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It is the proliferation abnormal of the blood lineages (granulocytes) of the bony marrow, and also in the spleen. It is therefore a syndrome myeloproliferative.
In some cases, one notes the responsibility of the ionizing radiations or the exhibition to the benzene.
Chronic myelogenous leukemia The signs of the illness
The illness can occur to all age but especially at the young adult between 20 and 50 years. The diagnosis is evoked before a fatigue, a change of the general state, a weight of the left flank, a fever.
The discovery of a very big spleen and sometimes of a big liver orient the diagnosis.
Chronic myelogenous leukemia Exams and complementary analyses
The numeration formulates red chalk watch a very important hyperleucocytose (50 000 in 200 000 GB/mm3s) containing all elements of the lineage myélogranuleuse.
The myélogramme shows a very rich marrow with predominance of granular cells.
Chronic myelogenous leukemia The other exams and complementary analyses - * The biopsy of marrow;
- * The blood lyzozyme, the B12 vitamin, the uric acid is raised;
- * The phosphatases alkali leucocytaires is very bass;
- * The caryotype shows a shortening of the chromosome 22 (Philadelphia chromosome or Phi).
It is in fact about a translocation of a fragment of the chromosome 9 on the chromosome 22.
Chronic myelogenous leukemia Complications Are possible: - * Of the vascular thromboses;
- * Of the superinfections;
- * Of the hemorrhages;
- * The sharp transformation is an evolution possible of the leukemia chronic myéloïde.
The apparition of bony pains, of neurological signs, of signs of medullary insufficiency made practice the myélogramme that shows a marrow rich in blastes (young or immature cells).
Treatment
In the beginning of the illness the hydroxyurée (Hydréa) is efficient.
The Misulban (busulfan) preceded of a cure of allopurinol is used also to get a decrease of the number of the leukocytes.
Then the interféron esparto is prescribed.
A graft of marrow bony allogénique is proposed in some cases.
This treatment has the rate of the leukocytes and the size of the spleen decreased.
Leukemia chronic myélomonocytaire
It is a syndrome myeloproliferative concerning the aged topic.
A splenomegalie exists (increase of volume of the spleen, an anemia, a thrombopénie (decrease of the number of the blood tablets) moderate, an increase of the monocytes. Marrow is rich with blastes, of the monocytes.
Leukemias to tricholeucocytes
These are shrewd hémopathies characterized by a progressive medullary insufficiency with myélofibrose (fibrosis of marrow) and a blood infiltration of marrow and the spleen by "long-haired" cells.
The clinical signs are those of a neutropénie (reduction of some white globules) with big spleen and big liver. Some infections are frequent.
The diagnosis makes itself on the numeration formulates red chalk and the puncture of marrow.
The treatment uses the cladribine or the interféron esparto, the antibiotics in case of infection.
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