Survival period of leukemia in the elderly
1. How long can the elderly live with leukemia?
The survival period of leukemia in the elderly mainly depends on the treatment of patients. Different patients have different treatment conditions, so the life span is uncertain. Elderly patients should be treated according to their own conditions, and reasonable treatment can prolong the life of patients.
2. What are the symptoms of leukemia in the elderly?
About two-thirds of the elderly over 60 years old have a slow onset and are often asymptomatic in the early stage. Most of them were found during physical examination or blood test. The main clinical manifestations are lymphadenopathy and hepatosplenomegaly. The symptoms of senile leukemia are mostly comprehensive, not only anemia, but also other complications: the incidence of senile leukemia will be higher, and the onset will be slower and more subtle than that of adults. The main symptom at the time of onset is anemia, and other symptoms rarely appear. Some elderly leukemia patients show low proliferative leukemia, cytopenia and low bone marrow proliferation. Leukemia in the elderly is mostly chronic lymphoblastic leukemia, which is asymptomatic in the early stage and develops slowly. Many of them were found during physical examination or blood test. Clinically, the main manifestations are lymphadenopathy and hepatosplenomegaly. Many patients will live longer because of the slow progress of the disease. Some elderly people will suffer from hairy cell leukemia, a rare chronic leukemia. Its onset is hidden, patients are prone to fatigue, splenomegaly and other symptoms, and its hemogram is pancytopenia.
3. Pathogenesis of leukemia in the elderly.
The incidence of leukemia in the elderly is relatively high. First of all, acute leukemia is the most common and chronic leukemia is the most common. Secondly, acute leukemia is characterized by a sharp increase in immature white blood cells, which generally account for less than 5% in bone marrow. This phenomenon of rapid increase of immature white blood cells prevents bone marrow from producing healthy blood cells and is replaced by immature white blood cells. Acute leukemia is more common in adolescents and children. Acute leukemia must be treated immediately because of the sharp increase and spread of malignant cells. If left untreated, the patient will die within months or even weeks, and the degree of bone marrow hyperplasia is low.
Methods of preventing leukemia in the elderly
1, primary prevention: eat more fresh fruits and vegetables, eat a reasonable diet, exercise properly, and enhance the body's resistance. Advocate environmental protection and reduce the pollution of natural resources. Pregnant women should avoid ionizing radiation and unnecessary drug intake during pregnancy.
2. Secondary prevention: screening people, middle-aged and elderly people should have regular physical examinations in order to find asymptomatic leukemia patients. Necessary further examination of suspicious cases, such as blood routine, white blood cell classification, B-ultrasound, lymph node puncture smear, etc. Do early detection, early diagnosis and early treatment.
3. Tertiary prevention: Patients who have been diagnosed with chronic lymphoblastic leukemia are given appropriate treatment according to clinical stages, physical condition and complications. Control the disease, improve the quality of life of patients and prolong the survival time.
Can leukemia be cured?
1, experts explained that whether leukemia can be cured depends on the specific situation of the patient, because the emergence of leukemia will not only weaken the patient's physique, but also be related to psychological stress and trauma, but as long as the patient can actively cooperate with the treatment, it can be recovered.
2. First of all, the cure of leukemia requires the patient to make a correct diagnosis, analyze and remove the mental factors that lead to the disease, so that the patient's mind can change from dull to cheerful, establish confidence in life, and get rid of the shadow of trouble and anxiety. In the treatment, don't choose a doctor, especially don't listen to false advertisements and quack doctors, so as not to be deceived. The reliable way is to go to a regular hospital for treatment. Health education should be given to patients to make them realize that leukemia is neither incurable nor contagious, so there is no need to worry. However, there is no specific medicine for leukemia at present, so we should be prepared for a protracted war.
The latest drugs for leukemia
1, drugs that interfere with nucleic acid biosynthesis
These drugs are also called antimetabolites. They interfere with the division and reproduction of leukemia cells through their own specificity. The specific varieties are:
Cytarabine, injection. It is used for all kinds of acute leukemia and meningeal leukemia, and is the most effective and widely used variety in chemotherapy.
Cyclic cytidine. Injection. Indications are the same as cytarabine.
Methotrexate (mtx) is commonly used as injection and tablet. It is the most important therapeutic drug for childhood lymphoblastic leukemia and the first choice for all intrathecal chemotherapy.
Hydroxyurea (hu) is taken orally. It is the main therapeutic drug for chronic myeloid leukemia.
6- mercaptopurine (6-mp, LG). It is an oral maintenance drug for acute lymphoblastic leukemia. It is also used for chronic myeloid leukemia.
Oral 6-tg in the treatment of acute leukemia or chronic myeloid leukemia.
Leukemia patients are indifferent to chemotherapy.
2. Drugs that directly affect the dna structure and function of cancer cells.
They include alkylating agents, topoisomerase inhibitors and some kinds of antibiotics. Its function is to destroy the dna chain of cancer cells, wrong code base pairing, and make its function invalid. These varieties are:
Ann (Bai An, Malan, Mai, Bu). Oral drugs for chronic myeloid leukemia are rarely used now.
Podophyllotoxin derivatives for injection. It is an important therapeutic drug for refractory leukemia.
Wei Meng (Zanthoxylum nitidum, vm-26). New? Instead of podophyllum derivatives, it is mostly used to treat children's acute gonorrhea.
Mitomycin injection. For chronic myeloid leukemia and lymphoma.
Chlorambucil (Liu Kening, cbl, cb 1348), oral. Mainly used for chronic lymphocytic leukemia and hairy cell leukemia.
Phenylalanine nitrogen mustard, oral. Mainly used for chronic gonorrhea or chronic myelopathy.
Bian Nitrogen Mustard Injection. Mainly used for meningeal leukemia and chronic lymphoma.
Cyclophosphamide (ctx) has injections and tablets. Can be use for treating various leukemia, and forms different chemotherapy schemes with other anti-leukemia chemotherapy drugs.
Cyclohexylnitrosourea. Oral treatment of meningeal leukemia and chronic lymphoma.
3. Drugs that interfere with the transcription process and prevent rna synthesis
Daunorubicin Injection. It belongs to anthracycline antibiotics, which can be embedded between dna base pairs, inhibit rna synthesis and prevent dna replication, and has cytotoxic effect. It is an important drug for the treatment of various acute leukemia, and has a good effect on acute lymphoblastic leukemia. It can also be used as a second-line chemotherapy drug resistant to other chemotherapy.
Adriamycin for injection (nordoxorubicin, 1da, adm). In recent years, it has been listed as a drug with the same mechanism as daunorubicin, but with better curative effect. It has been used as the first choice for the treatment of acute leukemia, but it is expensive.
Adriamycin injection. The pharmacological action and indications are the same as daunorubicin, but the gastrointestinal side effects are relatively large.
Epirubicin (ep 1), an isomer of adriamycin, has the same curative effect as adriamycin, but its toxicity is low, especially cardiotoxicity.
Pyrrubicin (thp-adm) 1979 Semi-synthetic anthracycline anticancer drugs, similar in structure to adriamycin, are used for leukemia and other cancers.
Acm-a，acl，acr。 Anthracycline anticancer drugs have similar efficacy to adriamycin.
4. Drugs that inhibit the synthesis and function of protein.
Vincristine for injection. The effective component extracted from Catharanthus roseus is tubulin inhibitor. When it inhibits microtubule polymerization, it can prevent the formation of spindle filaments and the division of cancer cells. It is an effective drug for the treatment of acute and chronic leukemia, and is often used for acute leukemia in children. It is also used to treat malignant lymphoma and other cancers.
Vinblastine (Vinblastine amide, Siake, vds) is a semi-synthetic vinblastine derivative, and its indications are similar to those of vincristine, but its toxicity is low.
Homoharringtonine It is an alkaloid extracted from Cephalotaxus fortunei, which is a drug that interferes with nucleoprotein formation and inhibits cancer cell division. It is a commonly used medicine for treating acute and chronic leukemia.
L-asparaginase for injection. Drugs that affect the supply of amino acids. L- asparagine cannot be synthesized by acute lymphoblastic cancer cells themselves, and needs to be absorbed from outside the cells. This medicine can hydrolyze asparagine, making cancer cells lack nutrition and unable to survive. It is mainly used for acute gonorrhea and is an important drug for treating acute gonorrhea in children. Its biggest disadvantage is that it can induce diabetes.
5. Other therapeutic drugs
All trans retinoic acid (atrt). 1986, Shanghai Institute of Hematology and Ruijin Hospital discovered for the first time that it has a good curative effect on m3, which can induce cell differentiation and inhibit the proliferation of leukemia cells. After popularization and application, a large number of m3 patients were treated.
Arsenic trioxide (as203). This medicine is a chemical medicine for the treatment of m3, which was first screened by Chinese scholars from the traditional Chinese medicine for the treatment of leukemia in 1970s. It has dual functions of inducing cell differentiation and apoptosis. It can still be effective for cases that are ineffective in tretinoin treatment, and it has been made into injection, which has become a common drug for treating m3.
Gleevec (stl57 1, imatinib mesylate). The latest chemical drugs for the treatment of chronic myeloid leukemia. It was first used in 1998. Its function is to block the synthesis of some protein in cancer cells, thus inhibiting its replication, proliferation and drug resistance mechanism, with low adverse reactions and good curative effect, and the remission rate is higher than that of any previous drugs (0. 4g at least 12 weeks is 1 course of treatment). It is also effective in the case of acceleration period and rapid change period (day 0). 6g) is considered to be the best drug to treat CML at present. In recent years, it has been used in China and achieved ideal clinical results. The hematological complete remission rates of CML Ⅲ were 95-34-7% respectively. The negative rate of ph chromosome was 4 1- 17-7% respectively. However, the long-term efficacy, advantages and disadvantages remain to be seen. It has been reported recently that this product may be toxic to the heart. This product has synergistic effect with interferon, daunorubicin, cytarabine, vincristine and etoposide. , can be reduced after the merger. On the contrary, it has antagonistic effect on dexamethasone, toptecan, methotrexate and hydroxyurea. Other leukemia with positive ph chromosome can be treated with this product. However, this medicine is expensive, and the daily cost is thousands of dollars, which is unbearable for ordinary patients.