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The process of hematopoiesis (hematopoiesis) occurs in the red bone marrow. First, blast cells are formed there, and then the erythrocytes themselves, leukocytes and platelets. Not everyone knows what leukemia is, symptoms in children and possible reasons the 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 the 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 radiotherapy and with frequent x-ray exposure of the child.
Exposure to chemicals (toluene, pesticides, paints, arsenic).
Uncontrolled intake of medicines (chloramphenicol, antibiotics).
Infection of the body with oncogenic viruses.
hereditary predisposition.
Hormonal and immune disorders.
Gene mutations.
birth defects development and syndromes (Klinefelter's syndrome,).
Smoking.
. Common cause occurrence of leukemia.
collagenoses.
primary thrombocytopenia.

With leukemia in children, the cause may lie in other hemoblastoses (multiple myeloma, lymphogranulomatosis and non-Hodgkin's lymphomas). Often, children get 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 by body).

Childhood leukemias are lymphoblastic (developing as a result of uncontrolled division of lymphoblasts) and non-lymphoblastic (developing from other cells). The second group includes erythromyelosis, megakaryocytic, undifferentiated, myeloblastic, promyelocytic, myelomonoblastic, eosinophilic and monoblastic leukemias. Each form of blood cancer has its own symptoms and treatment.

How the disease manifests itself

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

Increase in 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, pallor of visible mucous membranes and increased fatigue.
Decreased ability of children to learn. Reason - oxygen deficiency fabrics.
hemorrhagic manifestations. Symptoms of childhood leukemia include bruising and bleeding different localization(nasal, gingival, gastrointestinal). Perhaps a change in the color of urine due to hematuria (impurities of blood in urine). In older girls, uterine bleeding is often observed. Frequent sign leukemia - bruises and petechial rashes on the body.
Nausea and vomiting.
Hypotrophy.
Enlargement of the liver and spleen.
Increase in individual groups lymph nodes.
Sleep disturbance.
Decreased appetite.

Blood leukemia in children is manifested by signs of damage to the brain, kidneys, heart, genital and other organs. The reason is the formation of infiltrates (clusters of cells in tissues).

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

Chronic leukemia proceeds with phases of exacerbation and remission. In the preclinical stage, the first signs of the disease are observed in the form of subfebrile temperature, pain in the hypochondrium on the left, weakness and sweating. In the advanced stage, symptoms characteristic of acute leukemia appear. In children of the first year of life clinical picture gets erased. Leukemia in newborns is manifested by respiratory failure, enlargement of the spleen and liver, rashes, fever and hemorrhages.

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

Diagnostics

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

Questioning the patient and his parents. Risk factors for blood cancer and duration of symptoms are established.
General analysis blood. It reveals a decrease in the level of platelets and erythrocytes, an acceleration of ESR, a decrease in hemoglobin, a predominance of blast (immature) cells, reticulocytopenia (a lack of reticulocytes in the blood), the absence of eosinophils, basophils, and leukocytosis (an increase in leukocytes). A valuable diagnostic feature is the absence of intermediate cell forms (segmented, young, stab).
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 (puncture of the sternum in order to obtain a sample bone marrow).
Myelogram. Most informative in acute leukemia. The acute form of leukemia is characterized by the content of more than 30% of 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.
Trepanobiopsy (taking material from the ilium). It is carried out in doubtful cases.
cytogenetic study.
Coagulogram.
Ultrasound, CT and MRI. Required to assess the state of organs.
neurological research.

Features of treatment

Is leukemia treated 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 the treatment of leukemia in children are:

The use of chemotherapy drugs. They help to 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 drugs is mandatory.
Transfusions (transfusion of blood components).
Application restorative means(immunomodulators, iron preparations).
Usage hormonal drugs(Prednisolone) and antibiotics (in case of secondary infection).
Infusion therapy.
Purification of blood by plasmapheresis.
Bone marrow and stem cell transplant.
Irradiation of the spleen. Required for high magnification.
balanced, good nutrition.
Irradiation (radiotherapy). Effective if found chronic leukemia in children. X-ray therapy is also carried out with infiltration of the lymph nodes, mediastinal organs, testicles and pharynx.

recovery prognosis

If there is leukemia in children, then it is possible to recover. The most favorable prognosis is observed when:

timely visit to the doctor;
lack of self-treatment;
properly selected laughter therapy;
absence of lymphadenopathy, damage to the nervous system and liver;
acute lymphoblastic leukemia of the first type;
the age of the child is 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 old, there are signs of damage internal organs and brain, the prognosis worsens. In the absence of chemotherapy, radiation, or radical treatment mortality in leukemia in a child approaches 100%.

In 60-80% of cases, polychemotherapy with the use of cytostatics makes it possible to achieve stable and long-term remission. About 20% of children make a full recovery. Acute lymphoblastic forms of the disease have a more favorable prognosis for health. In 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 intractable pathologies in children today is leukemia. The disease is characterized by a violation of the process of hematopoiesis in the cells of the bone marrow and the replacement healthy cells immature blasts (diseased cells) from a number of leukocyte cells. Percentage children with cancer (leukemia, leukemia) is about 35%. Cancer lesion bleeding 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 polishes;
radiation exposure;
electromagnetic radiation, for example, during a long stay near computers or computer devices;
frequent relapses infectious diseases that can cause mutational changes in the child's body;
genetic disorders, including Down's disease;
strong drugs that provoke a change in the state of bone tissue in children.

These are the main suspected causes of leukemia in children. A mutation that occurs in the bone marrow causes the development and division of cancer cells called blasts. Cells may then re-mutate, causing irreversible development. tumor cells and malignant neoplasms.

The rapid division of pathological cells affects the state of leukocytes, and a person's immunity is sharply reduced. Oncological cells enter all the lymph nodes and organs, which is the cause of the change normal state health.

Types and degrees of leukemia

According to the form of the course of the disease, a child is divided into acute and chronic course. pathological process. An acute process exhausts children very quickly, and the condition deteriorates sharply. chronic course the disease can last for several years, and this form of the disease is more common in adults.

According to the change in the structure of leukocytes, there are: lymphoblastic leukemia (leukocytic), in which leukocytes are directly affected, myeloid leukemia, characterized by a change in granulocytes (leukocyte fraction) and erythroblastic.

Blood scheme of a healthy child and a patient with leukemia

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

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

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

Occasionally, secondary leukemia occurs against the background of 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 life span of blast cells increases, and leukocytes practically cease to function.

In children, leukemia is manifested by non-specific symptoms:

fast fatiguability;
disruption of normal sleep;
loss of appetite, up to the absence;
causeless temperature jumps;
headaches often (small children cannot speak and cry all the time);
less often nausea and vomiting for no reason;
uneven enlargement of the nodes of the lymphatic system;
severe sweating of the baby at night;
joint swelling and aching pain in them.

In rare cases, the first symptoms of leukemia in children are manifested by 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 (enlargement of the spleen);
hepatopathy (pain in the liver and an increase in size);
lymphadenopathy.

The same type of manifestations in children of 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 has the first signs of illness, parents often confuse them with colds or attributed to the baby'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 unhealthy condition of the child, it is recommended to undergo a preventive examination:

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

This is necessary to differentiate the diagnosis. Very often, the symptoms of leukemia are similar to those of anemia. In advanced cases are assigned additional research or repeated to control the dynamics of the disease.

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

You can not ignore the slightest changes in the state of health of the baby, you should immediately seek advice from a pediatrician, finding even individual mild symptoms. With this pathology, an early diagnosis is important. The disease progresses rapidly.

Therapeutic measures

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

The following are used for treatment: chemotherapy, radiotherapy methods, bone marrow transplantation, the drug is rarely injected into the canal with cerebrospinal fluid. Medical treatment assigned according to the degree and type of damage circulatory system and also use hormone therapy to stimulate the immune system.

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

The most severe disease of the hematopoietic system - leukemia in children: symptoms identified on initial stage process helps to prevent the development of complications. The disease has characteristics, lightning-fast metastasis to vital organs is observed:

spleen;
liver;
brain;
bone tissue.

The child is more likely to develop acute liver failure and neuroleukemia.

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

The rapid progression of the disease leads to an unfavorable outcome if cytostatic therapy is not started in time. Hematologist determines the cause of a sharp exacerbation chronic tonsillitis, influenza, because the basis of ailments may be 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 that influence the development of blood pathology:

the effect on the patient's body of harmful chemicals;
genetic changes;
radio magnetic radiation;
viral disease;
electromagnetic influence.

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

There are several stages in the development of the disease:

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

Children with Down's disease often get leukemia. primary immunodeficiencies, polycythemia. After application intensive care during organ transplantation, the risk of developing leukemia in a child increases.

Initial manifestations of the disease

Important to remember: early detection disease improves the quality of life of the child.

The first signs of the disease should serve as a reason to visit a hematologist.

In babies aged 2-4 years, appears fatigue, bone pain, appetite changes, sleep worsens, subfebrile temperature body. At sudden development ailment, 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 greatly enlarged, and the lacrimal and salivary glands infiltrated. The child's face is puffy. Blood is released from the gums and nasal cavity, inflammation of the mucous membrane of the tongue develops.

The baby may complain of palpitations, and during auscultation, muffled heart tones and functional noise are heard.

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, impaired vision. Often the baby experiences intense thirst, indomitable craving for food, diencephalic syndrome develops. Pain in the bones are prolonged, masquerading as a manifestation of polyarthritis.

Symptoms of a dangerous disease

The disease is manifested by such characteristic symptoms as:

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

Intoxication is accompanied by fever, decreased appetite, sweating and weakness. In the body of a child, toxic substances accumulate - metabolites, tryptophan and tyrosine, the protective functions of the body are weakened.

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

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

hyperthermia;
vomit;
headache.

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

Blood test indicators for the development of leukemia in a child

General study blood in cancer in children 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 form of the disease.

Remission is characterized by stabilization overall 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 the change 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. Significantly increased ESR. For a different phase of the disease, a certain value of leukocytes is characteristic: from 0.1.10⁹/l to 100-300.10⁹/l. The number of granulocytes is 1.5.10⁹/l. It is characterized by a decrease in the number of monocytes.

The scheme of treatment of 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, with a variety of symptoms. Chronic leukemia develops over several years, accompanied by a period of remission with the complete disappearance of clinical symptoms.

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

Spicy myeloid leukemia affects children from 0 to 2 years old, 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 importance has the age of the patient and the initial number of leukocytes. A favorable prognosis of the disease is observed in children from 1 to 9 years of age, and nursing patients 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 recovery of the child.

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

Therapy of 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 the appointment of a course of chemotherapeutic drugs. Treatment consists of several phases. In induction therapy, the specific goal is to achieve remission.

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

Intrathecal treatment can destroy cancer cells that affect nervous system, with the help of drugs injected into the brain through lumbar puncture. The duration of therapy is different: 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.

Babies under 12 months of age have the lowest chance of recovery. Use for the treatment of a sick child radiotherapy, appointment cytostatic agents that inhibit the growth and development of cancer cells. Immune correction is carried out with the help of glucocorticoid drugs.

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

Oncological diseases, including leukemia, in children always cause real horror in parents. Each neoplasm has its own clinical features and therefore treated differently.

What it is?

Leukemias in children are neoplasms that form in the hematopoietic system. These diseases are quite dangerous. Some of them lead to lethal outcome. Every day, scientists around the world conduct numerous studies and develop new drugs that would allow the treatment of these diseases.

In leukemia, normally functioning cells are replaced by diseased ones. Ultimately, this contributes to the violation of the correct hematopoiesis in the baby. Since these diseases are oncological, treatment is carried out by pediatric oncologists. Usually a baby with leukemia is observed in cancer center throughout his life.

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

Some medical specialists called leukemia "leukemia". In translation, this means a new formation of blood. To some extent, this interpretation of the disease is correct. Leukemia interferes with the production of healthy cells hematopoietic system. Atypical cells appear, unable to perform their basic functions.

The body cannot control the formation of "poor-quality" cellular elements in any way. They form on their own. 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 in the bone marrow. This organ is responsible for blood formation 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 the disturbed physiology. Every year, large financial resources are allocated all over the world to search for drugs that would save babies with leukemia. It must be said that there are significant positive developments in this area.

Of all the types of leukemia in children, the most common form is the acute form. it classic version diseases. According to statistics, in the structure of oncological incidence of leukemia, every tenth 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 an increase in the incidence of blood neoplasms in children.

Causes

To date, there is no single factor that contributes to the development of this dangerous disease at babies. Scientists put forward only new theories that explain the causes of the disease. So, they proved that exposure to ionizing radiation can lead to the development of blood neoplasms. It renders destructive effect to the hematopoietic organs.

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

There are also scientific versions that leukemia develops after exposure to chemically hazardous substances. The 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 neoplasms. At present, information has also appeared that various endogenous substances can cause leukemia. These include: sex hormones and steroids, some metabolic products of tryptophan and others.

For a long time in the scientific world there is a viral theory. According to this version, many oncogenic viruses are genetically incorporated in the body. However, with adequate functioning of the immune system and the absence of external factors, they are in a passive or non-working state. Impact of various causative factors, including radiation and chemicals, contributes to the transition of these oncogenic viruses into 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 healthy baby cannot be infected from a baby with leukemia. Leukemia is not transmitted by airborne droplets or by contact. The cause of the disease lies in the depths of 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 babies.

At the end of the 20th century, several scientists from Philadelphia found that babies with leukemia have abnormalities in the genetic apparatus. Some of their chromosomes are somewhat shorter in size than in healthy peers. This finding was the reason for 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 shown that some congenital anomalies development lead to an increase in the occurrence of neoplasms of the blood. So, in babies with Down syndrome, the likelihood of getting 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 neoplasms in babies. It takes more time to establish the etiopathogenesis of the disease.

Kinds

The classification of all clinical variants is rather complicated. It includes all forms of the disease that can develop in both newborns and adolescents. It gives an idea to doctors about how to determine the disease in babies. Oncological classifications are reviewed annually. Various adjustments are regularly made to them in connection with the emergence of new results of scientific research.

There are currently several major clinical groups blood neoplasms:

Acute. These clinical forms of the disease are characterized by the complete absence of healthy cells. In this case, specific red blood cells are not formed. Usually acute leukemia in children has enough severe course and are characterized by a sad, unfavorable outcome. Adequate and properly selected therapy can somewhat prolong the life of a child.
Chronic. It is characterized by the replacement of normal blood cells with white ones. This form has a better prognosis and a less aggressive course. To normalize the condition, various schemes for the administration and prescription of drugs are used.

Blood neoplasms have several features. So, an 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 or non-lymphoblastic (myeloid). These clinical forms of pathologies have several characteristic features.

The acute lymphoblastic variant usually manifests itself already 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. Pathology usually proceeds with a severe course. This clinical form is characterized by the appearance of the initial focus of the tumor 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 is equally common in both boys and girls. Usually the peak incidence occurs at the age of 2-4 years. It is characterized by the appearance of a tumor formed from a myeloid hematopoietic germ. Usually the growth of the neoplasm is quite fast. When there are too many cells, they reach the bone marrow, which leads to impaired hematopoiesis.

Acute myeloblastic variant is characterized by the appearance of a large number immature cells - myeloblasts. Primary changes occur in the bone marrow. Over time tumor process distributed 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 neoplasms are:

Changes in hematopoiesis. The appearance in the analyzes of atypical and immature cells that are completely absent in healthy person. Such pathological forms are able to divide very quickly and increase in number in a short period of time. This feature causes the rapid growth of the neoplasm and the severity of the course of the disease.
Anemia. Decrease in the number of red blood cells - feature hematopoietic neoplasms. The reduced content of erythrocytes leads to the fact that tissue hypoxia occurs. This condition is characterized by insufficient supply of oxygen and nutrients to all organs and tissues of the body. Severe anemia is characteristic of oncological neoplasms.
thrombocytopenia. At given state declining normal amount platelets. Normally these platelets responsible for normal blood clotting. With a decrease this indicator the child has numerous hemorrhagic changes, manifested by the appearance adverse symptoms.

Symptoms

Usually the first signs of leukemia are very subtle. The well-being of the child early stages virtually no disease. Kid leads habitual image life. It is not possible to suspect the disease "visually". Leukemia is usually detected during clinical analyzes or upon transition to the active stage.

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

For some time, the child develops adverse symptoms of the disease. Skin tone often changes. It becomes pale or takes on an earthy color. Mucous membranes can erode and bleed. This leads to the development of stomatitis and gingivitis. In some cases, inflammation in oral cavity are ulcerative necrotic.

There may be an increase in lymph nodes. In some forms of leukemia, they become visible from the side. Usually the lymph nodes are dense to the touch and very tightly soldered to the surrounding skin. Doctors distinguish Mikulich's 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 in different ways in babies. The most characteristic manifestation is bruising on the legs. They usually appear spontaneously without traumatic injury and not as a result of falls. Babies may also experience nosebleeds and gum bleeding. Most dangerous forms- hemorrhages in the abdominal cavity.

Enough common symptom becomes the appearance of muscle pain and soreness in the joints. This is due to the development small hemorrhages in the articular spaces. long current disease leads to the development of pathological excessive fragility of bones in a child. Bone becomes loose and easily subject to any damage, as well as mechanical stress.

The active development of the disease leads to the appearance of disorders of the internal organs. For babies with leukemia, an increase in the size of the liver and spleen (hepatosplenomegaly) is characteristic. 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 work of the heart. This is largely due to severe anemia. Insufficient supply of oxygen to the heart muscle provokes increased contractions of the heart. In a child, this condition is manifested by the appearance of tachycardia, and in some situations - even arrhythmia (irregular heart rhythm).

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

The rapid development of the disease contributes to disorders in physiological development child. Usually, babies with leukemia lag significantly behind their peers in many health indicators. A 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 anticancer drugs, as well as the consequences of chemotherapy lead to severe suffering of the baby.

For leukemia, a decrease in the number of leukocytes is also very characteristic. 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. Babies with leukemia are several times more likely to get sick, even the most common 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 to identify the disease in a timely manner. These tests are prescribed to the child, as a rule, by a pediatric oncologist or hematologist. Experts diagnose everything oncological neoplasms blood.

You can suspect a disease at home if the child has adverse characteristic symptoms. If they are found, you should immediately contact for a consultation and for carrying 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 to 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. The acceleration of ESR in combination with a change in the number of erythrocytes and platelets also indicates a possible leukemia in a baby.

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

Additional diagnostic methods include highly informative studies - computed tomography and magnetic resonance imaging. They help to identify various neoplasms. Bone marrow studies reveal everything pathological changes, which are present in hematopoietic organ. MRI of the abdominal organs will help to detect an increase in 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 features baby. Children with multiple chronic diseases are more difficult to recover. It is not always possible to recover from leukemia. On the late stages diseases usually the prognosis is unfavorable.

Treatment

The appointment 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 stationary conditions. Usually the course of the disease is undulating. Periods of complete well-being, as a rule, are replaced by relapses.

The main therapy for leukemia is the appointment of chemotherapy drugs. The treatment regimen can be different and depends largely on clinical form illness. Therapeutic drugs may be prescribed for various dosages and vary in frequency of use. An important task of treatment is the selection of 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 with radical methods. These include: a bone marrow transplant from a donor and the introduction of stem cells. To eliminate the symptoms of severe anemia resort to blood transfusion.

Babies with leukemia must receive high-calorie nutrition. Usually their calorie content daily ration somewhat exceeds age norms. This diet is necessary for the child to active work immune system. Toddlers not getting what they need nutrients are weaker and do not tolerate chemotherapy well.

Prevention

Unfortunately, today specific preventive measures leukemia has not been developed. There has never been a magic cure for cancer. Every baby can get sick with leukemia, especially if he has factors predisposing to the disease. In order to identify neoplasms as early as possible, parents should be attentive to their baby. The appearance of the first adverse 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 better the prognosis. Some clinical options diseases respond well to treatment with chemotherapy drugs. A complete blood count helps to detect many signs of leukemia in the early stages. Such a study should be carried out annually for babies with risk factors.

What are the symptoms of a child's parents need to sound the alarm. The answer to this question lies in the water material.