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Chronic Lymphocytic Leukemia

Causes and origins of chronic leukemia

In chronic leukemia, the proliferating cells are often reached maturity, unlike acute leukemia, which explains the slower spontaneous evolution.

Chronic lymphocytic leukemia is the most common cause of leukemia in the West (new cases per year for thirty thousand inhabitants), with a peak frequency to the sixties. Malignant cells are lymphocytes (that is to say, the cells of the immune system), and more particularly, in the vast majority of cases (over 95%), B lymphocytes.

Very rarely, the disease affects not B cells, but another category, T lymphocytes Then it is most often pro-lymphocytic leukemia T.

Diagnosis and symptoms of chronic leukemia

This is a review of the phenotype of blood cells (not bone marrow) that will make the diagnosis. According to their stage of development, the disease is very different and does not require the same treatment. Stage A, the increase in lymphocytes is the only abnormality identified, and it alone justifies any treatment: according to many experts, could even at this stage not to mention cancer, but rather "hyper-lymphocytosis B chronic. "
It simply performs a blood count monitoring every six months or every year, in order to identify a possible aggravation. Studies are underway to better identify chronic lymphocytic leukemia diagnosed at stage A and whose evolutionary potential unfavorable because they require early treatment. It is perfectly possible, even common, to stay in stage A for years.

We speak of chronic lymphocytic leukemia B stage when we find an increase in the lymph nodes in three different regions of the body (eg, cervical lymph nodes, axillary and inguinal lymph nodes or cervical, axillary and spleen). This is due to the fact that the abnormal lymphocytes left the blood and bone marrow to accumulate in these "reservoirs".

Finally, we speak of a stage C when there is a shortfall in production of other blood components such as red blood cells or platelets (related to marrow infiltration by malignant cells in excess), which can lead to anemia or thrombocytopenia. Lymphocytic leukemia pro-T is the most common cause of aggressive signs at diagnosis as the presence of lymph outset, a hyper-lymphocytosis associated with general signs of impaired general condition of the patient.

Treatment of chronic leukemia

At the stage of the disease does not warrant any treatment, but a simple monitoring.
In stage B and C, according to the patient's age and the prognosis of the disease, it can be proposed monochemotherapy orally, both specific since not affect normal lymphocytes and well tolerated because it cause any nausea or alopecia or chemotherapy, namely a combination of several drugs.

The treatment can also be based on the use of monoclonal antibodies, some of which are currently being tested in combination.

Finally, a hematopoietic stem cell transplant may (rarely) be necessary.

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