How is acute red leukaemia treated?

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How is acute red leukaemia treated? There are many kinds of acute erythroleukemia, but they are harmful to human body to a great extent. Of course, many times when the disease is silent, so it is important to find their own symptoms in time. Now share with you how to treat acute erythroleukemia?.

How is acute red leukaemia treated?

First: treatment 1, pay attention to rest: high fever, severe anemia or obvious bleeding, should rest in bed. Eat high calorie, high protein food, maintain water, electrolyte balance. 2. Prevention and treatment of infection: serious infection is the main cause of death, so prevention and treatment of infection is very important. A "sterile" ward or area should be set up in the ward to isolate people with low neutrophil count or undergoing chemotherapy. Pay attention to the oral cavity, nasopharynx, anus around the skin hygiene, prevent mucosal ulcer, erosion, bleeding, once there is timely symptomatic treatment. Food and utensils should be sterilized first. Oral non absorbed antibiotics such as gentamicin, colistin and anti mold such as nystatin and vancomycin are used to kill or reduce bacteria and mold in the intestine. Bacterial culture and drug sensitivity test were performed before treatment in patients with infection to select effective antibiotics. Generally speaking, fungal infection can use nystatin, clotrimazole, miconazole, etc; Ara-C and ribavirin can be selected for virus infection. When infection is caused by granulocytopenia, it can be treated symptomatically by intravenous infusion of leukocytes and plasma. 3. Correction of anemia: Patients with significant anemia can be infused with red blood cells or fresh whole blood as appropriate; Autoimmune anemia can be treated with adrenocortical hormone, testosterone propionate or protein assimilation hormone. 4. Control of bleeding: chemotherapy for leukemia is the most effective way to correct bleeding. However, thrombocytopenia and bleeding are easy to occur before chemotherapy remission, which can be prevented by oral administration of anluoxue. When there is serious bleeding, adrenocortical hormone can be used, whole blood or platelet transfusion. Acute leukemia (especially promyelocytic leukemia) is easy to be complicated with DIC. Once diagnosed, heparin should be used quickly. When DIC is combined with fibrinolysis, anti fibrinolytic drugs (such as p-carboxybenzylamine, hemostatic aromatic acid, etc.) should be given at the same time of heparin treatment. If necessary, fresh blood or plasma can be infused. 5. Prevention and treatment of hyperuricemia: during chemotherapy for patients with high white blood cell count, a large number of white blood cells may be destroyed and decomposed, resulting in the increase of blood uric acid, and sometimes the urinary tract may be obstructed by uric acid stones. Therefore, special attention should be paid to urine volume, urine sediment and uric acid concentration. In addition to encouraging patients to drink more water, purinol 10mg / KGD should be given, Three times for 5-6 days; When it comes to blood.

Second, chemotherapy is the main method for the treatment of acute leukemia. Because of the side effects of chemotherapy, we should use "detoxified Taxus" during and after chemotherapy to reduce its side effects, and take it for a long time to prevent recurrence and metastasis. Chemotherapy can be divided into two stages: remission induction and maintenance treatment, during which intensive treatment, consolidation treatment and central nervous system preventive treatment can be added. Remission induction is a strong chemotherapy with a large dose of multiple drugs, in order to rapidly kill a large number of leukemia cells, control the disease, achieve complete remission, and lay a good foundation for future treatment. The so-called complete remission refers to the complete disappearance of the symptoms and signs of leukemia, and the return of blood and bone marrow to normal. At the end of treatment, the number of leukemia cells in the body is estimated to be 5 × 1010～13；， After treatment, there are still a considerable number of leukemic cells in the body, estimated to be below 108-109, and there are still leukemic cells infiltration in some hidden places outside the medulla. The aim is to consolidate the complete remission induced by remission, and to make the patient maintain this "disease-free" state for a long time, and finally achieve cure. Consolidation therapy is after maintenance therapy. Before maintenance treatment, the remission induction protocol was repeated with the patient's permission. Intensive treatment is to repeat the original remission induction scheme in the middle of several courses of maintenance treatment. Prophylactic treatment of central nervous system should be carried out immediately after remission of induction therapy, so as to avoid and reduce the occurrence of central nervous system leukemia. A complete treatment plan should follow the above principles. 1. Remission induction therapy: VP regimen is commonly used in the treatment of all. Based on VP regimen, DRN (daunorubicin), ADM (adriamycin), Ara-C, L-Asp (L-asparaginase) and 6-MP constitute many effective multi drug combination regimens. The Cr (complete remission) rate of newly diagnosed cases in children can reach 90% - 95%; 80% - 90% in adults. The multi drug combination regimen is mainly used for the treatment of refractory and recurrent cases, and the commonly used regimens are shown in the table. 2. Induction of remission for acute lymphoblastic leukemia (AML) chemotherapy regimen dosage: VP regimen VCR 2mg IV, PDN 60mg once a week on the first day, DVP regimen DRN 1mg / kg iv, once a week on the first day, VCR 1.5mg/m2 IV for 4-6 weeks, PDN 40mg / m2 oral once a week on the first day, On the first day to the eighth day, pomp regimen PDN 60mg / D, 5 days as a course of VCR 2mg, MTX 30mg on the first day, 6-MP 100mg on the second and fifth days, vdcp regimen DRN 40mg / m2 / D, 1, 2, 3, 15, 16 and 17 days as a course of VCR 2mg, CTX 0.4-0.8/m2 on the first, 8, 15 and 21 days, PDN 40-60mg / m2 on the first and 15 days? After 1-14 days, the dosage of vcr2mg in DVP + ASP regimen was reduced. On the first day, once a week, bone marrow examination was performed on the 15th day. If there were still leukemia cells, the dosage of drn50mg / m2 was used for a course of 4 weeks. On the first, second and third day, the dosage of pdn60mg / m2 was taken orally. On the first to 28th day, the dosage of l-asp600u / m2 was used. On the 17th to 28th day, the dosage of VP and DVP regimen was suitable for children. 3. Maintenance treatment: if Cr is achieved with the above plan, the original plan should be continued to consolidate the curative effect. VP and VDP regimen should be continued for another 2-3 weeks; Pomp regimen can be used for another two courses. During remission, 6-mpl was given orally for 7 days, followed by CTX 400 mg intravenously; MTX was given 5 mg intravenously or orally for 7 days intermittently, on the 1st, 5th and 9th day; The above treatments were repeated after 3 days. 4. Treatment of recurrence: VP regimen or ara-c5-10mg, IV once a day for 4 times, or drnlmg / kg / D, IV for 4 days.

Third: radiotherapy 1, spleen irradiation: splenomegaly, pain, can not be operated. The dose was 1000-2000 cGy / 3-10 times for 3-12 days. 2. Epidural infiltration and compression of spinal cord: the irradiation field was beyond the two vertebral bodies of the lesion area, and the irradiation dose was 300-400 cGy / time. After 3 times of irradiation, it was changed to 200 cGy / time, 15 times of irradiation. 3. Central nervous system irradiation: mainly used for patients with increased white blood cell count, T-cell type, thrombocytopenia, enlarged lymph nodes and spleen. (1) prophylactic irradiation was started after the remission of chemotherapy symptoms. The whole cranium was irradiated with two opposite fields. The irradiation dose was 1800-2200cgy. (2) therapeutic irradiation: combined with chemotherapy, whole brain irradiation 1800cGy. (3) treatment of recurrence: Central irradiation, 2000-2500cgy in cranium and 1000-1250cgy in bone marrow. 4. Total dose: 800 cGy / time for 3 days. In addition, the local extramedullary lesions can be treated by local irradiation without palliative treatment. Radiotherapy should be combined with high-dose adrenocortical hormone, or MTX + Ara-C + hydrocortisone intraspinal injection.

matters needing attention

As long as we insist on following the requirements, I believe your physical condition will be significantly improved. Remember that patients with acute erythroleukemia, must avoid mouth. Usually their diet must pay attention to ah, sometimes really, because they do not pay attention to diet, resulting in acute erythroleukemia recurrence.