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[問題] 血癌

什麼是AML (ACUTE MYELOID LEUKEMIA) 是否有得救?
Acute myeloid leukemia (AML), also known as acute myelogenous leukemia, is a cancer of the myeloid line of blood cells, characterized by the rapid growth of abnormal white blood cells that accumulate in the bone marrow and interfere with the production of normal blood cells. AML is the most common acute leukemia affecting adults, and its incidence increases with age. Although AML is a relatively rare disease, accounting for approximately 1.2% of cancer deaths in the United States,[1] its incidence is expected to increase as the population ages.. n$ [, X' e$ P+ X% l

+ N; ?. {8 E6 k5 M8 X9 Twww2.tvboxnow.comThe symptoms of AML are caused by replacement of normal bone marrow with leukemic cells, which causes a drop in red blood cells, platelets, and normal white blood cells. These symptoms include fatigue, shortness of breath, easy bruising and bleeding, and increased risk of infection. Several risk factors and chromosomal abnormalities have been identified, but the specific cause is not clear. As an acute leukemia, AML progresses rapidly and is typically fatal within weeks or months if left untreated.www2.tvboxnow.com) k" K5 C0 Y. M

# `# c7 Y8 C% K! E# s, Y+ i$ [AML has several subtypes; treatment and prognosis varies among subtypes. Five-year survival varies from 15–70%, and relapse rate varies from 33-78%, depending on subtype. AML is treated initially with chemotherapy aimed at inducing a remission; patients may go on to receive additional chemotherapy or a hematopoietic stem cell transplant. Recent research into the genetics of AML has resulted in the availability of tests that can predict which drug or drugs may work best for a particular patient, as well as how long that patient is likely to survive.
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  • carwing

Thank you very much, tonyic, nice and clear.
AML:acute myelocytic leukemia 即急性髓细胞白血病,是一类白血病的总称.www2.tvboxnow.com- j1 m) E- Z6 m
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AML的年发生率约是每10万人中有2.3人,而且年纪越大发生的机会越高.
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病因: 目前还没有找到真正的致病因,但一般认为遗传、辐射、化学物质(如苯)、药物及其他职业上的暴露(如浓烟、颜料、杀虫剂等)可能与AML的发生有关.
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临床表现:  ⑴.贫血 如苍白,无力,心悸,气短等,老年病人贫血更为多见。少数病例可在确诊前数月至数年先出现难治性贫血(refractory anemiaRA),以后再逐渐发展成AML(但绝少发展为ALL)。发生贫血的原因有:由于正常造血干细胞因白血病克隆增殖而受抑,红系祖细胞对红细胞生成素(erythropoietin,EPO)的反应性降低,骨髓微环境破坏使红细胞生成减少;出现无效红细胞生成;合并明显(少见)或隐性溶血,红细胞寿命缩短;合并急、慢性失血,或脾功能亢进等。 & b" t& M" j' ]( x, ]

+ }7 N4 g* y+ q; a  w公仔箱論壇  ⑵.发热和感染 发热是初诊尤其是化疗骨髓抑制期患者的常见症状,其原因主要是感染,感染可发生在体表、体内任何部位。中性粒细胞减少(当<1.0×109/L时感染机会明显增多)伴功能缺陷,化疗和皮质激素的应用使机体免疫功能下降皮肤、黏膜(口腔、胃肠道等)出血、溃疡导致屏障破坏是引起感染的主要因素。
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  ⑶.出血 约60%的初诊AML有不同程度出血,皮肤黏膜(鼻、口腔及牙龈)出血最常见,眼底、球结膜出血较易见,女性可有月经增多,血尿较少见,但镜下血尿不易被发现,严重的胃肠、呼吸道和颅内出血虽不多见却常是致死的原因。急性白血病出血的机制较复杂:骨髓衰竭导致血小板减少是最重要的原因。通常血小板<20×109/L时多伴高危出血倾向,若合并全身感染或严重贫血时更可加重出血;化疗、细菌内毒素和白血病细胞浸润损伤血管内皮以及凝血障碍都是引起出血的因素。
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  • carwing

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