Astana Medical University Department of Internal Disease №1

leucosis
Made by Yeleukenova Zhanel 463 GM
Check by Baidurin S.

A.

Astana 2018

of a blood cancer at which emergence of the pathological

mature neoplastic lymphocytes having abnormally long life expectancy is observed.

60 years.

DNA is programmed on a proliferation of abnormal lymphocytes.
At first

the damaged lymphocytes gather in lymph nodes. After achievement of a certain quantity they with current of a lymph migrate in a lien and a liver, thus, promoting augmentation of the sizes of the above-named organs. In process of the attack of marrow, malignant lymphocytes replace normal cells, provoking, anemic processes and reduction of quantity of healthy formulated elements of a blood. In parallel to these processes note decrease of the activity of antibodies.

in any way. If symptoms nevertheless appeared, belong to them:
The

lymphadenitis which isn't followed by pain
Fatigue
Temperature increase
Pain in the top left part of a stomach which can be caused by lien augmentation
Night sweating
Loss of weight
Frequent infections

packages becomes perceptible.
The lien reaches the appreciable sizes, its mass

is enlarged

g/l; the quantity of thrombocytes > 100x10/l is struck less

than 3 organs
Group B (the forecast intermediate) the Maintenance of HB and thrombocytes the same, as in group A; 3 organs and more are struck
Group C (forecast bad, less than 2-year survival) HB <100 g/l; quantity of thrombocytes <100x10/l

under a microscope it is possible to suspect a leucosis.

Most of patients with a chronic leucosis has an increased quantity of leucocytes and l, depression of number of erythrocytes and lymphocytes d thrombocytes. The maintenance of cells of a leykolizis is enlarged (Botkin's – Gumprekht cells)

Biochemical blood test helps to specify function of kidneys and structure of a blood.

The research of marrow gives the chance to establish the diagnosis of a leukosis and to estimate efficiency of treatment. Hyperplasia of lymphocytic elements.

of a research are used: cytochemistry, flowing cytometry, immunocytochemistry, cytogenetics

and molecular and genetic research.

X-ray inspections of a thorax and bones allow to tap a lesion of lymph nodes of a mediastinum, bones and joints.

The Computer Tomography (CT) gives the chance to find a lesion of lymph nodes in a thoracal cavity and a stomach.

research of a head and spinal cord.

Ultrasonography (US) allows to

distinguish tumoral and cystic educations, to tap a lesion of kidneys, liver and lien, lymph nodes.

diseases of Hemoimmunoterapiya;
Fludarabin + Cyclophosphamide + Rituximab (FCR);
Fludarabin + Rituximab

(FR);
Pentostatin + Cyclophosphamide + Rituximab (PCR);
Bendamustin + Rituximab (BR);
Obinutuzumab + Hlorambutsil.

associated diseases Obinutuzumab + Hlorambutsil;
Rituximab + Hlorambutsil;
Bendamustin (70 mg/sq.m in

1 cycle with rising to 90 mg/sq.m) + Rituximab (BR);
Cyclophosphamide + Prednizolon± Rituximab;
Rituximab;
Флударабин±Ритуксимаб;
Kladribin;
Hlorambutsil.

at treatment of a recurrence and refractory options of HLL

is Ibrutinib. Ibrutinib in a dose of 420 mg is applied (3 x 140-mg in capsules).

Indications for treatment ibrutiniby:
· ECOG status 0-1.
· The diagnosis of HLL, is established according to criteria of the mezhunanarodny working group on studying of HLL, 2008;
· Existence of indications by the beginning of therapy.
· To the patient должнен to be conducted at least one course of therapy of HLL with including of purine analogs or is taped

leukosis often have infectious diseases. In most cases it is

infections of the top and lower respiratory tracts. In certain cases there can be more serious infectious diseases.
Formation of more aggressive form of cancer. A small amount of the people suffering from a chronic lymphocytic leukosis can have more aggressive form of cancer, a so-called diffuse V-macrocellular lymphoma. Sometimes such degeneration is called Richter's syndrome.

neoplasms. At the people suffering from a chronic lymphocytic leukosis

the risk of formation of other types of cancer, such as melanoma, cancer of a lung and cancer of digestive tract is increased.
Disturbances from immune system. At a small share of patients with a chronic lymphocytic leukosis the autoimmune disease at which the cells of immune system designed to protect an organism from an infection by mistake attack erythrocytes or thrombocytes develops.