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diagnosis Once a doctor suspects that an individual's blood is abnormal, blood and bone marrow tests are performed to rule out leukemia. Additional tissue samples may be needed to confirm the diagnosis or to help plan treatment. If an individual has symptoms that suggest leukemia, the doctor may do a physical exam and ask about the personal and family medical history. The doctor also may order laboratory tests, including blood tests. Bone marrow tests: The bone marrow is sampled by a technique known as bone marrow aspiration. During this procedure, a thin, hollow needle with a syringe attachment is used to suction up (aspirate) a teaspoon-sized sample of liquid bone marrow from the back of the hip bone. A larger needle is then employed to obtain a bone marrow biopsy ("core" biopsy), which removes roughly a 1/16 inch cylindrical piece of bone marrow from the hip site. After the bone marrow samples are obtained, they are examined by many physician specialists, including a pathologist (disease diagnosis specialist, who examines samples under a microscope), hematologist (blood specialist), and oncologist (cancer specialist). The individual is generally awake during the procedure, but local anesthetics (such as lidocaine) and sedatives (such as midazolam or Versed®) may be administered. There is usually no pain involved. Cytogenetic analysis: Cytogenetic analysis detects changes in the chromosomes, including the presence of the Philadelphia chromosome (a genetic abnormality that can lead to leukemia). It can be done using a regular microscope or a more modern lab technology called fluorescence in situ hybridization (FISH). Blood will be drawn from the individual and analyzed for the genetic abnormality. X-ray: X-rays are used to see whether there are enlarged lymph nodes in the chest, localized masses in the lungs, or evidence of spreading to the outer bones or joints. Computerized tomography (CT): Computed tomography (CT) scan is a computer-assisted x-ray that produces cross-sectional images of the body. CT scans are not often used in leukemia patients unless the doctor suspects that the disease has spread to other organs. In such cases, CT scans may detect changes in the lymph nodes around the heart, trachea (windpipe), or abdomen. Lymph node enlargement is more common in patients with acute or chronic lymphocytic leukemia (ALL, CLL). Magnetic resonance imaging (MRI): Magnetic resonance imaging (MRI) scan is a procedure that uses electromagnets and radio waves to create computer-generated pictures of the internal organs. MRI may be used if the doctor suspects that leukemia involves the brain or lungs. Radionuclide scan: A radionuclide scan may be performed to rule out non-leukemic disorders in individuals who complain of bone pain. The radiologist injects the individual with a radioactive chemical (such as gallium-67), which will accumulate in areas of infection or malignancy and can be viewed with a special camera. This procedure is not used for individuals who already have been diagnosed with leukemia. signs and symptoms Leukemia cells are abnormal cells that cannot do what normal blood cells do. They cannot help the body fight infections. For this reason, individuals with leukemia often get infections and have fevers. Also, those with leukemia often have less than the normal amount of healthy red blood cells and platelets. As a result, there are not enough red blood cells to carry oxygen through the body. With this condition, called anemia, individuals may look pale and feel weak and tired. When there are not enough platelets, patients bleed and bruise easily. Like all blood cells, leukemia cells travel through the body. Depending on the number of abnormal cells and where these cells collect, patients with leukemia may have a number of symptoms. Some of the common symptoms of leukemia include: fever, chills, and other flu-like symptoms; weakness and fatigue; frequent infections; loss of appetite and/or weight; swollen or tender lymph nodes, liver, or spleen; easy bleeding or bruising; tiny red spots, called petechia,under the skin; swollen or bleeding gums; sweating, especially at night; and/or bone or joint pain. In acute leukemia, symptoms appear and get worse quickly. In chronic leukemia, symptoms may not appear for a long time. When symptoms do appear, they generally are mild at first and get worse gradually. Doctors often find chronic leukemia during a routine checkup - before there are any symptoms - with blood tests revealing abnormal white blood cell counts. In acute leukemia, the abnormal cells may collect in the brain or spinal cord. The result may be headaches, vomiting, confusion, loss of muscle control, and seizures. Leukemia cells can collect in the testicles and cause swelling. Some individuals develop sores in the eyes or on the skin. Leukemia also can affect the digestive tract, kidneys, lungs, or other parts of the body. Chronic leukemia often goes undetected for many years until it is identified in a routine blood test. Nearly one in five chronic leukemia patients have no symptoms at the time of their diagnosis. In chronic leukemia, the abnormal blood cells may gradually collect in various parts of the body. Chronic leukemia may affect the skin, central nervous system, digestive tract, kidneys, and testicles. complications Fatigue: Leukemia can cause individuals to have too few red blood cells, resulting in anemia. Anemia can make the individual feel tired by decreasing the number of red blood cells that can carry oxygen to tissues. Treatment for leukemia, such as with chemotherapy, can also cause a drop in red blood cells, leading to fatigue. Excess bleeding: Blood cells called platelets help control bleeding by prompting the blood to clot. A shortage of blood platelets (thrombocytopenia) can result in easy bleeding and bruising, including frequent or severe nosebleeds, bleeding from the gums, or tiny red marks caused by bleeding into the skin. Pain: Leukemia can cause bone pain or joint pain as the bone marrow expands when excess white blood cells build up. Enlarged spleen: Some of the extra blood cells produced when an individual has leukemia are stored in the spleen, causing the spleen to become swollen or enlarged. Rarely, the spleen becomes so large that it is at risk of bursting. More commonly, the swollen spleen takes up space in the abdomen and makes the individual feel full even after small meals or causes pain on the left side of the body below the ribs and difficulty breathing. Stroke or excess clotting: Some individuals with CML produce too many platelets. Without treatment, this high platelet count, called thrombocytosis, can cause excessive clotting of the blood, which can lead to stroke. Stroke is neurological damage to the brain due to a lack of oxygen. An increase in blood clotting can lead to the blocking of blood vessels in the brain, decreasing the oxygen to the brain tissue and causing brain cell death. Infection: White blood cells help the body fight off infection. Although individuals with leukemia have too many white blood cells, these cells are often leukemic (damaged) and do not function properly. As a result, they are not able to fight infection as well as healthy white cells can. In addition, treatment can cause the white cell count to drop too low (neutropenia), also making individuals vulnerable to infection. Metastasis: Metastasis is the movement or spreading of cancer cells from one organ or tissue to another. Leukemic cells in the blood can deposit into organs and tissues, such as the brain and spine, causing further cancer development. Death: If leukemia cannot be successfully treated, it ultimately is fatal. causes and risk factors Age: Approximately 60-70% of leukemia cases occur in individuals who are older than 50. The most common form of leukemia among children under 19 years of age is ALL. The incidence of ALL among one to four-year-old children is more than 9 times greater than the rate for young adults ages 20-24. Gender: Incidence rates for all types of leukemia are higher among males than among females. Males account for more than 56% of the cases of leukemia. This may be hormonally related. Radiation exposure: The risk of chronic myelogenous leukemia (CML) is increased among individuals who have been exposed to high doses of radiation. Radiation damages bone cells and may cause cancerous cells to develop. Atomic bomb survivors in Japan, those who lived near the nuclear reactor accident in Chernobyl, and armed forces who participated in American nuclear detonations during the late 1950s are examples of groups exposed to high levels of radiation. It is important to note, however, that standard diagnostic X-rays pose little or no increase in leukemia risk. Chemicals: The risk for acute leukemia is increased 20 times among workers with long-term exposure to benzene. Risk also is increased among workers exposed to some other solvents, herbicides, and pesticides. Agricultural chemicals, in particular, have been linked with an increased risk of chronic lymphocytic leukemia (CLL). In addition, some reports suggest that leukemia risk may be increased in workers in factories exposed to dioxin, styrenes, butadienes, or ethylene oxides. Viruses: The human T-cell leukemia virus I (HTLV-I) is related to acute T-cell leukemia. This type of leukemia is well documented in parts of the Caribbean and Asia, but it is uncommon in the United States and Europe. Higher rates of leukemia have also been reported in workers who are exposed to animal viruses, such as butchers, slaughterhouse workers, and veterinarians. Genetics: Studies have reported that in some types of leukemia, such as AML, genetics also may play a role in the risk for recurrence of the disease. Leukemia risk is increased 15 times among children with Down's syndrome, which is a genetically linked chromosomal abnormality (usually an extra copy of chromosome 21). Three rare inherited disorders, including Fanconi's anemia, Bloom's syndrome, and ataxia telangiectasia, also have an increased risk for leukemia. Race: Leukemia varies among racial and ethnic groups with different genetic make-ups. For example, rates of lymphoma and leukemia, such as chronic lymphocytic leukemia (CLL), are especially high in some Jewish populations, whereas Asian populations rarely develop CLL. First-degree relatives, including parents, children, and siblings of CLL patients, have two to four times the risk for leukemia due to genetics. Leukemia is one of the top 15 most frequently occurring cancers in minority groups. Cigarette smoking: Cigarette smoking is a known lifestyle-related risk factor for leukemia. Potential leukemia-causing chemicals in tobacco smoke include benzene, polonium-210, and polycyclic aromatic hydrocarbons (PAHs). These carcinogens (cancer-causing substances) are absorbed by the lungs and are spread via the bloodstream. It is estimated that one in four cases of acute myelogenous leukemia (AML) is the result of cigarette smoking. Cancer therapy: Individuals who have received chemotherapy and radiation therapy for previous cancers have a slightly greater chance of getting secondary leukemia (leukemia that arises after therapy). Acute myelogenous leukemia (AML) has been reported after chemotherapy and/or radiotherapy for various solid tumors (such as breast cancer and ovarian cancer), blood malignancies, and non-malignant conditions. The chemotherapeutic agents most often associated with secondary leukemias are procarbazine, chlorambucil, etoposide, mechlorethamine, teniposide, and cyclophosphamide. The risk is increased when these drugs are combined with radiation therapy. Many secondary leukemias are AMLs that develop within nine years after treatment of Hodgkin's disease, non-Hodgkin's lymphoma, or childhood CLL. Further chemotherapy often is ineffective in patients with secondary AML. Their prognosis is less favorable than that of typical AML patients. Other causes: The use of the antibiotic chloramphenicol has been linked with the development of childhood leukemia. Chloramphenicol is rarely used today. Other medications, such as growth hormones and phenylbutazone, also have reportedly shown some associations with leukemia. Leukemias and lymphomas have been observed in recipients of organ transplants, and certain immunodeficiency syndromes are associated with leukemias.
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akutne limfocitne leukemije ( ALL ) , jenajčešći oblik dječje leukemije . Akutne mijeloične leukemije ( AML ) , je manje učestala . Akutni oblici leukemije ih imaju tendenciju da se vrlo brzo razvijaju . Kronična mijelogena leukemija ( CML ) i kronična limfocitna leukemija ( CLL ), ne vidi se zapravo toliko u djece . Oni rastu sporije od akutne leukemije . Maloljetnička mijelomonocitnu leukemija ( JMML ) je rijetkost . Njegova stopa rasta pada između akutne i kronične leukemije . Uzrokuje koštane srži stvara matične stanice , koje razvijaju u zrele krvne stanice . Kadadijete ima leukemiju , te stanice stvaraju prekomjerne bijelo - krvnih stanica , a oni istisnuti prostor za zdraviji stanice . Prema American Cancer Association , znanstvenici još uvijek ne znaju zašto se to događa . Iako faktori rizika kao što su Downov sindrom , izloženosti radijaciji i presađivanja organa mogu pridonijeti njegovom razvoju . Dijete čiji brat ili sestra također imao leukemiju može biti na veći rizik . Simptomi Akodijete ima leukemiju , ona može često osjećaju umorno zbog nedostatak crvenih krvnih stanica . Budući da nemaju normalne bijele krvne stanice , ona možda neće biti u mogućnosti da se bori protiv groznice ili infekcije lako . I zato su abnormalne bijele krvne stanice istiskivanja trombociti , ona može modricu ili lako krvare . Ostali simptomi uključuju bolove u kostima i zglobovima , otečene trbuh , gubitak težine ili problema s disanjem . Ako primijetite kombinaciju tih simptoma kod vašeg djeteta , odmah nazovite liječnika . Dijagnoza Akoliječnik sumnja leukemije , on će napraviti kompletan pregled , uključujući krvnu sliku . Krvna slika određuje je lidijete nedostaje u crvenim krvnim stanicama i trombocitima i da li postoji previše bijelih krvnih stanica . Dalje , biopsijakoštane srži je učinio . Tijekom ovog postupka ,igla u kosti , auzorak se ukloni srži . Laboratorij ispituje uzorak vidjeti što vrste stanica živi u srži . Računalna tomografija ( CT) iliX - ray govori liječnika akoleukemija proširila . A ako on želi da vidi da li se proširio na spinalne tekućine , on će napraviti lumbalnu - ispitivanje proboja . Liječenje Liječenje će početi nakon štodijete je dijagnosticiran iliječnik zna kojoj fazi leukemijedijete u. Liječenje može potrajati 2 1 /2 do 3 godine, a može uključivati kemoterapiju i zračenje . U ciljano - terapije lijekovima , neki lijekovi se daju djetetu da se bore dijelove stanice raka . To može biti u kombinaciji s kemoterapijom . Transplantacija koštane srži su učinili , kada postojiopasnost od recidiva ili akorecidiv je upravo došlo . From:http://hr.265health.com/cancer/leukemia/1016014773.html