The chronic lymphoid leukosis
(HLL) represents a benign tumor, its substrate is made by mainly morphologically end-stage lymphocytes. The disease is shown by a lymphatic leukocytosis, diffusion lymphocytic growth in marrow, a hyperadenosis, a spleen and a liver.
Classification of a chronic lymphoid leukosis
According to classification To. R. Raic soavt. (1975) allocate five stages of a disease.
0. Lymphocytosis in peripheral blood or marrow
over 15 x 109/l
1. Lymphocytosis and increase in lymph nodes.
2. A lymphocytosis and increase in the sizes of a liver or spleen (the lymphadenopathy can be absent).
3. A lymphocytosis and decrease in hemoglobin less than 100 g/l (other signs can be absent).
4. A lymphocytosis and decrease in quantity of plates
less than 100 x 109/l
(other signs can be absent).
classification of J. - L. Binetc soavt.
(1977) three stages are allocated.
A. Involvement of lymph nodes no more than in three areas.
B. Involvement of lymph nodes of three and more areas.
C. Accession of anemia with hemoglobin level less than 100 g/l and/or thrombocytopenia
less than 100Õ109/l
Symptoms of a chronic lymphoid leukosis
Most often the first symptom of a chronic lymphoid leukosis is the angiomegaly. Owing to increase in a spleen, emergence of heavy feeling in a stomach is possible. Quite often patients test considerable general weakness, lose weight, they increased the frequency of development of infectious diseases. Symptoms develop gradually, for a long time. Approximately in 25% of cases the disease is found accidentally at the blood test appointed in other occasion (medical examination, inspection concerning not hematologic disease).
In most cases at primary address of the patient there is not enough research of peripheral blood (absolute lymphocytosis). Sternal puncture, a trepanobiopsiya of an ileal bone and according to indications a biopsy of a lymph node are necessary (with prints). The histologic picture in typical option of a disease is provided by infiltration by small lymphocytes among which a small amount of prolymphocytes, lymphoblasts is found, the stertost of the drawing of the structure of a node takes place, the significant resorption of bone beams with their thinning and formation of fragments comes to light. Infiltration of marrow generally small lymphocytes has diffusion or diffusion and focal character. The volume of fatty tissue is sharply reduced.
Treatment of a chronic lymphoid leukosis
From the moment of diagnosis of the patient is under observation of the hematologist and during certain time (up to several years) special therapy is not carried out.
Carry out vitamin therapy - vitamins of group B (B6, B12), ascorbic acid, additional rest is recommended, it is necessary to avoid overcooling.
When progressing process appoint cytostatics: Chlorbutinum of 2-5 mg 1-3 times a day.
At emergence of signs of a decompensation Cyclophosphanum of 200 mg/days is most effective. With signs of sarcomatous transformation apply combinations of drugs: vinblastine (10 mg/week.) + Cyclophosphanum (1000 mg/week.) 3-4 weeks.
LITTER (Cyclophosphanum of 600 mg/sq.m + Vincristinum of 2 mg/sq.m in the 1 and 8 days + Prednisolonum of 60 mg from 1 to 14 day), schemes MOP, CHOP. Radiation therapy is shown at small efficiency of chemotherapeutic drugs. The total dose makes 3000 is glad. Apply on area of the increased lymph nodes and a spleen. For potentiation of action of cytostatic therapy conduct 7-10-day courses of steroid drugs small doses. Antibacterial drugs of a broad spectrum of activity for treatment of complications + gamma-globulin of 2-8 doses every other day. In viral infections add a deoxyribonuclease on 20-40 mg to treatment 1-2 times a day intramusculary and locally. The patient appoint a bed rest.
In hemolytic and posthemorrhagic anemia carry out transfusion of eritrotsitny weight. With a high leukocytosis and a cytopenia apply to treatment of a lymphoid leukosis leykotsitoforez.
From the moment of detection of a disease of HLL all patients have to be under observation of the hematologist. The doctor has to explain danger of contact with infections, needs in additional rest. Sick HLL the sick note for rest and recuperation, especially during the outbreaks of viral infections is issued. Sanatorium treatment is recommended to patients. Contacts with toxic substances, overcooling and insolation, hard physical work are contraindicated to them.
The working capacity of sick HLL remains, but the choice of profession and working conditions is carried out according to the recommendation of VTEK. Only at frequent infectious complications, a process decompensation, tumoral forms the patients lose working capacity (become disabled group), and then require foreign care (disabled people of the I group). Average lifetime of patients with a chronic lymphoid leukosis makes about 3-5 years. However some patients live much more, and duration of their life is 25-30 years
Folk remedies at treatment of a chronic lymphoid leukosis
Practically in all leukoses recommend the phytotherapy rich with iron and ascorbic acid.
to make boiled water 25 g of fruits of a rowan and 25 g of hips, to accept on 1 glass a day.
To fill in 25 g of hips and 25 g of berries of blackcurrant with boiled water, to insist. To accept on 1/2 glass 3-4 times a day.
Tincture of a sabelnik marsh:
To pour out 60 g of a sabelnik in a half liter can and to fill in with good vodka. To close a cover and to insist 8 days in the dark place. To accept on 1 tablespoon, diluting 50-100 ml of water, 3 times a day to food. For a course it is necessary to drink not less than 3 l of tincture.
Infusion of a sabelnik marsh:
To make 1 tablespoon of the crushed grass of a sabelnik 1 glass of boiled water. To insist 1 hour. To filter. To drink in a day equal parts. The course of treatment lasts not less than half a year.
The lungwort medicinal
regulates activity of hemadens, strengthens formation of blood, stops bleedings. The lungwort possesses anti-inflammatory, knitting, antiseptic and wound healing actions.
Infusion of a lungwort medicinal:
To fill in 1-2 tablespoons of the crushed dried-up grass with 2 glasses of boiled water, to insist 2 hours, to filter. To accept on 1/2 glass 3 times a day in 20-30 minutes prior to food.
Tincture of a white silverweed:
100 g of a dry root of a silverweed to fill in 1 l of vodka, to insist 21 days in the dark place, to filter. To accept 30 drops 3 times a day in 20 minutes prior to food.
Tincture of a red brush:
50 g of a dry root to fill in 1 / 2 l of vodka, to insist 30 days in the dark place. To accept till 30-40 drops (incomplete teaspoon) 3 times a day za30-40 minutes to food.
Chronic lymphoid leukosis at children
At children's age forecast of a disease favorable:
the lymphoid leukosis at children
recovers in 95 cases from hundred. At adults it is much more difficult to predict a course of a disease as adults are more inclined to a recurrence and worse react to chemotherapy. At the same time, each recurrence of a disease worsens the forecast of a lymphoid leukosis for 10 — 12%.