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 常见类型的白血病 are:

• 急性淋巴细胞白血病 (所有)
• 急性髓性白血病 (AML)
• 慢性淋巴细胞白血病 (CLL)
• 慢性骨髓性白血病 (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. 这导致了许多症状.

白血病的病因尚不清楚. 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在儿童中最常见.

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
• 一些遗传疾病，如 唐氏综合症
• 骨髓增生异常综合征 —a blood disease, which raises the risk for AML

症状

白血病的症状可能是:

• 感到虚弱或疲倦
• 发烧或盗汗
• 不劳而获的减肥
• 容易出血和擦伤
• 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. 会做一次身体检查. The doctor will check for swelling of the liver, 脾, 或者腋窝的淋巴结, 腹股沟, 和颈部.

测试可能包括:

• Blood tests—to look for leukemia ce在那 in blood
• 骨髓抽吸及 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
• 影像学检查，例如:
  • 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.

可以使用许多治疗方法. 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
• 支持性治疗，例如:
  • 防止副作用的药物
  • 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
• 骨髓移植—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

• 急性髓性白血病. EBSCO DynaMed网站. 可以在: http://www.力学.com/condition/acute-myeloid-leukemia-aml. 于2021年3月24日发布.
• 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. 国际卫生与环境卫生. 2019;222(1):49-67.
• 白血病. 美国癌症协会网站. 可以在: http://www.癌症.org/癌症/leukemia.html. 于2021年3月24日发布.
• 白血病. 白血病 & 淋巴瘤学会网站. 可以在: http://www.在那.org/leukemia. 于2021年3月24日发布.
• 白血病. 国家癌症研究所网站. 可以在: http://www.Cancer Types.gov /类型/Leukemia. 于2021年3月24日发布.
• 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. 于2021年3月24日发布.