The next day, Zifeng came to the city hospital, and Dr. Xu gave Zifeng an examination report and said to him that Worrying Er may have leukemia, this news is too unbearable for Worrying Child, who originally lost her memory, and now says that she may have a disease!

Zifeng looked at Dr. Xu and said, "Dr. Xu, are you sure?" I don't believe it's true! Zifeng said in disbelief!

"I know this is difficult for you to accept, but if you find it early, we can treat it slowly, and there is still a chance of recovery, Mr. Jiang, don't be discouraged!" Dr. Xu reassured!

"Doctor, is that the worry in the early days?" Zifeng asked.

"Yes! It's early! We initially thought it was acute lymphoblastic leukemia, and it had the following manifestations!

anaemia

It usually develops early and progressively worsens. Manifestations include pallor, weakness, dizziness, palpitations, anorexia, and edema. The degree of anemia in patients is often disproportionate to the amount of bleeding.

haemorrhage

About half of the cases have bleeding of varying severity. Bleeding usually occurs slightly later than anemia, but it often prompts the patient to seek medical attention and have a hemogram done. Common bleeding includes skin bleeding spots, purple epistaxis, gum and oral bleeding, and increased menstruation; In severe cases, hematuria, gastrointestinal bleeding (hematemesis, hematochezia), retinal hemorrhage can cause visual impairment, and even intracranial hemorrhage, which is often life-threatening.

Fever and infection

More than half of patients present with fever, which can be low-grade or high-grade. Regardless of whether the fever is pre-treatment or during treatment, I mostly mean that it is co-infected. Infections can occur anywhere in the body, but angina and stomatitis are the most common, upper respiratory tract and lung infections, perianitis, paraanal abscess, and gastroenteritis are more common, and leukemia is one of the leading causes of death. Some acute leukemia fever may have no obvious foci of infection (especially neutrophil <0.2×10^9\/L), but infection cannot be ruled out; On the other hand, patients with a body temperature of 38.5°C and fever that subsides spontaneously after the start of chemotherapy suggest that the fever is related to the leukemia itself (tumor fever). Of course, there is no shortage of clinical cases where tumor fever and infection coexist.

Common pathogenic bacteria for infection include Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Staphylococcus aureus and other conditionally pathogenic bacteria, anaerobic bacteria, etc.

Bone and joint pain

Leukemic infiltration of the bone and periosteum causes bone pain, which can be diffuse pain in the limbs or back, or localized to arthralgia, often causing difficulty in movement and easily misdiagnosed as osteomyelitis or rheumatism. More than one-third of patients have sternal tenderness, which is helpful in the diagnosis. A small number of severe bone pains are caused by bone marrow necrosis.

Enlargement of the liver, spleen, and lymph nodes

Mild to moderate hepatosplenomegaly is more common, usually no more than 4 to 6 cm below the costume. ALL has a higher incidence and more pronounced magnification than hepatosplenomegaly. Lymphadenopathy ALL is also common and can involve superficial or deep lymph nodes such as mediastinum, mesentery, retroperitoneum, etc., but the degree of enlargement is generally mild, usually ≤ 3.0 cm in diameter. Hepatosplenic lymphadenopathy is more pronounced in T-ALL AND B-ALL.

Central Nervous System Leukemia (CNSL)

CNSL often occurs during remission of ALL and is relatively rare in newly diagnosed patients. The site of infiltration is mostly in the arachnoid and dura mater, followed by the brain parenchyma, choroid, or cranial nerves. Severe patients have typical manifestations of increased intracranial pressure such as headache, vomiting, Xiang qiang, and even convulsions and coma. resembles intracranial hemorrhage; Mild cases only complain of mild headache and dizziness. Involvement of cranial nerves (mainly cranial nerves VI and VII) can cause visual impairment and facial paralysis.

Infiltration of other tissues and organs

Skin infiltration of ALL is relatively rare, and leukemia often appears in remission ALL, which is manifested as unilateral or bilateral painless enlargement with a hard and non-tender texture, which is the source of extramedullary recurrence of leukemia second only to CNSL. Leukemia infiltrates can also involve various tissues and organs such as the lungs, pleura, kidneys, digestive tract, heart, brain, uterus, ovaries, parotid glands, and eyes, and manifest dysfunction of corresponding organs, but can also be asymptomatic. Dr. Xu told Zifeng about the general symptoms of this disease!

"Doctor, is there a good chance of a cure?" Zifeng asked worriedly.

"Miss Jiang's is early, and the chance of cure is relatively high, you have to treat it as soon as possible! Our treatments are divided into several segments! Dr. Xu said.

"Those paragraphs." Zifeng asked.

General efficacy varies depending on the type and the period of discovery. The younger the patient, the higher the rate of recovery. Slow healing here means that the patient no longer has cancer cells in the body and the bone marrow is normal. Since the 50s, more people have survived longer thanks to significant advances in chemotherapy. For adult lymphoid leukemia (ALL), the recovery rate is between 80% and 90%, and if completely cured, 40% of patients can survive for another 5 years; For myeloid leukemia, the rate of recovery is between 60% and 70%, and if completely cured, 20% of patients will survive for at least 3 years.

For patients with this disease, the most important thing is to control the disease first. Patients must be hospitalized for chemotherapy, given a high-calorie, high-protein, high-vitamin diet, pay attention to oral hygiene, strengthen nursing, perform aseptic isolation, and treat regularly to prevent infection. Because people with leukemia have a small number of healthy blood cells, blood and platelets are usually transported to enhance natural immune function and hemostasis. Patients are also given other medications to prevent side effects such as nausea and vomiting during chemotherapy. Patients with ALL can wait for a satisfactory recovery after a few weeks of treatment in the hospital. To control the disease, patients should continue to receive low-dose chemotherapy and radiation therapy for 1 month or more to completely remove the cancer cells.

The best way to treat acute myeloid leukemia is to prolong its recovery period, which depends on the success of bone marrow transfer, bone marrow transplantation must be tissue type compatible, genetic characteristics are similar, and family members are usually selected as bone marrow donors.

There are three phases of bone marrow transplantation: preparation, surgery, and recovery. The patient's cancerous white blood cells are first controlled, usually with chemotherapy and, possibly, mechanical separation of the cancer cells from the bloodstream. During the procedure, the bone marrow is chemically cleaned to avoid rejection of the new person's bone marrow, and about a tablespoon of bone marrow is accepted from the donor. The recovery period is the most dangerous period, as the newly implanted bone marrow has not yet started to produce white blood cells, and the patient may die from infection at any time. It is not until 2~6 weeks later that the new bone marrow begins to produce blood cells efficiently. Bone marrow transplantation is very expensive and risky, but it gives patients with relapsed ALL a good chance of survival.

"That's the case, but if you want to have a bone marrow transplant, your relatives are gone, so what should I do!" Zifeng has a headache when she thinks of this! When he came out of the hospital, he had been thinking about this problem, he was very worried about Yu'er, he called Yu, and asked Yu to come out, and Yu'er's condition couldn't be delayed any longer! Zifeng has to discuss with Yu well, what should I do!