Acute leukemia is a disease of the hematopoietic system, which is based on the unlimited proliferation of tumor cells, which are its morphological substrate. Acute myeloid leukemia according to the FAB classification is divided into seven options. The classification is based on the level of differentiation of cells representing the substrate of leukemia. A tumor clone of myeloblasts originates from stem cells that are able to grow colonies of myeloid cells, megakaryocytes, red blood cells, and macrophages.
The most commonly observed variants are M0 ‑ M3. The first two are based on cells without differentiation. Option M2 - differentiated cell. M3 ‑ promyelocytic variant, characterized by abnormal cells with giant granules. M4 and M5 - myelomonoblastic and monoblastic leukemia. M6 - erythromyelosis, with enhanced proliferation of erythroid cells. M7 - megakaryoblastic leukemia. Of all the options that represent acute myeloid leukemia, the prognosis is most favorable for M0 ‑ M2.
Etiopathogenesis of leukemia
What is acute myeloid leukemia. The disease is based on the increased ability of cells to mutate, arising under the influence of external factors (radiation, viruses, chemicals) and a predisposition to hereditary instability of the genome. As a result, tumor cells capable of unlimited division arise. They form a clone, which, in turn, by repeated mutations gives rise to subclones.
Tumor cells are continuously formed in the bone marrow, damaging and displacing the normal germ of hematopoiesis. Gradually, they enter the peripheral blood and metastasize to the organs, forming additional foci of pathological hematopoiesis. Myeloid leukemia develops with a characteristic clinical picture of it.
Clinic of acute myeloid leukemia
Due to impaired normal blood formation in patients, anemia develops, the number of mature neutrophils and platelets decreases sharply. Dizziness worries. weakness. Signs of bleeding appear: hemorrhages on the skin and mucous membranes, increased bleeding during menstruation, nosebleeds. Bone pains, an increase in lymph nodes of various groups appear. The spleen and liver increase. Due to impaired leukocyte function, decreased immunity, acute myeloid leukemia flows with the addition of infections. Often he manifests with severe sore throats.
In the later stages, signs of renal failure and neurological symptoms may join.
In its course, acute myeloid leukemia goes through the stages of developed manifestations, remissions, relapses. In case of ineffective treatment, it ends in a terminal stage. The stages of the disease are characterized by clinical manifestations and a certain picture of blood and bone marrow.
Leukemia Diagnosis
Acute myeloid leukemia is based on cytochemical studies of cells representing its substrate, and immunophenotyping - the determination of myeloid cell markers. The morphological methods for detecting blast cells in establishing the type of leukemia are given indicative value, although they continue to be used.
Sometimes a genotypic research method based on a polymerase chain reaction is used. It is used to determine the residual manifestations of the disease in patients in remission.
The prognosis of acute myeloid leukemia is less favorable than the prognosis for acute lymphocytic leukemia. Up to 75% of patients with adequate treatment achieve remission. There is evidence of a cure of 20% who have reached remission with continued intensive treatment. Bone marrow transplantation gives encouraging results.