Myeloproliferative disease: causes, symptoms, diagnosis

Myeloproliferative diseases, causes, symptoms, diagnostics of which will be discussed below, represent a group of conditions against which increased production of platelets, leukocytes or erythrocytes is noted in the bone marrow. There are six types of pathologies in total.

General information

The bone marrow normally produces the stem (immature) cells. After a while they mature, become full. A stem cell can be the starting point for the formation of two types of elements: lymphoid and myeloid cells. Immature cells are the material for the formation of leukocytes. From the elements of the myeloid series are formed:

• Erythrocytes. They transport oxygen and other nutrient compounds to organs and tissues.
• Leukocytes. These elements are responsible for confronting infectious and other pathologies.
• Platelets. These cells prevent bleeding, form clots.

Before transformation into erythrocytes, leukocytes or thrombocytes, the stem cell needs to go through several stages. If there is a myeloproliferative disease, then from a large amount of the starting material, one or more types of formed cells are formed. Usually, the pathology progresses slowly enough as the excess of blood elements increases.

Classification

The type that can have a myeloproliferative disease depends on the number of red blood cells, platelets or leukocytes. In some cases, an excess of elements of more than one species is noted in the body. Pathologies are divided into:

• Chronic neutrophilic leukemia.
• True polycythemia.
• Chronic myelogenous leukemia.
• Essential thrombocytopenia.
• Idiopathic (chronic) myelofibrosis.
• Eosinophilic leukemia.

Stages of pathologies

Chronic myeloproliferative disease can be transformed into acute leukemia. This condition is characterized by an excess of leukocytes. Chronic myeloproliferative disease does not have a definite staging scheme. Therapeutic measures will depend on the type of pathology. As for the ways of spreading, the myeloproliferative disease can develop in one of three ways:

• Sprouting into other tissues. In this case, the malignant neoplasm spreads into the surrounding healthy segments, affecting them.
• Lymphogenous way. Myeloproliferative disease can penetrate into the lymphatic system and spread through its tissues to other tissues and organs.
• Hematogenous way. Malignant neoplasms penetrate into the capillaries and veins that feed tissues and organs.

When the spread of tumor cells occurs, it is likely that a new (secondary) tumor will form. This process is called metastasis. Secondary, as well as primary neoplasms, refer to one type of malignant tumor. For example, the spread of leukemic cells to the brain takes place. It reveals tumor elements. They refer to leukemia, not to brain cancer.

Signs of pathology

How is myeloproliferative disease manifested? Symptoms of pathology are as follows:

• Weight loss, anorexia.
• Fast fatiguability.
• Discomfort in the stomach and a sense of fast food satiety. The latter is provoked by an increase in the spleen (splenomegaly).
• Predisposition to bleeding, bruising or manifestations of thrombosis.
• Violation of consciousness.
• Pain in the joints, puffiness, provoked by gouty arthritis.
• Tinnitus.
• Soreness in the left upper quadrant of the abdomen and the left shoulder, which is the consequence of the inflammatory process or a spleen infarction.

Examination

Myeloproliferative blood disease is revealed on the basis of the results of laboratory tests. The survey includes the following activities:

• Inspection of the patient. In this case, the specialist determines the general condition, reveals signs of pathology (swelling, for example), as well as manifestations that are not observed in a healthy person. The doctor also asks the patient about the way of life, the transferred diseases, bad habits, prescribed treatment.
• The expanded UAC. Blood sampling is performed to determine:
  
  - the number of platelets and erythrocytes;
  - ratios and numbers of leukocytes;
  - hemoglobin level;
  - the volume occupied by erythrocytes.

• Aspiration and bone marrow biopsy. During the procedure, a hollow, thick needle is inserted into the sternum or iliac bone. These manipulations allow you to take samples of bone marrow and tissue, as well as blood. The material is studied under a microscope for the presence of pathological elements in it.
• Cytogenetic analysis. This procedure allows you to identify changes in chromosomes.

Chronic myeloproliferative disease: treatment

To date, there are several methods of therapy of pathology. This or that option is chosen depending on the patient's condition and the manifestations that accompany the myeloproliferative disease. Treatment can be appointed standard - tested by practice, or experimental. The second option is a study using some new means.

Phlebotomy

This procedure is the taking of blood from the vein. The material is then sent to a biochemical or general analysis. In some cases, phlebotomy is prescribed to patients who have been diagnosed with myeloproliferative disease. Treatment in this case is aimed at reducing the number of red blood cells.

Platelet apheresis

This method is similar to the previous one. The difference is that the removal of extra platelets by means of special equipment is carried out here. The patient takes blood, which is passed through the separator. He holds up the platelets. "Purified" blood is returned to the patient.

Transfusion

This procedure is a blood transfusion. In this case, some elements are replaced by others. In particular, the patient receives transfusion of leukocytes, erythrocytes and platelets instead of his destroyed and damaged cells.

Chemotherapy

This method involves the use of cytotoxic drugs. Their action is aimed at destroying tumor cells or slowing the growth of the tumor. When administered orally, intravenously or intramuscularly, the active components penetrate the systemic circulation, destroying the pathological elements. Such chemotherapy is called systemic. The regional technique is the introduction of funds into the spinal canal, the affected organ or the body cavity itself.

Radiation therapy

Treatment is carried out using X-ray or other high-frequency radiation. Radiation therapy allows to achieve absolute elimination of tumor cells and slowing the growth of neoplasm. In practice, two types of this treatment are used. External radiation therapy is the impact from the apparatus next to the patient. With the internal method, radioactive substances are filled with needles, catheters, tubes, which are subsequently injected directly into the tumor or into tissues located near it. What method will be used by a specialist depends on the degree of malignancy of the process. Patients who have been diagnosed with myeloproliferative blood disease are exposed, as a rule, to the spleen area.

Chemotherapy with cell transplantation

This method of treatment consists in using drugs in high doses and replacing the cells affected by the antitumor effect with new ones. Immature elements are obtained from the donor or the patient and frozen. After the end of chemotherapy, the stored material is introduced into the body. The newly introduced cells begin to mature and activate the formation of new blood elements.

Recovery period

After the treatment, the patient should visit the doctor regularly. To evaluate the effectiveness of therapy, a number of procedures used before prescribing may be required. In accordance with the results obtained, a decision is made to continue, complete or change the treatment regimen. Some examinations should be repeated regularly even after the completion of the therapeutic course. They allow you to evaluate the effectiveness of activities and in time to identify a relapse.