Subleukemic myelosis is the benign variant of chronic leukemia

Subleukemic myelosis is one of the representatives of the group of slow chronic leukemias, in which the cause of the disease is a pathological change in the myelocyte precursor cell. Simultaneously with disturbances in the process of maturation of hematopoietic cells, this disease develops reactive fibrosis-sclerotic lesions in the bones of the skeleton with concomitant compression of the bone marrow and proliferative changes in the spleen and liver. That is why subleukemic myelosis is referred to as myeloproliferative leukemia.

Causes of myelofibrosis and variants of the course of the disease

In the overwhelming majority of cases, this disease occurs in patients who are already 50 years of age or older, so certain importance is attached to genetic failures in the nuclear material of progenitor stem cells, autoimmune disorders, and viral infections. The morphological substratum of myelosis is the change in all three germs of hematopoiesis - granulocytic, megakaryocytic and erythroid. It is the degree of severity of these disorders that determines the course of the disease and the prognosis.

In the vast majority of cases, subleukemic myelosis proceeds quite benignly, and there is a direct relationship between the age of the patient at the time of debut of the disease and the prognosis - the younger the patient, the heavier myelofibrosis proceeds. In the terminal stage of the disease, which can develop 5-15 or even 20 years after the first symptoms are identified, blast crises occur in patients. Then the disease acquires the features of acute leukemia: in the peripheral blood appears a large number of blasts. Symptoms of such a development of the disease are fever, signs of intoxication, anemic and hemorrhagic syndrome. This often increases the spleen and liver. In some patients, rapid progression of the disease with early onset of bleeding syndrome and anemia of the patient is possible.

Clinical picture of subleukemic myelosis

Most of the patients are concerned about the pronounced general weakness, the heaviness in the abdomen, which is aggravated by movement and especially after eating (it is explained by a significant increase in the spleen and liver). There are complaints of headache, pain in the bones and spine. Very rarely in the terminal stage of the disease, severe sensory disorders can develop in the patient. The doctor should necessarily exclude funikulyarnyj a myelosis - a pathological condition of nervous system, arising at some megaloblastic anemias. This condition most often occurs with anemia, which occurs in patients with insufficient intake of vitamin B12 in the body.

In addition, often there are thromboses, the cause of which is an increased number of platelets in the peripheral blood in general and bleeding disorders of the blood. The latter may be due to the morphological immaturity of even a sufficiently large number of platelets. Sooner or later thrombocytosis leads to the development of splenomegaly, but in the spleen, not only platelets, but also erythrocytes begin to actively destroy, which is the cause of the development of anemia.

Patient screening and treatment options

The diagnosis of "Subleukemic myelosis" should be made not on the basis of a clinical blood test, but on the results of sternal puncture or trepanobiopsy of the ilium. Changes in blood analysis are largely non-specific, and it is impossible to diagnose "Subleukemic myelosis" in detecting an increased or decreased number of blood cells and changing their percentage.

Treatment of the disease also depends on the state of the bone marrow and the existing disorders of the structure of the bone. In some cases, enough dynamic observation of the patient, whereas with rapidly progressive myelofibrosis, the appointment of chemotherapy drugs is necessary.

In the terminal stage of the disease, in some cases it is necessary to conduct radiation therapy, a massive prescription of chemotherapy drugs for the treatment of acute myelogenous leukemia, removal of the spleen - but in each case, a qualified hematologist should prescribe the treatment.