Leukemia

Definition

白血病是一种血细胞癌. 血细胞有三种主要类型:

• 白细胞(WBC)，也称为淋巴细胞，有助于免疫系统
• 红细胞(RBC)携带氧气
• 血小板——帮助血液在受伤部位凝结

白细胞最常与白血病有关.

最常见的白血病类型有:

• Acute lymphocytic leukemia (ALL)
• Acute myelogenous leukemia (AML)
• Chronic lymphocytic leukemia (CLL)
• Chronic myelogenous leukemia (CML)

White Blood Cells

白血病细胞数量超过健康的白细胞，聚集在脾脏和淋巴结.

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Causes

白血病起源于制造血细胞的骨髓. 当某些血细胞在没有控制或秩序的情况下分裂时，就会发生这种情况. 不正常的细胞排挤健康的血细胞. This causes many of the symptoms.

The cause of leukemia is not clear. 这可能是基因和环境共同作用的结果.

Risk Factors

AML和CML最常见于60岁以上的成年人. ALL is most common in children.

其他可能增加患白血病风险的因素有:

• 放射治疗史或 chemotherapy
• 暴露于某些化学物质中，如苯
• Smoking—linked to AML
• Some genetic diseases, such as Down syndrome
• Myelodysplastic syndrome -一种血液疾病，会增加患急性髓性白血病的风险

Symptoms

Symptoms of leukemia may be:

• Feeling weak or tired
• Fever or night sweats
• Weight loss without trying
• Easy bleeding and bruising
• Problems breathing
• 皮肤苍白，或皮肤下有小红斑
• 颈部、腋下、腹部或腹股沟的无痛肿块
• 骨头或关节疼痛，或腹部不适

Diagnosis

医生会询问你的症状和健康史. A physical exam will be done. 医生将检查肝脏是否肿胀, spleen, or lymph nodes in the armpits, groin, and neck.

Tests may include:

• 血液检查——在血液中寻找白血病细胞
• Bone marrow aspiration and biopsy -提取骨髓样本并检测癌细胞

如果发现癌细胞，可以进行其他检查. 这些检查检查癌症是否已经扩散. They may include:

• Lumbar puncture -检查大脑和脊髓周围的液体是否有癌细胞
• Imaging tests, such as:
  • Chest x-rays
  • CT scan
  • MRI scan
  • Ultrasound
  • PET/CT scan

Treatment

治疗急性白血病的目标是消灭癌细胞，使血液和骨髓恢复正常. 慢性白血病很难治愈. 治疗的重点是减缓疾病.

A number of treatments may be used. 这取决于人的年龄、健康状况以及疾病的类型和阶段. Options may include:

• 靶向治疗——减少血液和骨髓中癌细胞数量的药物
• Chemotherapy 通过口服、注射或静脉注射来杀死癌细胞
• 免疫疗法——帮助身体对抗癌细胞的药物
• Supportive therapy, such as:
  • Drugs to prevent side effects
  • 抗生素和抗病毒药物——预防感染
  • Blood transfusions-替换少量的血细胞
• External or internal 放射疗法——通常在骨髓移植前杀死癌细胞
• Bone marrow transplant注射健康的骨髓来制造健康的血细胞
• Splenectomy如果脾脏出现问题，手术切除脾脏

Prevention

以下方法可减低患白血病的风险:

• Not smoking
• 避免有害化学物质，如苯
• 尽可能避免接触高水平辐射

References

• Acute myeloid leukemia. EBSCO DynaMed website. Available at: http://www.dynamed.com/condition/acute-myeloid-leukemia-aml. Accessed March 24, 2021.
• 范梅尔-法布里G, Gamet-Payrastre L，等. 家庭农药暴露与儿童和青少年白血病风险:最新的系统评价和荟萃分析. Int J Hyg Environ Health. 2019;222(1):49-67.
• Leukemia. American Cancer Society website. Available at: http://www.cancer.org/cancer/leukemia.html. Accessed March 24, 2021.
• Leukemia. Leukemia & Lymphoma Society website. Available at: http://www.lls.org/leukemia. Accessed March 24, 2021.
• Leukemia. National Cancer Institute website. Available at: http://www.cancer.gov/types/leukemia. Accessed March 24, 2021.
• PET扫描可以改善白血病的治疗. UW Health website. Available at: http://www.uwhealth.org/news/a-pet-scan-may-improve-leukemia-care/14001. Accessed March 24, 2021.