radiation exposure and exposure can also be proven historically. In Japan, after the largest explosion in Hiroshima and Nagasaki, the incidence of leukemia in children increased several times. Japanese doctors calculated that it exceeded the average statistical values by more than 10 times!

There are also scientific versions that leukemia develops after exposure to chemically hazardous substances. Researchers proved this fact by simulating the appearance of the disease in the laboratory in experimental animals. Scientists note that exposure to certain hydrocarbons, aromatic amines, nitrogen compounds, and insecticides contributes to the development of blood tumors. Currently, there is also information that various endogenous substances can cause leukemia. These include: sex hormones and steroids, some tryptophan metabolic products and others.

For a long time There is a viral theory in the scientific world. According to this version, many oncogenic viruses are genetically embedded in the body. However, with adequate functioning of the immune system and the absence of exposure to external factors, they are in a passive or non-working state. Impact of various causal factors, including radiation and chemicals, contributes to the transition of these oncogenic viruses to an active state. This viral theory was proposed in 1970 by Hubner.

However, not all doctors and scientists share the opinion that oncogenic viruses initially exist in the body. They explain this by the fact that in all cases, a child with leukemia cannot infect a healthy one. Leukemia is not transmitted by airborne droplets or by contact. The cause of the disease lies deep within the body. Numerous breakdowns and disturbances in the functioning of the immune system often lead to the appearance of neoplasms of the hematopoietic organs in children.

At the end of the 20th century, several scientists from Philadelphia found that children suffering from leukemia have abnormalities in the genetic apparatus. Some of their chromosomes are slightly shorter in size than those of healthy peers. This finding gave rise to the proposal of a hereditary theory of the disease. It has been scientifically proven that in families where there are cases of leukemia, the incidence of leukemia occurs three times more often.

European scientists have proven that some congenital anomalies development lead to an increase in the incidence of blood tumors. Thus, in children with Down syndrome, the likelihood of developing leukemia increases by more than 20 times. Such a variety of different theories suggests that at present there is no single idea about the development, and most importantly, the appearance of blood tumors in babies. It still takes time to establish the etiopathogenesis of the disease.

Species

The classification of all clinical variants is quite complex. It includes all forms of the disease that can develop in both newborns and adolescents. It gives doctors an idea of how to identify the disease in children. Oncological classifications are revised annually. Various adjustments are regularly made to them in connection with the emergence of new scientific research results.

Currently there are several main clinical groups blood tumors:

Spicy. These clinical forms of the disease are characterized by a complete absence of healthy cells. In this case, specific red blood cells are not formed. Typically, acute leukemia in children has enough severe course and are characterized by a sad, unfavorable outcome. Adequate and correctly selected therapy can somewhat prolong a child’s life.
Chronic. Characterized by the replacement of normal blood cells with white ones. This form has a more favorable prognosis and a less aggressive course. To normalize the condition, various drug administration and prescription regimens are used.

Blood tumors have several features. Thus, the acute form of leukemia cannot become chronic. These are two different nosological diseases. Also, the course of the disease undergoes a transition through several successive stages. Acute leukemia can be lymphoblastic and non-lymphoblastic (myeloid). These clinical forms of pathologies have several characteristic features.

The acute lymphoblastic variant usually manifests itself in infants. According to statistics, the peak incidence of this type of leukemia occurs at the age of 1-2 years. The prognosis of the disease is unfavorable. The pathology usually occurs with a severe course. This clinical form is characterized by the appearance of an initial tumor focus in the bone marrow. Then characteristic changes appear in the spleen and lymph nodes, over time the disease spreads to the nervous system.

The non-lymphoblastic variant occurs equally often in both boys and girls. Typically, the peak incidence occurs between 2 and 4 years of age. It is characterized by the appearance of a tumor formed from the myeloid hematopoietic germ. Usually the tumor grows quite quickly. When there are too many cells, they reach the bone marrow, which leads to hematopoietic disorders.

Acute myeloblastic variant is characterized by the appearance large quantity immature cells - myeloblasts. Primary changes occur in the bone marrow. Over time tumor process spreads throughout the child's body. The course of the disease is quite severe. To identify this clinical variant of the disease, numerous tests are required. diagnostic examinations. Delayed treatment or its absence leads to death.

The main signs characteristic of blood tumors are:

Changes in hematopoietic parameters. The appearance in analyzes of atypical and immature cells that are completely absent in healthy person. Such pathological forms are capable of dividing very quickly and increasing in number in a short period of time. This feature determines the rapid growth of the tumor and the severity of the disease.
Anemia. Decreased red blood cell count – characteristic feature hematopoietic neoplasms. The reduced content of red blood cells leads to tissue hypoxia. This condition is characterized by insufficient supply of oxygen and nutrients to all organs and tissues of the body. Oncological tumors are characterized by severe anemia.
Thrombocytopenia. At this state is decreasing normal amount platelets. These are normal blood platelets responsible for normal blood clotting. When decreasing this indicator the child develops numerous hemorrhagic changes, manifested by the appearance adverse symptoms.

Symptoms

Usually the first signs of leukemia are very subtle. The child's well-being is early stages practically does not suffer from the disease. Baby leads familiar image life. It is not possible to suspect the disease “visually”. Leukemia is usually detected during clinical tests or upon transition to the active stage.

Early non-specific symptoms include: loss of appetite, fatigue, difficulty falling asleep and duration of sleep at night, slight apathy and slowness. Usually these signs do not cause any concern to parents. Suspect the disease early stage Often even the most attentive fathers and mothers will not be able to.

Over a period of time, the child develops unfavorable symptoms of the disease. Skin tone often changes. It becomes pale or takes on a sallow color. The mucous membranes may erode and bleed. This leads to the development of stomatitis and gingivitis. In some cases of inflammation in oral cavity are ulcerative-necrotic.

Enlarged lymph nodes may be observed. In some forms of leukemia they become visible from the outside. Usually the lymph nodes are dense to the touch and are very tightly fused with the surrounding skin. Doctors distinguish Mikulicz syndrome. This condition is characterized by enlargement of the lacrimal and salivary glands. This specific syndrome is caused by leukemic infiltration.

A decrease in the total number of platelets in the blood leads to the appearance of various hemorrhagic syndromes. They can manifest themselves differently in children. The most typical manifestation is bruising on the legs. They usually appear spontaneously without traumatic injury and not as a result of falls. Also, babies may experience nosebleeds and gum bleeding. The most dangerous forms- hemorrhages into the abdominal cavity.

Enough common symptom muscle pain and soreness in the joints appears. This is due to the development minor hemorrhages in the joint cavities. Long course The disease leads to the development of pathological excessive fragility of bones in the child. Bone tissue becomes loose and easily susceptible to any damage, as well as mechanical stress.

The active development of the disease leads to the appearance of disorders of the internal organs. Children with leukemia are characterized by an increase in the size of the liver and spleen (hepatosplenomegaly). Usually this symptom can be easily identified by palpation of the abdomen or during an ultrasound examination.

Late stages are accompanied by disturbances in the functioning of the heart. This is largely due to severe anemia. Insufficient oxygen supply to the heart muscle provokes increased heart contractions. In a child, this condition is manifested by the appearance of tachycardia, and in some situations even arrhythmia (irregular heart rhythm).

Body temperature does not always change during leukemia. In many children, it can remain normal throughout the illness. Some clinical forms of leukemia are accompanied by fever. Usually it increases during a pronounced deterioration of the condition - a leukemic crisis.

The rapid development of the disease contributes to disturbances in physiological development child. Typically, children with leukemia are significantly behind their peers in many health indicators. The long and severe course of the disease leads to the fact that sick children do not gain weight well. Appetite disorders and side effect medicinal antitumor drugs, as well as the consequences of chemotherapy lead to significant suffering for the baby.

Leukemia is also very characterized by a decrease in the number of leukocytes. Normally, these cells are designed to protect the body from any infections. A decrease in white blood cells (leukopenia) contributes to a pronounced decrease in immunity. Children suffering from leukemia are several times more likely to get sick, even the most simple colds. Children with severe leukopenia are forced to undergo treatment in a special sterile box.

Diagnostics

Unfortunately, it is not always possible to detect leukemia in the early stages. Laboratory diagnostic methods should help identify the disease in a timely manner. These tests are usually prescribed to the child by a pediatric oncologist or hematologist. Experts diagnose everything oncological neoplasms blood.

You can suspect a disease at home when a child develops unfavorable symptoms. characteristic symptoms. If they are detected, you should immediately seek advice and carry out additional diagnostics to a hematologist. Usually, several examinations are required to establish the correct diagnosis.

The first screening test is a complete blood count. This simple and affordable test helps detect a decrease in the number of red blood cells and platelets. Also, a blood smear can be informative for identifying atypical immature blood cells. An acceleration of ESR in combination with a change in the number of red blood cells and platelets also indicates possible leukemia in the baby.

The main study to accurately determine the presence of immature cells in the body is considered spinal tap. During this procedure, the doctor makes a puncture and removes a small amount of biological material for examination. The method is invasive and requires a fairly well trained specialist. This study allows you to accurately detect the presence of leukemia, as well as establish its stage and morphological appearance.

Additional diagnostic methods include highly informative studies - computed tomography and magnetic resonance imaging. They help identify various neoplasms. Bone marrow tests reveal everything pathological changes, which are present in hematopoietic organ. MRI of the abdominal organs will help to detect enlargement of the liver and spleen, as well as to exclude signs of intra-abdominal hemorrhage in advanced stages of the disease.

Forecast for the future

The course of different clinical forms of the disease may be different. It depends on many factors. Some forms of leukemia are curable. It all depends on individual characteristics baby. Children with multiple chronic diseases, are more difficult to recover. It is not always possible to recover from leukemia. On late stages The prognosis for the disease is usually unfavorable.

Treatment

The prescription of a treatment regimen for leukemia remains with the hematologist or pediatric oncologist. Currently, several treatment programs have been developed that are aimed at prolonging remission. Relapse of the disease is treated in inpatient conditions. Usually the course of the disease is wavy. Periods of complete well-being are usually followed by relapses.

The main treatment for leukemia is the administration of chemotherapy drugs. The treatment regimen may vary and depends largely on clinical form diseases. Therapy drugs can be prescribed in different dosages and differ in the frequency of application. An important goal of treatment is to select an adequate regimen to cope with the excess number of atypical tumor cells and promote the growth of healthy ones.

In some cases, polychemotherapy is supplemented with immunostimulation. Such treatment is necessary to activate the immune system and improve the functioning of the immune system. Also, some forms of leukemia can be treated using radical methods. These include: bone marrow transplantation from a donor and the introduction of stem cells. To eliminate the symptoms of severe anemia, blood transfusions are used.

Children with leukemia must receive high-calorie nutrition. Usually their calorie content daily ration slightly exceeds age standards. This diet is necessary for a child to active work immune system. Kids not getting what they need nutrients, are more weakened and do not tolerate chemotherapy well.

Prevention

Unfortunately, today specific preventive measures leukemia have not been developed. There has never been a magic vaccine against cancer. Every child can get leukemia, especially if they have factors predisposing them to the disease. In order to identify neoplasms as early as possible, parents must be attentive to their baby. The appearance of the first unfavorable symptoms of the disease should alert them and motivate them to seek help from a doctor.

It is important to remember that the earlier leukemia is detected, the more favorable the prognosis. Some clinical options diseases respond well to treatment with chemotherapy drugs. A general blood test helps identify many signs of leukemia in the early stages. Such a study should be carried out annually for children with risk factors.

What symptoms in a child should alert parents? The answer to this question lies in the water material.