白血病

定义

白血病 is a 癌症 of the blood ce在那. Three main types of blood ce在那 are:

• White blood ce在那 (WBC), also called lymphocytes—help the immune system
• Red blood ce在那 (RBC)—carry oxygen
• Platelets—help the blood clot at injury sites

White blood ce在那 are most often involved in leukemia.

The most common types of leukemia are:

• Acute lymphocytic leukemia (所有)
• Acute myelogenous leukemia (AML)
• Chronic lymphocytic leukemia (CLL)
• Chronic myelogenous leukemia (CML)

白细胞

白血病 ce在那 outnumber healthy white blood ce在那 and gather in 脾 and lymph nodes.

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原因

白血病 starts in the bone marrow where blood ce在那 are made. It happens when certain blood ce在那 divide without control or order. The abnormal ce在那 crowd out the healthy blood ce在那. This causes many of the symptoms.

The cause of leukemia is not clear. It is likely a combination of genes and environment.

风险因素

AML and CML are most common in adults over 60 years. ALL is most common in children.

Other things that may raise the risk of leukemia are:

• A history of radiation treatment or 化疗
• Exposure to certain chemicals, such as benzene
• 吸烟-与AML相关
• Some genetic diseases, such as 唐氏综合症
• Myelodysplastic syndrome —a blood disease, which raises the risk for AML

症状

症状 of leukemia may be:

• Feeling weak or tired
• Fever or night sweats
• Weight loss without trying
• Easy bleeding and bruising
• 呼吸的问题
• Pale skin, or tiny red spots under the skin
• Painless lumps in the neck, underarms, belly, or 腹股沟
• Pain in the bones or joints, or discomfort in the belly

诊断

The doctor will ask about your symptoms and health history. A physical exam will be done. The doctor will check for swelling of the liver, 脾, or lymph nodes in the armpits, 腹股沟, 和颈部.

测试可能包括:

• Blood tests—to look for leukemia ce在那 in blood
• 骨 marrow aspiration and 活组织检查 —a sample of bone marrow is taken and tested for 癌症 ce在那

If 癌症 ce在那 are found, other tests may be done. These tests check if the 癌症 has spread. 它们可能包括:

• 腰椎穿刺 —tests fluid around the brain and spinal cord for 癌症 ce在那
• Imaging tests, such as:
  • 胸部x光检查
  • CT扫描
  • 核磁共振成像扫描
  • 超声波
  • PET / CT扫描

治疗

The goal for acute leukemia is to destroy 癌症 ce在那 and return blood and bone marrow to normal. Chronic leukemia is rarely curable. 治疗 focuses on slowing the disease.

A number of treatments may be used. It depends on the person's age, health, and the type and stage of the disease. 选项可能包括:

• Targeted therapy—drugs that reduce the number of 癌症 ce在那 in the blood and bone marrow
• 化疗 by mouth, injection, or IV—to kill 癌症 ce在那
• Immunotherapy—drugs to help the body fight 癌症 ce在那
• 支持ive therapy, such as:
  • Drugs to prevent side effects
  • Antibiotics and anti-viral drugs—to prevent infections
  • 输血—to replace low numbers of blood ce在那
• 外部 or 内部 radiation therapy—to kill 癌症 ce在那, often before a bone marrow transplant
• 骨 marrow transplant—an injection of healthy bone marrow, to make healthy blood ce在那
• 脾切除术—surgery to remove the 脾, if it is causing problems

预防

The risk of leukemia may be reduced by:

• 不吸烟
• Avoiding harmful chemicals, such as benzene
• Avoiding exposure to high levels of radiation, when possible

参考文献

• Acute myeloid leukemia. EBSCO DynaMed website. 可以在: http://www.力学.com/condition/acute-myeloid-leukemia-aml. Accessed March 24, 2021.
• Van Maele-Fabry G, Gamet-Payrastre L, et al. Household exposure to pesticides and risk of leukemia in children and adolescents: updated systematic review and meta-analysis. Int J Hyg Environ Health. 2019;222(1):49-67.
• 白血病. American Cancer Society website. 可以在: http://www.癌症.org/癌症/leukemia.html. Accessed March 24, 2021.
• 白血病. 白血病 & 淋巴瘤的社会 website. 可以在: http://www.在那.org/leukemia. Accessed March 24, 2021.
• 白血病. National Cancer Institute website. 可以在: http://www.Cancer Types.gov /类型/Leukemia. Accessed March 24, 2021.
• A PET scan may improve leukemia care. 威斯康星大学健康网站. 可以在: http://www.uwhealth.org/news/a-pet-scan-may-improve-leukemia-care/14001. Accessed March 24, 2021.