Myeloproliferative diseases, causes, symptoms, the diagnosis of which will be discussed later, are a group of conditions against which increased production of platelets, leukocytes or red blood cells is observed in the bone marrow. In total, there are six types of pathologies.
General information
Bone marrow normally produces stem (immature) cells. After a while, they mature, become full. The stem cell may be the starting point for the formation of two types of elements: cells of the lymphoid and myeloid series. Immature cells are the material for the formation of white blood cells. From the elements of the myeloid series are formed:
- Red blood cells. They transport oxygen and other nutrients to organs and tissues.
- White blood cells. These elements are responsible for confronting infectious and other pathologies.
- Platelets. These cells prevent bleeding, form clots.
Before transforming into red blood cells, white blood cells or platelets, the stem cell must go through several stages. If a myeloproliferative disease is present, then 1 or more types of shaped cells are formed from a large amount of the starting material. Usually, the pathology progresses rather slowly, as the excess of blood elements increases.
Classification
The type that myeloproliferative disease can have depends on the number of red blood cells, platelets, or white blood cells. In some cases, an excess of elements of more than one species is noted in the body. Pathologies are divided into:
- Chronic neutrophilic leukemia.
- True polycythemia.
- Chronic myelogenous leukemia.
- Essential thrombocytopenia.
- Idiopathic (chronic) myelofibrosis.
- Eosinophilic leukemia.
Pathology stages
Chronic myeloproliferative disease can transform into acute leukemia. This condition is characterized by an excess of leukocytes. Chronic myeloproliferative disease does not have a specific staging scheme. Therapeutic measures will depend on the type of pathology. As for the pathways, myeloproliferative disease can develop in one of three ways:
- Germination in other tissues. In this case, the malignant neoplasm spreads to the surrounding healthy segments, affecting them.
- Lymphogenous way. Myeloproliferative disease can penetrate the lymphatic system and spread through its vessels through other tissues and organs.
- Hematogenous route. The cells of the malignant neoplasm penetrate the capillaries and veins that feed the tissues and organs.
When tumor cells spread, a new (secondary) neoplasm is likely to form. This process is called metastasis. Secondary, like primary neoplasms, belong to the same type of malignant tumor. For example, there is a proliferation of leukemic cells in the brain. Tumor elements are found in it. They relate to leukemia, not brain cancer.
Signs of pathology
How is myeloproliferative disease manifested? Symptoms of the pathology are as follows:
- Weight loss, anorexia.
- Fast fatiguability.
- Discomfort in the stomach and a feeling of quick satiety with food. The latter is provoked by an increase in the spleen (splenomegaly).
- A predisposition to bleeding, bruising, or manifestations of thrombosis.
- Impaired consciousness.
- Joint pain, swelling, provoked by gouty arthritis.
- Tinnitus.
- Soreness in the left upper quadrant of the abdomen and left shoulder, which is a consequence of the inflammatory process or spleen infarction.
Survey
Myeloproliferative blood disease is detected based on laboratory results. The survey includes the following activities:
- Examination of the patient. In this case, the specialist determines the general condition, reveals signs of pathology (swelling, for example), as well as manifestations that are not observed in a healthy person. The doctor also asks the patient about the lifestyle, past illnesses, bad habits, prescribed treatment.
- Deployed UAC. Blood sampling is carried out to determine:
- platelet and red blood cell counts;
- the ratio and number of leukocytes;
- hemoglobin level;
- the volume occupied by red blood cells.
- Bone marrow aspiration and biopsy. During the procedure, a thick hollow needle is inserted into the sternum or ilium. These manipulations allow you to take samples of bone marrow and tissue, as well as blood. The material is examined under a microscope for the presence of pathological elements in it.
- Cytogenetic analysis. This procedure allows you to identify changes in the chromosomes.
Chronic myeloproliferative disease: treatment
To date, there are several methods of treatment of pathology. This or that option is selected depending on the condition of the patient and the manifestations that accompany the myeloproliferative disease. Treatment can be prescribed standard - proven by practice, or experimental. The second option is a study using one or another new means.
Phlebotomy
This procedure is taking blood from a vein. The material is then sent for biochemical or general analysis. In some cases, phlebotomy is prescribed to patients who are diagnosed with myeloproliferative disease. Treatment in this case is aimed at reducing the number of red blood cells.
Platelet apheresis
This method is similar to the previous one. The difference is that there is the elimination of excess platelets using special equipment. The patient takes blood, which is passed through the separator. It delays platelets. The "purified" blood is returned to the patient.
Transfusion
This procedure is a blood transfusion. In this case, one element is replaced by another. In particular, the patient receives transfusion of leukocytes, erythrocytes and platelets instead of his destroyed and damaged cells.
Chemotherapy
This method involves the use of cytostatic drugs. Their action is aimed at destroying tumor cells or slowing the growth of tumors. With oral, intravenous or intramuscular use of drugs, their active components penetrate the systemic circulation, destroying pathological elements. Such chemotherapy is called systemic. The regional technique is the introduction of funds into the spinal canal, the affected organ or body cavity directly.
Radiation therapy
Treatment is carried out using x-ray or other high-frequency radiation. Radiation therapy allows the absolute elimination of tumor cells and slows the growth of tumors. In practice, two types of this treatment are used. External radiation therapy is the effect of an apparatus located next to the patient. In the internal method, radioactive substances are filled with needles, catheters, tubes, which are subsequently inserted directly into the tumor or into tissues located near it. Which method will be used by a specialist depends on the degree of malignancy of the process. Patients diagnosed with myeloproliferative blood disease are usually exposed to the spleen zone.
Chemotherapy with cell transplantation
This method of treatment consists in the use of drugs in high doses and the replacement of cells affected by the antitumor effect with new ones. Immature elements are obtained from the donor or the patient himself and are frozen. After chemotherapy, the stored material is introduced into the body. Newly introduced cells begin to mature and activate the formation of new blood elements.
Recovery period
After treatment, the patient should regularly visit a doctor. To evaluate the effectiveness of therapy, it may be necessary to carry out a number of procedures that were used previously before the appointment. In accordance with the results obtained, a decision is made to continue, complete or change the treatment regimen. Some examinations should be repeated regularly even after completion of the therapeutic course. They allow you to evaluate the effectiveness of measures and timely identify relapse.