"I'm not the God of Medicine", "Blood Doubt", "Blue Life and Death"... Many people's understanding of leukemia comes from film and television dramas.
As a type of blood tumor, leukemia not only harms the entire blood and immune system, but also affects every system in the body.
Among them, acute myeloid leukemia (AML) is the most common type of acute leukemia in adults.
It is ferocious and has limited treatment options, especially for most elderly patients, with a median survival of between 6 and 10 months, and has been dubbed the "older's nightmare."
April 21st is World AML Day.
Taking this opportunity, let's take a look at AML
Correspondent Cao Yong
Yangzi Evening News/Ziniu News reporter Yang Yan
Unexplained persistent bleeding should be vigilant
Ms. Chen, 24 years old this year, has just been married for more than a year, and her husband is about to have a baby.
One day in 2021, Ms. Chen suddenly developed a palm-sized ecchymosis on her waist and abdomen. At the same time, she developed persistent fever, repeated coughing, expectoration of phlegm, and chest tightness.
Subsequently, Ms. Chen was rushed to the hospital by her family members.
The "ecchymosis" on Ms. Chen's body attracted the attention of Zhu Yu, the deputy director and deputy chief physician of the Department of Hematology, Jiangsu Provincial People's Hospital (The First Affiliated Hospital of Nanjing Medical University).
Because according to Dr. Zhu Yu's many years of experience, the sudden appearance of "ecchymosis" is a symptom of subepidermal bleeding. After ruling out the cause of the collision, Dr. Zhu Yu highly suspected that the patient's blood system had a "problem". .
Subsequently, Ms. Chen's blood test confirmed Dr. Zhu Yu's judgment.
Routine blood tests showed that the white blood cells were much higher than normal, but the platelet count was only one-tenth of that of normal people. Dr. Zhu immediately advised the patient to have a bone marrow examination.
After bone marrow biopsy, Ms. Chen was finally diagnosed with acute myeloid leukemia.
Fortunately, after chemotherapy and allogeneic hematopoietic stem cell transplantation, Ms. Chen was out of danger and is now in stable condition.
What the heck is AML?
Fortunately for Ms. Chen, because of her young age, her acute myeloid leukemia was effectively controlled after chemotherapy and hematopoietic stem cell transplantation.
However, for those elderly patients over 60 years old, the disease is extremely aggressive. Most elderly AML patients have high-risk genetic characteristics, high treatment difficulty, extremely low survival rate after onset, and 5-year survival rate of diagnosed patients. It's only about 5%-15%, which is a pity!
Most elderly patients cannot tolerate intensive chemotherapy due to their weak physical conditions, which greatly reduces the clinical efficacy. Their median survival time is a short 6-10 months.
Therefore, acute myeloid leukemia is also known as "the nightmare of the elderly"!
To understand it, we have to start with a relatively small but very important cell in the human body - hematopoietic stem cells.
Hematopoietic stem cells mainly exist in the human bone marrow, can self-renew and differentiate into blood cells with various functions, including the "three brothers" who perform their respective duties - red blood cells in the "oxygen transport department" and "hemostasis department". platelets and white blood cells of the "immune sector".
It is the efforts of hematopoietic stem cells that help the establishment and dynamic balance of the human blood system.
The problem arises when malignant clones of hematopoietic stem cells appear.
Leukemia cells proliferate unrestrictedly in the bone marrow, making red blood cells, white blood cells, platelets and other cells unable to produce and function normally.
The limited generation of the "three brothers" has led to "malfunctions" in the "oxygen transport, hemostasis and immune departments", causing fever, infection, bleeding, anemia, hepatosplenomegaly and other symptoms, and finally leading to multiple organ dysfunction and even death.
Avoid these risk factors
With the advancement of medical technology, the gene mutation of acute myeloid leukemia can be detected in many patients through gene detection technology, and many gene mutations have become the target of targeted therapy. By combining targeted drug therapy, it can effectively relieve the patient's condition.
"At present, genetic testing for patients with acute myeloid leukemia has become a very important part of the diagnosis and treatment process. Although genetic testing is expensive, it is an indispensable step in formulating a comprehensive diagnosis and treatment plan. Currently, medical insurance also covers For some genetic testing projects, 40%-50% of the cost can be paid to help reduce the burden on patients." Dr. Zhu Yu told us.
Here, Dr. Zhu Yu also reminds the general public: in daily life, try to minimize contact with newly renovated houses; it is best to test for chemical components such as formaldehyde and benzene before moving in; reduce the frequency of hair dyeing, especially to avoid some inferior hair dyeing Stop smoking, limit alcohol, eat more fruits and vegetables; at the same time, maintain good living habits, maintain a good mood, and improve the body’s immunity and resistance; in case of colds, fever, soft tissue swelling and pain, in the drug At the same time of treatment, remember to carry out routine blood tests to prevent missed diagnosis of acute myeloid leukemia.
Elderly patients should pay special attention to symptoms such as hemorrhage, fever, hepatosplenomegaly, etc., and seek medical examination in time.