CLINICAL FEATURES OF THE DISORDERS OF NERVOUS SYSTEM DURING THE CHRONIC MYELOID LEUKEMIA
About the author:
Piddubna O. O.
CLINICAL AND EXPERIMENTAL MEDICINE
Type of article:
Chronic myeloid leukemia (CML) is a tumor that develops from pre-myelopoiesis cells that differentiate into mature forms. CML is a common type of leukemia. Its share accounts for about 20% of all leukemias. The annual incidence of CML is practically stable over the last 50 years and is between 1 and 1.5 per 100,000 of the population in all countries. Males are susceptible to disease bit more often than women, and the proportion of males accounts for 55-60% of patients. CML is found in all age groups, and half of the patients are first diagnosed with CML in the age of 30-50 years, more often in the age of 30-40 years, although some authors mark the peak of the incidence between the fifth and sixth decades of life. The cell substrate of leukemia consists mainly of granulocytes, neutrophils. The disease has three stages: initial, depleted benign (monoclonal) and terminal malignant (polyclonal). Neurological disorders in oncohematological diseases are among the secondary lesions of the nervous system. They combine various mechanisms of development and localization of the pathological states of the nervous system, which are associated with tumor diseases of the blood system. Oncohematological diseases make up 3% of all tumors in adults and 36,6% in children. The overlay of neurological symptoms to the main symptoms of the disease greatly affects the severity of the state of patients and affects the outcome of treatment. At the present stage, there is a steady increase in the frequency of neurological sequela of chemotherapy due to the intensification of antitumor treatment and the widespread use of neurotoxic cytostatics. To date, there is no literature data on the damage of the nervous system in the CML. Thus, the timely detection of a neurological deficiency is important for solving the further tactics of patient management. The purpose of our study was to carry out a comprehensive analysis of the clinical features of the damage to the nervous system in chronic myelogenous leukemia, depending on the duration of the disease. Among the list of our patients complaints, the most frequent were the general weakness (100%), headache (83.3%), dizziness (79.2%), rapid fatigue (79.2%), mood decrease (75%), memory impairment (70.8%), numbness of the limbs (70.8%), pain in the limbs (58.3%) and along the spine (66.7%). The main neurological syndromes in both groups of patients were encephalopathic (20 patients), neuropathic (10 patients) and radiculopathic (6 patients) syndromes. The presentation of encephalopathy in patients in the first group was already during the first year of treatment (78.6%), but also prevalent amid patients in the second group (90%) and was generally limited to plastic hypertension and atactic syndrome. Whilst calculating the vegetative index of Kerdo (KI) amid patients from the first group, the advantage of the number of sympathycotonics (7 patients) over parasympathycotonics (2 patients) were identified, in contrast to patients in the second group, in which patients with an increase in parasympathetic VNS tone (7 patients) comparing to sympathicotonia (6 patients). According to the results of psycho-diagnostic evaluation using the MMSE scale, Schultz tables and the Luria test, no probable differences were found between patient groups.
chronic myelogenous leukemia, oncohematological diseases, neurological disorders in chronic myelogenous leukemia, neurotoxicity, chemotherapy.
- Brincker H. Chronic myeloid leukemia. Basic principles. Scandinavian journal of Haematology. 2010;29:241-4.
- Call T, Noel P, Haberman T. Basics of clinical Haematology. May clinical procedure journal. 2004;69:315-9.
- Gunz TW. Molecular diagnosis of tumors. Clinical Haematology. 2007;6:3-8.
- Yuille MR, Matutes E, Marossy A. Familial chronic lymphocytic leukaemia: a survey and review of published studies. British journal of haematology. 2010;109(4):794-9.
- Volkova SA, Borkov NN. Osnovy klinicheskoy gematologii. NizhGMA; 2012. s. 277-322. [in Russiаn].
- Vorobev AI. Rukovodstvo po gematologii. M.: Nyudiamed; 2007. 1275 s. [in Russiаn].
- Poddubnaya IV. Nehodzhkinskie limfomyi. Klinicheskaya onkogematologiya: rukovodstvo dlya vrachey. M.: Meditsina; 2007. s. 724-71. [in Russiаn].
- Folstein MF, Folstein SE, McHugh PR. Mini-mental state. A practical method for grading the cognitive state of patients for the clinician. Journal of psychiatric research. 1975;12(3):189-98.
- Ziganov MA. Skorochtenie. M.: Eksmo; 2008. 224 s. [in Russiаn].
- Moskalenko VF, Gulchiy OP. Biostatistika: pidruch. dlya stud. K.: Knyga plyus; 2009. 184 s. [in Ukrainian].
Publication of the article:
«Bulletin of problems biology and medicine» Issue 2 Part 2 (151), 2019 year, 147-150 pages, index UDK 616.83-071: [616.4-008.8+616.155.392]