The leukemia acute occur suddenly and quickly diagnosed.
The main symptoms
Most often, acute leukemia settles abruptly in a few days without warning signs. It may sometimes remain silent but usually results in rapid deterioration of the general condition and an association of symptoms that reflects the inability of the bone marrow to make the normal blood cells due to the proliferation of leukemic cells .
- Reduction in the number of red blood cells in the blood ( anemia ) is responsible for pallor, shortness of breath, fatigue, acceleration of the heart rhythm …;
- Decreased platelet count ( thrombocytopenia ) can lead to bleeding, particularly in the gums or nose. These can sometimes be more severe when they occur in the brain or digestive system. Often, the patient also presents bruises (spontaneous), or as a result of slight blows;
- The reduction in the number of mature white blood cells ( leucopenia ) increases the risk of infections.
Other signs, less frequent, may also appear: increased lymph node size, increased spleen or liver size (usually painless symptoms), swollen and painful gums, small lesions of the skin (leukemias ).
Leukemia can be suspected as a result of a simple blood test, when the blood count (NFS) is abnormal: the blood test shows a decrease in the number of red blood cells, platelets and polymorphonuclear cells. It may also demonstrate the presence of leukemic cells through an abnormally high amount of white blood cells.
However, the diagnosis of acute leukemia can not be based solely on this blood test. If the results of the blood count indicate suspected acute leukemia, the patient should be referred to a specialized hematology center to confirm the diagnosis through a myelogram .
The myelogram is the key test for diagnosing acute leukemia. It consists of analyzing the cells of the bone marrow under the microscope . Bone marrow sampling is carried out under local anesthesia , by puncture in the sternum or in the pelvic bone (iliac spine). This gesture lasts only a few seconds but can be painful. Some analgesics are therefore often prescribed in addition to anesthesia.
The diagnosis is confirmed if the analysis shows that the marrow contains more than 20% immature cells. The morphological analysis of the cells then makes it possible to define the subcategory of acute leukemia. Further biological examinations provide additional data to better characterize the disease. This is notably the case of the study of abnormal cell chromosomes, which makes it possible to refine the diagnosis and prognosis, in order to choose the best treatment for the patient.
Dossier realized with the assistance of Professor Didier Blaise of the Department of Onco-Hematology and Transplantation and Cellular Therapy at the Paoli-Calmettes Institute in Marseille and Professor Emeritus Eliane Gluckman, Scientific Director of Eurocord, AP-HP, University of Paris VII Hôpital Saint-Louis in Paris.
Photo credit: Cristina Pedrazzini / SPL / Phanie