Cruel President's Sweetheart

The next day, Zifeng came to the city hospital. Dr. Xu gave Zifeng an examination report and told him that You'er might be suffering from leukemia. This news was too much for Zifeng to bear. Originally, You'er lost her memory. Ah, now it is said that she may have a disease!
Zi Feng looked at Dr. Xu and said, "Doctor Xu, are you sure? I don't believe this is true!" Zi Feng said in disbelief!

"I know this is difficult for you to accept, but if we find out early, we can treat it slowly, and there is still a chance of recovery. President Jiang, don't be discouraged!" Dr. Xu comforted!
"Doctor, is it the early stage of worry?" Zi Feng asked.

"Yes! It's in the early stage! We initially thought it was acute lymphoblastic leukemia, and it has the following manifestations!

anemia
Often appear early and gradually worsen.Performance pale, weakness, dizziness, palpitations, anorexia and edema.The degree of anemia in patients is often out of proportion to the amount of bleeding.

Bleeding
About half of the cases had varying degrees of bleeding.The occurrence of bleeding is generally later than that of anemia, but it often wakes up the patient to seek medical treatment and do blood test.Common bleeding includes skin bleeding spots, purpura epistaxis, gingival and oral bleeding, and increased menstruation; in severe cases, hematuria, gastrointestinal bleeding (hematemesis, blood in the stool), retinal hemorrhage can cause visual impairment, and even intracranial hemorrhage may occur. life threatening.

fever and infection

More than half of the patients had fever onset, which could be low-grade or high-grade fever.No matter the fever before treatment or during treatment, I mostly mean co-infection.Infection can occur anywhere in the body, but angina and stomatitis are the most common, upper respiratory tract and lung infection, perianal inflammation, perianal abscess and gastroenteritis are more common, if combined with leukemia is the main cause of death one.Fever in some acute leukemia patients may have no obvious infection focus (especially when neutrophils <0.2×10^9/L), but infection cannot be ruled out; on the contrary, patients whose body temperature is <38.5°C and the fever subsides automatically after chemotherapy starts indicate fever Associated with leukemia itself (tumor fever).Of course, there is no shortage of cases where tumor fever and infection coexist in clinical practice.

Infection common pathogens are Escherichia coli, Pseudomonas aeruginosa, Klebsiella, Staphylococcus aureus and other opportunistic pathogens, anaerobic bacteria and so on.

bone and joint pain
Leukemic infiltration of bone and periosteum causes bone pain, which can be diffuse pain in the limbs or back, or limited to joint pain, which often leads to difficulty in movement and is easily misdiagnosed as osteomyelitis or rheumatism.More than 1/3 of patients have sternal tenderness, which is helpful for the diagnosis of this disease.A small number of severe bone pain is caused by bone marrow necrosis.

Hepatosplenomegaly and lymphadenopathy
Mild to moderate hepatosplenomegaly is more common, generally no more than 4 to 6 cm below the ribs. The incidence of ALL is higher than that of hepatosplenomegaly, and the degree of enlargement is also more obvious.Lymph node enlargement ALL is also relatively common, and can involve superficial or deep lymph nodes such as mediastinum, mesentery, and retroperitoneum, but the degree of enlargement is generally mild, and the diameter is usually ≤3.0cm.Hepatosplenomegaly is generally more obvious in T-ALL and B-ALL.

Central Nervous System Leukemia (CNSL)

CNSL often appears in the remission stage of ALL, and it is relatively rare in newly diagnosed patients.Infiltration mostly occurs in arachnoid and dura mater, followed by brain parenchyma, choroid or cranial nerves.Severe cases have typical manifestations of increased intracranial pressure such as headache, vomiting, stiff neck, and even convulsions and coma.Similar to intracranial hemorrhage; mild cases only complain of mild headache and dizziness.Cranial nerves (mainly cranial nerves VI and VII) are involved, and vision impairment and facial paralysis may occur.

Infiltration of other tissues and organs

Skin infiltration of ALL is relatively rare, and leukemia often occurs in ALL in remission, manifested as unilateral or bilateral painless swelling, with a persistent hard texture and no tenderness, which is the source of extramedullary leukemia recurrence second only to CNSL.Leukemic infiltration can also involve various tissues and organs such as the lung, pleura, kidney, digestive tract, heart, brain, uterus, ovary, parotid gland, and eye, and show dysfunction of corresponding organs, but also can be asymptomatic.Dr. Xu told Zifeng about the general symptoms of the disease!
"Doctor, is there a high chance of being cured?" Zi Feng asked worriedly.

"Miss Jiang's disease is in the early stage, and the chance of being cured is relatively high. You have to treat it as soon as possible! Our treatment is divided into several stages!" Dr. Xu said.

"How many paragraphs?" Zi Feng asked.

The general efficacy varies according to the type and the period of discovery.The younger the patient, the higher the slow recovery rate.Slow recovery here means that there are no more cancer cells in the patient's body, and the bone marrow is normal.Since the 50s, thanks to major advances in chemotherapy, more people are surviving longer.For adult lymphoid leukemia (ALL), the slow recovery rate is between 80% and 90%. If it is completely cured, 40% of the patients can survive for another 5 years; for myelogenous leukemia, the slow recovery rate Between 60% and 70%, if completely cured, 20% of patients can survive for at least 3 years.

For patients with this disease, the most important thing is to control the disease first.The patient must be hospitalized for chemical treatment, given a high-calorie, high-protein, high-vitamin diet, pay attention to oral hygiene, strengthen nursing, carry out aseptic isolation, and treat regularly to prevent infection.Because leukemia patients have low numbers of healthy blood cells, blood and platelet transfusions are often performed to enhance natural immune function and stop bleeding.Patients also need to receive infusion of other drugs to prevent some side effects such as nausea and vomiting during chemotherapy. Patients with ALL can wait for a satisfactory slow recovery after several weeks of treatment in the hospital.To control the disease, patients will continue to receive low-dose chemotherapy and radiation therapy for 1 month or more to completely eliminate cancer cells.

The best way for acute myelogenous leukemia is to prolong its slow recovery period. Whether it can be cured depends on the success of bone marrow transplantation. Bone marrow transplantation must have compatible tissue types and similar genetic characteristics. Usually, family members are selected as bone marrow donors. .

Bone marrow transplantation is divided into three periods: preparation period, operation period and recovery period.The first step is to control the patient's cancerous white blood cells, usually with chemotherapy and, if possible, mechanical means of separating the cancer cells from the blood.During the procedure, the bone marrow is chemically cleaned to avoid rejection of the new infused marrow, and about a tablespoon of bone marrow is received from the donor.The recovery period is the most dangerous period. The newly implanted bone marrow has not yet started to produce white blood cells, and the patient may die from infection at any time.It is not until 2 to 6 weeks later that the new bone marrow begins to produce blood cells efficiently.Bone marrow transplantation is very expensive and risky, but it gives patients with relapsed ALL a good chance of survival.

"That's it, but if you want to perform a bone marrow transplant, You'er's relatives are gone, so what should I do!" Zi Feng felt a headache when he thought of this!He has been thinking about this problem since he came out of the hospital. He was very worried about You'er. He called Yu and asked Yu to come out. The condition of You'er can't be delayed any longer!Zi Feng had to discuss it with Yu about what to do!