Aleukemia

ALEUKEMIA (from Greek a- negative particle, leukos - white and haima - blood), or pseudoleukemia, a term used to denote a type of leukemic disease in which the characteristic symptom of leukemia is absent, i.e., there is no clear increase in immature forms of white blood cells in the blood. However, in the absence of quantitative deviations in the total number of white blood cells, aleukemia almost always shows certain qualitative and quantitative deviations in the form of lymphocytosis up to 80-90% (A. lymphatic), or eosinophilia, basophilia, myelocytosis (A. myeloid) - so-called subleukemic blood pictures. In many cases, the blood picture in A. differs little from normal, except for the usual hypochromic anemia. Since the essence of the process in aleukemia remains the same as in leukemia, and transitions from aleukemia to typical leukemia are observed (rarely in reverse), aleukemia is now generally considered to be a form of leukemia. Aleukemias are rarer than proper leukemias; myeloid forms of aleukemia are especially rare. ALEUKIA (from Greek a- negative particle and leukos - white), a term introduced by Frank (E. Frank) in 1915 to denote a disease characterized by bleeding, a rapidly progressive decrease in the total number of leukocytes in the blood due to granulocytes, anemia, and a decrease in platelets; previously described as aplastic anemia. It occurs as a complication of typhoid fever (rarely), in poisoning by benzene, under the influence of X-rays. But there is also a cryptogenic form of A., which is a rather rare disease (no more than 70 cases have been described in world literature). A. is more common between the ages of 12 and 35 years, but also occurs in small children. One of the first symptoms is profuse bleeding from mucous membranes and skin hemorrhages (both with the slightest trauma and without it). The gums present a picture of scorbutic gingivitis; ulcerative stomatitis affects the cheeks, tongue, tonsils, posterior pharyngeal wall; in addition, a picture of diphtheroid angina with necrosis of the uvula is often observed in the oral cavity. Liquid stools with blood are often observed; urobilin is absent in the urine; bilirubin content in serum is normal. In the blood - severe oligocytosis (down to 1 million red blood cells and below); color index is less than or equal to 1; polychromatophils and reticulocytes are completely absent; nuclear forms are also absent or occur as single specimens; poikilocytosis does not occur. From the side of leukocytes - severe leukopenia from 2,000 to 600 per 1 cubic mm; absolute neutropenia (800-150 per 1 cubic mm), hypo- or aneosinophilia; the predominant type of cells are small or meso-lymphocytes; immature forms are not encountered. Severe thrombocytopenia (see) with single large platelets. In its course, A. haemorrhagica has an acute septic character and always ends fatally. Therapy is powerless, splenectomy is useless. The pathogenesis of A. haemorrhagica is not clarified. At autopsy, total atrophy of the bone marrow is found: in the epiphyses of long bones - pure fatty marrow. In sections of the sternum marrow, exclusively paired anuclear red blood cells and a very small number of nuclear red blood cells are found; myelocytes, eosinophils and megakaryocytes are extremely rare, often absent altogether. Benzene, salvarsan, and X-ray forms of A., which have a great resemblance in clinical and patho-anatomical pictures to cryptogenic A., differ from it only in a more favorable prognosis provided the cause of the disease is eliminated.