Leukemia or, as is customary in medicine, leukemia is a type of cancer associated with blood pathology. The disease is popularly called “bleeding”, as it is characterized by an increase in the composition of white cells in the blood.

Leukemia is a fleeting disease, so knowing its main symptoms and diagnostic methods is advisable for every person who is even a little worried about their health. We will talk about the signs of the development of leukemia, the reasons for its appearance and the treatment of the disease in the article below. Interesting? Then be sure to read the material presented today.

Leukemia is a blood cancer that develops due to a functional failure in the reproduction pattern of blood cells. The disease originates in the bone marrow, after which the affected cells enter the blood and directly provoke the pathology of the biomaterial.

Leukemia is characterized by the fact that as it progresses, the number of (white cells) in the human blood increases, which not only grow exponentially, but also cease to perform the functions assigned to them.

Leukemia is divided into two main types:

1. Leukemia is an acute form, during which unformed leukocytes are affected, which significantly disrupts the composition of the blood. In this case, the affected leukocytes quickly stop developing and are reborn, so to speak, defective.
2. Chronic leukemia, which is characterized by damage to already full-fledged leukocytes. This form of the disease is potentially no more dangerous than the acute form, since in most cases it is treated or remitted much faster.

It is important to understand that both forms of leukemia have approximately the same symptoms, so it is simply impossible to establish an accurate diagnosis based only on the symptoms of the disease.

Often the signs of leukemia are as follows:

• At the initial stage, weakness, sweating, weight loss, pain in the bones, skin problems, intoxication of the body and characteristic changes in the composition of the blood appear. This symptomatology can manifest itself from the first day of blood damage until the serious development of the disease, which occurs from about 2-8 months of its course.
• At the stages of strong development and advanced course of leukemia - a sharp decline in immunity, constant temperature instability, enlarged lymph nodes, severe pallor of the skin, joint pain, shortness of breath, breathing problems, yellowing of the sclera of the eyes, blurred vision, numbness of the limbs, face and pronounced changes in blood composition.

Having noticed a certain “bouquet” of the symptoms noted above, it is important for any person to immediately visit the clinic and take the appropriate tests to determine leukemia.

Remember that early diagnosis of the disease significantly increases the chances of its complete cure.

Otherwise, the patient will be overtaken by serious complications, consisting of unbearable pain in different parts of the body, a severe decrease in immunity, the development of cancer of other organs and, worst of all, death.

Reasons for the development of the disease

The development of leukemia does not occur for one specific reason. This disease can develop due to numerous factors that can negatively affect the processes occurring in the body. Let us remember that blood cancer originates in the bone marrow and then develops throughout the body.

For example, below are the most common causes of leukemia (according to medical statistics):

• long-term smoking and alcoholism
• prolonged human contact with chemical reagents without appropriate protection
• excessive or frequent radiation exposure
• serious problems with immunity
• the presence of chronic ailments of the body
• development of certain infectious diseases
• heredity

The greatest danger of leukemia is not that it can develop for a large number of reasons. What is much worse is that this disease can affect a person even if there is only one cancer cell in the blood. Considering this feature of leukemia, it is advisable for any person to be systematically examined in a hospital, so that it is always possible to prevent the disease in the early stages of development.

Diagnostic methods

Now that the symptoms of leukemia in adults and the causes of the development of the disease have been discussed in some detail, let us turn our attention to the methods of diagnosing it. In this regard, leukemia is a relatively primitive disease that is diagnosed through blood tests.

The main survey indicators subject to careful analysis are presented in the following list:

1. Level . Naturally, the most important indicator, because blood cancer is characterized precisely by increased and defective reproduction of white cells (leukocytes, in case someone has forgotten). Depending on the form and duration of the pathology, the level of leukocytes may be different. Thus, at the early stage, the norm of the indicator is violated only by 60-70%, but at later stages the number of white cells increases by 5-20 times.
2. The presence of bone marrow biopsy, tumor clusters of differentiation and other hematological formations in the blood. This indicator is very important, as it allows you to determine the qualitative characteristics of leukocytes and the general composition of the blood, which is simply necessary for making an accurate diagnosis.
3. Content . It is worth noting that their level has some dependence on the level of leukocytes, therefore, with the development of leukemia, it increases by 50-200% of the norm.
4. Decrease in level. The indicator, by the way, often has strong deviations from the norm, but in the initial stages of leukemia it is often in order.

Naturally, unusual tests are carried out to diagnose blood cancer. Here the level of examination is noticeably higher and often consists of molecular genetic, cytogenetic, flow cytometric and cytochemical methods for assessing the condition of the blood.

In addition to examining the affected biomaterial, bone marrow x-rays and spleen punctures are also performed. Diagnosis of leukemia, as well as treatment of this disease, must be carried out in specialized centers whose activities are based specifically on work in this medical field.

Disease therapy and prognosis

Treatment of leukemia is a very complex procedure, which is often simply not feasible. In 80% of cases, determining the impossibility of a complete cure for the disease, many specialists switch to remission of blood cancer. The essence of the latter is to slow down the course of the disease, relieve its symptoms and prolong the patient’s life.

The final choice of whether to treat leukemia or its remission is determined based on:

• symptoms of the disease (the more serious they are, the greater the chance that the choice will fall on remission)
• stages of the disease and its type (the weaker they are, the greater the chances of completely getting rid of the disease)
• the age of the patient (the younger he is, the greater the chance that an adult will be able to defeat leukemia)
• general health (the better it is, the more seriously you can think about organizing therapy for leukemia)

Regardless of the chosen option for getting rid of the disease, the basis of therapeutic measures is to stop the growth of cancer cells as much as possible. Today, therapy and remission of leukemia are possible:

1. By organizing chemotherapy, that is, exposing the affected area of ​​the spinal cord to appropriate substances.
2. Through the organization of radiation therapy, which consists of exposing the affected area of ​​the spinal cord and the patient’s blood to ionizing radiation.
3. Carrying out a transplant, which is a very complex procedure. It is carried out by partially removing the affected bone marrow and introducing healthy donor cells into it.

It is important to organize treatment of leukemia in centers specializing in this matter immediately after the disease has been identified. Let us repeat, we cannot delay in getting rid of blood cancer, because the most important thing – the patient’s life – depends on the speed of organizing therapy.

More information about leukemia can be found in the video:

Many people who have experienced leukemia in one way or another are interested in one question, namely, “What is the prognosis for the treatment of this pathology?” Perhaps it is impossible to say anything specific about blood cancer, because the success of its therapy depends on many factors. The main ones are the degree of development of leukemia and the condition of the patient’s body.

The weaker the blood and spinal cord of a person is affected and the stronger his body, the greater the chance that he will be able to fully recover.

Otherwise, the disease will only remit and the patient can live from 1.5 to 25 years with chronic leukemia and about 4-12 months with the development of an acute form of the disease.

A considerable number of people are also interested in the issue of leukemia prevention. Let’s say right away that it is impossible to insure against leukemia, as well as against any form of cancer.

Preventive measures for the disease converge only on:

1. Firstly, reduce the factors of its development in a person’s life to a minimum. This is especially true for people who are genetically predisposed to leukemia. That is, the main protection against this pathology is not to smoke, not to drink, to treat all ailments to the end and to maintain a healthy immune system.
2. Secondly, try to lead a healthy lifestyle, which requires good sleep, the most proper nutrition and the absence of bad habits.
3. Thirdly, be constantly examined in the clinic so that it is possible to identify any abnormalities in the composition of the blood and eliminate them in a timely manner.

This concludes, perhaps, the most important information on leukemia. As you can see, blood cancer is a rather dangerous disease, but under some circumstances it is quite treatable. We hope that today's material was useful to you and provided answers to your questions. Good health to you!

Leukemia is a serious blood disease that is classified as neoplastic (malignant). In medicine it has two more names - leukemia or leukemia. This disease knows no age restrictions. It affects children of all ages, including infants. It can occur in youth, middle age, and old age. Leukemia affects both men and women equally. Although, according to statistics, people with white skin get it much more often than dark-skinned people.

Types of leukemia

With the development of leukemia, a certain type of blood cell degenerates into malignant one. The classification of the disease is based on this.

1. When it passes into leukemia cells (blood cells of the lymph nodes, spleen and liver), it is called LYMPHOLIC LEUKEMIA.
2. Degeneration of myelocytes (blood cells formed in the bone marrow) leads to MYELOLEUKEMIA.

Degeneration of other types of leukocytes, leading to leukemia, although it occurs, is much less common. Each of these species is divided into subspecies, of which there are quite a lot. Only a specialist who has modern diagnostic equipment and laboratories equipped with everything necessary can understand them.

The division of leukemia into two fundamental types is explained by disturbances in the transformation of different cells - myeloblasts and lymphoblasts. In both cases, instead of healthy leukocytes, leukemia cells appear in the blood.

In addition to classification by type of lesion, distinguish between acute and chronic leukemia. Unlike all other diseases, these two forms of leukemia have nothing to do with the nature of the disease. Their peculiarity is that the chronic form almost never turns into acute and, conversely, the acute form cannot become chronic under any circumstances. Only in isolated cases, chronic leukemia can be complicated by an acute course.

This is due to the fact that acute leukemia occurs during the transformation of immature cells (blasts). At the same time, their rapid reproduction begins and increased growth occurs. This process cannot be controlled, so the likelihood of death with this form of the disease is quite high.

Chronic leukemia develops when the growth of mutated blood cells that are fully mature or in the maturation stage progresses. It differs in the duration of its course. The patient only needs supportive therapy to ensure his condition remains stable.

Causes of leukemia

What exactly causes the mutation of blood cells is currently not fully understood. But it has been proven that one of the factors causing leukemia is radiation exposure. The risk of disease appears even with small doses of radiation. In addition, there are other causes of leukemia:

• In particular, leukemia can be caused by leukemic drugs and some chemicals used in everyday life, for example, benzene, pesticides, etc. Leukemia drugs include antibiotics of the penicillin group, cytostatics, butadione, chloramphenicol, as well as drugs used in chemotherapy.
• Most infectious viral diseases are accompanied by the invasion of viruses into the body at the cellular level. They cause mutational degeneration of healthy cells into pathological ones. Under certain factors, these mutant cells can transform into malignant ones, leading to leukemia. The largest number of leukemia diseases is observed among HIV-infected people.
• One of the causes of chronic leukemia is a hereditary factor that can manifest itself even after several generations. This is the most common cause of leukemia in children.

Etiology and pathogenesis

The main hematological signs of leukemia are changes in blood quality and an increase in the number of young blood cells. At the same time it increases or decreases. Leukopenia and are noted. Leukemia is characterized by abnormalities in the chromosomal composition of cells. Based on them, the doctor can make a prognosis of the disease and choose the optimal treatment method.

Common symptoms of leukemia

With leukemia, a correct diagnosis and timely treatment are of great importance. At the initial stage, the symptoms of blood leukemia of any kind are more reminiscent of colds and some other diseases. Listen to how you feel. The first manifestations of leukemia are manifested by the following signs:

1. The person experiences weakness and malaise. He constantly wants to sleep or, conversely, sleep disappears.
2. Brain activity is disrupted: a person has difficulty remembering what is happening around him and cannot concentrate on basic things.
3. The skin turns pale, bruises appear under the eyes.
4. The wounds do not heal for a long time. Possible from the nose and gums.
5. The temperature rises for no apparent reason. It can stay at 37.6º for a long time.
6. There are minor pains in the bones.
7. Gradually, the liver, spleen and lymph nodes become enlarged.
8. The disease is accompanied by increased sweating and increased heart rate. Dizziness and fainting are possible.
9. Colds occur more often and last longer than usual, chronic diseases worsen.
10. The desire to eat disappears, so the person begins to lose weight sharply.

If you notice the following signs, do not put off visiting a hematologist. It is better to be a little safe than to treat the disease when it is advanced.

These are common symptoms common to all types of leukemia. But, for each type there are characteristic signs, features of the course and treatment. Let's look at them.

Video: presentation about leukemia (eng)

Lymphoblastic acute leukemia

This type of leukemia is most common in children and young people. Acute lymphoblastic leukemia is characterized by a disorder of hematopoiesis. An excessive amount of pathologically altered immature cells - blasts - is produced. They precede the appearance of lymphocytes. The blasts begin to multiply rapidly. They accumulate in the lymph nodes and spleen, preventing the formation and normal functioning of normal blood cells.

The disease begins with a prodromal (latent) period. It can last from one week to several months. The sick person has no specific complaints. He just feels constantly tired. He begins to feel unwell due to his temperature rising to 37.6°. Some people notice that their lymph nodes in the neck, armpits, and groin are enlarged. There are minor pains in the bones. But at the same time, the person continues to perform his work duties. After some time (it is different for everyone), a period of pronounced manifestations begins. It occurs suddenly, with a sharp increase in all manifestations. In this case, various variants of acute leukemia are possible, the occurrence of which is indicated by the following symptoms of acute leukemia:

• Anginous (ulcerative-necrotic) accompanied by severe sore throat. This is one of the most dangerous manifestations of a malignant disease.
• Anemic. With this manifestation, hypochromic anemia begins to progress. The number of leukocytes in the blood increases sharply (from several hundred per mm³ to several hundred thousand per mm³). Leukemia is evidenced by the fact that more than 90% of the blood consists of parent cells: lymphoblasts, hemohistoblasts, myeloblasts, hemocytoblasts. The cells on which the transition to mature ones depends (young, myelocytes, promyelocytes) are absent. As a result, the number of lymphocytes is reduced to 1%. The platelet count is also reduced.

• Hemorrhagic in the form of hemorrhages on the mucous membrane, open areas of the skin. Bleeding from the gums occurs and uterine, kidney, gastric and intestinal bleeding is possible. In the last phase, pleurisy and pneumonia with the release of hemorrhagic exudate may occur.
• Splenomegalic- a characteristic enlargement of the spleen caused by increased destruction of mutated leukocytes. In this case, the patient experiences a feeling of heaviness in the abdomen on the left side.
• There are frequent cases when the leukemic infiltrate penetrates the bones of the ribs, collarbone, skull, etc. It can affect the bone tissue of the eye socket. This form of acute leukemia is called chlorleukemia.

Clinical manifestations may combine various symptoms. For example, acute myeloblastic leukemia is rarely accompanied by enlarged lymph nodes. This is not typical for acute lymphoblastic leukemia. Lymph nodes acquire increased sensitivity only with ulcerative-necrotic manifestations of chronic lymphoblastic leukemia. But all forms of the disease are characterized by the fact that the spleen becomes larger, blood pressure decreases, and the pulse quickens.

Acute leukemia in childhood

Acute leukemia most often affects children's bodies. The highest percentage of the disease is between the ages of three and six years. Acute leukemia in children is manifested by the following symptoms:

1. Spleen and liver- enlarged, so the child has a large belly.
2. Lymph node sizes also exceed the norm. If the enlarged nodes are located in the chest area, the child suffers from a dry, debilitating cough, and shortness of breath occurs when walking.
3. When the mesenteric nodes are damaged, pain in the abdomen and legs.
4. Noted moderate and normochromic anemia.
5. The child gets tired quickly, the skin is pale.
6. ARVI symptoms are pronounced with fever, which may be accompanied by vomiting and severe headache. Seizures often occur.
7. If leukemia has reached the spinal cord and brain, then The child may lose balance while walking and fall frequently.

Symptoms of leukemia

Treatment of acute leukemia

Treatment of acute leukemia is carried out in three stages:

• Stage 1. Course of intensive therapy (induction), aimed at reducing the number of blast cells in the bone marrow to 5%. In this case, they should be completely absent in the normal bloodstream. This is achieved by chemotherapy using multicomponent cytostatic drugs. Based on the diagnosis, anthracyclines, glucocorticosteroid hormones and other drugs can also be used. Intensive therapy gives remission in children - in 95 cases out of 100, in adults - in 75%.
• Stage 2. Consolidation of remission (consolidation). This is done to avoid the possibility of relapse. This stage can last from four to six months. During this procedure, careful monitoring by a hematologist is required. Treatment is carried out in a clinical setting or in a day hospital. Chemotherapy drugs (6-mercaptopurine, methotrexate, prednisone, etc.) are used, which are administered intravenously.
• Stage 3. Maintenance therapy. This treatment continues for two to three years, at home. 6-mercaptopurine and methotrexate in tablet form are used. The patient is under outpatient hematology care. He must undergo periodic examinations (the date of visits is determined by the doctor) in order to monitor the quality of his blood composition.

If it is impossible to carry out chemotherapy due to a severe complication of an infectious nature, acute blood leukemia is treated by transfusion of donor red blood cells - from 100 to 200 ml three times every two to three to five days. In critical cases, bone marrow or stem cell transplantation is performed.

Many people try to treat leukemia with folk and homeopathic remedies. They are quite acceptable in chronic forms of the disease, as an additional restorative therapy. But in acute leukemia, the sooner intensive drug therapy is administered, the higher the chance of remission and the more favorable the prognosis.

Forecast

If the start of treatment is very late, the death of a patient with leukemia may occur within a few weeks. This is why the acute form is dangerous. However, modern treatment methods provide a high percentage of improvement in the patient’s condition. At the same time, 40% of adults achieve stable remission, with no relapses for more than 5-7 years. The prognosis for acute leukemia in children is more favorable. Improvement by age 15 is 94%. For teenagers over 15 years of age, this figure is slightly lower - only 80%. Recovery of children occurs in 50 cases out of 100.

An unfavorable prognosis is possible in infants (up to one year) and those who have reached ten years of age (and older) in the following cases:

1. High degree of spread of the disease at the time of accurate diagnosis.
2. Severe enlargement of the spleen.
3. The process has reached the mediastinal nodes.
4. The functioning of the central nervous system is disrupted.

Chronic lymphoblastic leukemia

Chronic leukemia is divided into two types: lymphoblastic (lymphocytic leukemia, lymphatic leukemia) and myeloblastic (myeloid leukemia). They have different symptoms. In this regard, each of them requires a specific treatment method.

Lymphatic leukemia

Lymphatic leukemia is characterized by the following symptoms:

1. Loss of appetite, sudden weight loss. Weakness, dizziness, severe headaches. Increased sweating.
2. Enlarged lymph nodes (from the size of a small pea to a chicken egg). They are not connected to the skin and easily roll during palpation. They can be felt in the groin area, on the neck, armpits, and sometimes in the abdominal cavity.
3. When the mediastinal lymph nodes enlarge, the veins are compressed and swelling of the face, neck, and arms occurs. They may turn blue.
4. The enlarged spleen protrudes 2-6 cm from under the ribs. The enlarged liver extends about the same amount beyond the edges of the ribs.
5. There is frequent heartbeat and sleep disturbance. As chronic lymphoblastic leukemia progresses, it causes decreased sexual function in men and amenorrhea in women.

A blood test for such leukemia shows that the number of lymphocytes in the leukocyte formula is sharply increased. It ranges from 80 to 95%. The number of leukocytes can reach 400,000 per 1 mm³. Blood platelets are normal (or slightly low). The number of red blood cells is significantly reduced. The chronic course of the disease can last for a period of three to six to seven years.

Treatment of lymphocytic leukemia

The peculiarity of chronic leukemia of any type is that it can proceed for years, while maintaining stability. In this case, treatment of leukemia in a hospital does not need to be carried out; simply check the blood condition periodically and, if necessary, engage in strengthening therapy at home. The main thing is to follow all the doctor’s instructions and eat right. Regular follow-up is an opportunity to avoid a difficult and unsafe course of intensive care.

Photo: increased number of leukocytes in the blood (in this case, lymphocytes) with leukemia

If there is a sharp increase in leukocytes in the blood and the patient’s condition worsens, then there is a need for chemotherapy using the drugs Chlorambucil (Leukeran), Cyclophosphamide, etc. The treatment course also includes monoclonal antibodies Campas and Rituximab.

The only way to completely cure chronic lymphocytic leukemia is bone marrow transplantation. However, this procedure is very toxic. It is used in rare cases, for example, for people at a young age, if the patient’s sister or brother is the donor. It should be noted that complete recovery can only be achieved by an allogeneic (from another person) bone marrow transplant for leukemia. This method is used to eliminate relapses, which, as a rule, are much more severe and more difficult to treat.

Chronic myeloblastic leukemia

Myeloblastic chronic leukemia is characterized by a gradual development of the disease. In this case, the following signs are observed:

1. Weight loss, dizziness and weakness, fever and increased sweating.
2. With this form of the disease, gingival and nosebleeds and pale skin are often observed.
3. The bones begin to ache.
4. Lymph nodes are usually not enlarged.
5. The spleen significantly exceeds its normal size and occupies almost the entire half of the internal cavity of the abdomen on the left side. The liver is also enlarged.

Chronic myeloblastic leukemia is characterized by an increased number of leukocytes - up to 500,000 per 1 mm³, reduced hemoglobin and a reduced number of red blood cells. The disease develops over two to five years.

Treatment of myelosis

Therapeutic therapy for chronic myeloblastic leukemia is selected depending on the stage of development of the disease. If it is in a stable condition, then only restorative therapy is carried out. The patient is recommended to eat well and undergo regular medical examinations. A course of restorative therapy is carried out with the drug Myelosan.

If leukocytes begin to multiply rapidly, and their number significantly exceeds the norm, radiation therapy is performed. It is aimed at irradiating the spleen. Monochemotherapy (treatment with Myelobromol, Dopan, Hexaphosphamide) is used as primary treatment. They are administered intravenously. Polychemotherapy according to one of the CVAMP or AVAMP programs gives a good effect. The most effective treatment for leukemia today remains bone marrow and stem cell transplantation.

Juvenile myelomonocytic leukemia

Children between the ages of two and four often develop a special form of chronic leukemia called juvenile myelomonocytic leukemia. It is one of the rarest types of leukemia. Most often boys get it. The cause of its occurrence is considered to be hereditary diseases: Noonan syndrome and neurofibromatosis type I.

The development of the disease is indicated by:

• Anemia (pallor of the skin, increased fatigue);
• Thrombocytopenia, manifested by nasal and gingival bleeding;
• The child is not gaining weight and is stunted.

Unlike all other types of leukemia, this type occurs suddenly and requires immediate medical attention. Myelomonocytic juvenile leukemia is practically not curable with conventional therapeutic agents. The only way to hope for recovery is an allogeneic bone marrow transplant, which is preferably carried out as soon as possible after diagnosis. Before this procedure, the child undergoes chemotherapy. In some cases, there is a need for splenectomy.

Myeloid nonlymphoblastic leukemia

The ancestors of blood cells that are formed in the bone marrow are stem cells. Under certain conditions, the process of stem cell maturation is disrupted. They begin to divide uncontrollably. This process is called myeloid leukemia. Most often, adults are susceptible to this disease. It is extremely rare in children. Myeloid leukemia is caused by a chromosomal defect (mutation of one chromosome) called the Philadelphia Rh chromosome.

The disease progresses slowly. The symptoms are unclear. Most often, the disease is diagnosed accidentally when a blood test is performed during a regular medical examination, etc. If leukemia in adults is suspected, a referral is issued for a bone marrow biopsy.

There are several stages of the disease:

1. Stable (chronic). At this stage, the number of blast cells in the bone marrow and general bloodstream does not exceed 5%. In most cases, the patient does not require hospitalization. He can continue to work while receiving maintenance treatment with anti-cancer pills at home.
2. Accelerating the development of the disease, during which the number of blast cells increases to 30%. Symptoms manifest themselves in the form of increased fatigue. The patient experiences nosebleeds and gum bleeding. Treatment is carried out in a hospital setting with intravenous administration of anticancer drugs.
3. Blast crisis. The onset of this stage is characterized by a sharp increase in blast cells. Intensive therapy is required to destroy them.

After treatment, remission is observed - a period during which the number of blast cells returns to normal. PCR diagnostics show that the “Philadelphia” chromosome no longer exists.

Most types of chronic leukemia can now be successfully treated. For this purpose, a group of experts from Israel, the USA, Russia and Germany developed special treatment protocols (programs), including radiation therapy, chemotherapy treatment, stem cell treatment and bone marrow transplantation. People diagnosed with chronic leukemia can live quite a long time. But people with acute leukemia live very little. But even in this case, everything depends on when the treatment course began, its effectiveness, the individual characteristics of the body and other factors. There are many cases where people “burned out” within a few weeks. In recent years, with correct, timely treatment and subsequent maintenance therapy, life expectancy in acute forms of leukemia has been increasing.

Video: lecture on myeloid leukemia in children

Hairy cell lymphocytic leukemia

Oncological blood disease, during the development of which bone marrow produces excessive numbers of lymphocytic cells, called hairy cell leukemia. It occurs in very rare cases. It is characterized by a slow development and course of the disease. Leukemia cells in this disease, when magnified many times, look like small bodies overgrown with “hair.” Hence the name of the disease. This form of leukemia occurs mainly in older men (after 50 years). According to statistics, women make up only 25% of the total number of cases.

There are three types of hairy cell leukemia: refractory, progressive and untreated. Progressive and untreated forms are the most common, since the main symptoms of the disease are associated by most patients with signs of advancing old age. For this reason, they go to the doctor very late, when the disease has already progressed. The refractory form of hairy cell leukemia is the most difficult. It occurs as a relapse after remission and is practically untreatable.

White blood cell with “hairs” in hairy cell leukemia

The symptoms of this disease do not differ from other types of leukemia. This form can only be identified by performing a biopsy, blood test, immunophenotyping, computed tomography and bone marrow aspiration. A blood test for leukemia shows that leukocytes are tens (hundreds) times higher than normal. At the same time, the number of platelets and red blood cells, as well as hemoglobin, are reduced to a minimum. All these are criteria that are characteristic of this disease.

Treatment includes:

• Chemotherapy treatments using cladribine and pentosatin (anti-cancer drugs);
• Biological therapy (immunotherapy) with Interferon alfa and Rituximab;
• Surgical method (splenectomy) - excision of the spleen;
• Stem cell transplant;
• General restorative therapy.

The effect of leukemia in cows on humans

Leukosis is a common disease in cattle. There is an assumption that the leukemia virus can be transmitted through milk. This is evidenced by experiments conducted on lambs. However, no studies have been conducted on the effects of milk from leukemia-infected animals on humans. It is not the causative agent of bovine leukemia itself that is considered dangerous (it dies when milk is heated to 80°C), but carcinogenic substances that cannot be destroyed by boiling. In addition, the milk of an animal with leukemia helps to reduce human immunity and causes allergic reactions.

Milk from cows with leukemia is strictly forbidden to be given to children, even after heat treatment. Adults can eat milk and meat from animals with leukemia only after treatment at high temperatures. Only the internal organs (liver), in which leukemia cells mainly multiply, are utilized.

Video: acute leukemia in the program “Live Healthy!”

In fact, leukemia has recently begun to increasingly affect the adult population. And now about 75% of all cases are over 40 years of age. Every year, more than 280,000 people worldwide suffer from this disease, and approximately 190,000 die. Every year, new methods and types of treatment appear that have reduced the mortality rate.

Blood leukemia, or leukemia as it is also called, is an oncological disease, the pathological process of which affects the hematopoietic system located in the bone marrow. At the same time, the number of immature and mutated leukocytes in the blood begins to increase. In common parlance, this disease is also called leukemia. Acute and chronic leukemia are divided.

Typically, the incidence of this disease increases in older people over 55-60 years of age. Most often, older people suffer from acute myeloblastic leukemia. Younger ones, 10-20 years old, already suffer from chronic lymphoblastic pathology. For people over 70 years old, another form of blood cancer is usually characteristic - myeloblastic leukemia.

If we take children, then they have one of the most dangerous types of blood oncology - acute lymphoblastic leukemia, and more often it affects boys from 2 to 5 years old. The acute form of myeloblastic leukemia already accounts for 27% of all cancers among children and affects children from 1 to 3 years old. And most often the prognosis is very disappointing, since the disease is very aggressive and progresses quickly.

Chronic

Causes

Scientists and doctors are still arguing about what exactly influences the occurrence of cancerous and malignant cells. But most doctors are already on the path to discovery, since most believe that both acute and chronic forms of leukemia arise as a result of pathology at the level of chromosomes within cells.

Recently, scientists discovered the so-called “Philadelphia chromosome”, which is located in the bone marrow and can lead to blood cancer - a mutation of red bone marrow cells. But as studies have shown, this chromosome becomes acquired during a person’s life, that is, it cannot be obtained from parents.

Acute myeloid leukemia occurs in people with Bloom syndrome, Down syndrome, Fanconi anemia, and in patients with Wiskott-Aldrich syndrome. Let's take a closer look at all the other factors that may influence the occurrence of this disease:

• Smoking. Cigarette smoke contains a huge amount of chemicals that directly affect blood cells when inhaled.
• Alcohol and nutrition. One of the endogenous factors that affect the entire body and every cell. In people with poor nutrition and problems with alcohol, the risk of developing cancer of any class increases by one and a half times.
• Working with hazardous chemicals. People who work in factories, laboratories, or with plastic, gasoline, or other petroleum products have an increased chance of getting sick.
• Chemotherapy and Radiotherapy. It happens that when treating a tumor, complications arise and another cancer appears.
• Immune deficiency. Any disease that weakens the immune system can lead to cancer.
• Genetics. Children whose parents had leukemia have a higher chance of getting the disease than the average child. Such people are usually included in the risk group, and they must undergo the necessary examinations annually.

To put it simply, first there is some external or internal effect on the cell. Then inside at the chromosomal level, it changes and mutates. After this cell divides, there are more of them. When a mutation occurs, the division program breaks down, and the cells themselves begin to divide faster. The death program also breaks down, and as a result they become immortal. And all this happens in tissues in the red bone marrow, which reproduce blood cells.

As a result, the tumor itself begins to produce underdeveloped leukocytes, which simply fill all the blood. They interfere with the work of red blood cells and platelets. And later the number of red blood cells decreases significantly.

Symptoms primarily depend on the type of leukemia and the stage of the cancer itself. It is clear that in later stages the symptoms are more vivid and more pronounced. Plus, other symptoms of the disease may appear. General signs of leukemia in adults:

• Pain in bones and muscles.
• Lymph nodes throughout the body become very enlarged and hurt when pressed.
• The patient more often begins to suffer from common colds and viral diseases - due to the deterioration of the immune system.
• Due to infection, fever and chills appear.
• Sharp weight loss of up to 10-15 kg in an adult.
• Loss of appetite.
• Weakness and rapid fatigue.
• I constantly want to sleep.
• Bleeding does not stop for a long time and wounds on the body do not heal well.
• Leg pain.
• Bruises on the body.
• Adult women may experience bleeding from the vagina.

First symptoms

The problem is that at the initial stage the disease manifests itself poorly, and the patient thinks that it is a common disease. Because of this there is a loss of time. The first symptoms of leukemia in adults:

• Increased size of the liver and spleen.
• You may notice slight bloating in the abdomen.
• The appearance of a rash, red spots on the body.
• Bruising may occur.
• The symptoms are similar to a cold.
• Slight dizziness.
• Joint pain.
• General malaise.

The first signs of leukemia are not so bright, so first of all you need to pay attention to a sharp decline in immunity and frequent illnesses. A patient can get sick, recover, and then start getting sick again a couple of days later. This is due to the fact that there are many immature mutant leukocytes in the blood that do not perform their function.

A decrease in the number of platelets leads to bleeding, rash, stars appearing on the skin or subcutaneous bleeding. In the acute form of leukemia, chills and fever first appear, and then bones and muscles begin to ache.

Symptoms of acute leukemia

Acute leukemia usually progresses rapidly and aggressively. Often, up to stage 4, the disease can develop within 6-8 months, which is why the mortality rate for this pathology is higher than for the chronic form. But at the same time, cancer begins to manifest itself earlier, so in this case you need to see a doctor in time and diagnose cancer. Symptoms of acute leukemia in adults:

• Weakness, nausea, vomiting.
• Dizziness
• Body cramps
• Memory impairment
• Frequent headaches
• Diarrhea and diarrhea
• Pale skin
• Heavy sweating
• Increased heart rate. Heart rate 80 -100

Symptoms of chronic leukemia

It is a slow and non-aggressive cancer that develops over several years. In the first stages it is almost impossible to recognize it.

• Frequent colds
• A hard and enlarged abdomen is due to an enlarged spleen and liver.
• The patient quickly loses weight, without any diets.

Symptoms of chronic lymphoblastic leukemia

Lymphocytic leukemia occurs more often in adulthood after 50 years. At the same time, there is an increase in lymphocytes in the blood. With an increase in -lymphocytes, it has the form of lymphocytic leukemia.

• Disruption of the entire lymphatic system.
• Anemia.
• Long-term colds.
• Pain in the spleen.
• Visual impairment.
• Tinnitus.
• May lead to stroke.
• Jaundice.
• Bleeding from the nose.

Diagnostics

Usually, with any cancer, the level of platelets and red blood cells in the blood drops significantly. And this is clearly visible on a general blood test. Plus, an additional biochemistry test is usually taken, and there you can see abnormalities with an enlarged liver and spleen.

Further, when diagnosing, the doctor usually prescribes an MRI and x-ray of all bones to identify the source of the disease itself. Once cancer is found, the nature of the malignancy needs to be determined. To do this, a spinal or bone marrow puncture is performed.

A very painful procedure where a thick needle is pierced into the bone and a sample of bone tissue is taken. Next, the tissues themselves go for a biopsy, where they look at the degree of differentiation of the cancer - that is, how much the cancer cells differ from normal ones. The more differences, the more aggressive and dangerous the cancer. And only then treatment is prescribed.

Therapy

The treatment itself is mainly aimed at destroying cancer cells, as well as reducing the level of immature white blood cells in the blood. The treatment itself may depend on the stage of the cancer, the type and classification of leukemia, and the size of the bone marrow lesion.

The most basic treatments are: chemotherapy, immunotherapy, radiation and bone marrow transplantation. If the spleen is completely damaged, it can be completely removed.

First of all, the patient undergoes a full diagnosis in order to find out the extent of the lesion and the stage of the disease. Nevertheless, the most basic method is chemotherapy, when a substance is introduced into the patient’s body aimed at destroying only pathological cancer cells.

Chemotherapy

Before this, the doctor performs a biopsy and tests the tissues and cells themselves for sensitivity to various reagents. But this is not always done; sometimes the doctor initially tries to introduce some type of chemical substance, and then looks at the reaction of the cancer itself.

Patients are prescribed medications that reduce vomiting and painkillers for severe symptoms. Several medications are usually prescribed, both as tablets and injections.

If the spinal cord is damaged, a spinal puncture is used, when the drug itself is injected into the lower back into the spinal canal. Ommaya reservoir is a similar procedure that places a catheter in the same area and the end is secured to the head.

Chemotherapy itself is done in courses over a long period of 6-8 months. Between injections there is usually a recovery period when the patient is allowed to rest. The patient may be sent home if he does not have a severe decrease in immunity, otherwise he may be placed in a sterile ward with constant observation.

Side effects

• Decreased immunity. The result is infectious complications.
• Risk of internal bleeding.
• Anemia.
• Hair and nail loss. Later they grow up.
• Nausea, vomiting, diarrhea.
• Weight loss.

Immunotherapy

Aimed at boosting the patient's immune system to fight cancer cells. A mandatory procedure after chemotherapy, since after it the patient’s immunity drops significantly. They use monoclonal antibodies that attack cancer tissue and Interferon - it already inhibits growth and reduces cancer aggression.

Side effects

• The appearance of fungus
• Seizures on the lips, palate and mucous membranes

Radiotherapy

Irradiation of the patient leads to the destruction and death of leukemoid cells. It is often used before a bone marrow transplant to kill off any remaining tumor tissue. Typically, this type of treatment is used only as an auxiliary method, as it has little power in the fight against leukemia.

• Fatigue
• Drowsiness
• Dry skin, mucous membranes.

Bone transplant

First, doctors need to completely destroy cancerous tissue in the bone marrow; for this they use chemicals. reagents. After which the remains are destroyed by radiation therapy. Later a bone marrow transplant occurs.

After this, peripheral blood stem cell transplantation is also used, through any of the large veins. Once the cells enter the blood, after a short period of time they turn into regular blood cells.

Side effects

• Rejection of donor cells
• Damage to the liver, gastrointestinal tract and skin.

Subsequent treatment

Doctors prescribe: Diet.

• Painkillers.
• Antiemetic drugs.
• Complex of vitamins.
• Antianemic therapy.
• Antiviral, antifungal drugs, antibiotics, for low immunity.

Prognosis and survival

Five-year survival rate is the period during which a patient lives after the disease is detected.

Doctors do not use the concept of “cure”, since the disease can always return again. That is why, after complete therapy, the patient undergoes a biochemical, general and window marker blood test every six months.

NOTE! Adults are much less susceptible to treatment than children with leukemia. This is due to the fact that a young body adapts and regenerates faster. Also, recovery during chemotherapy occurs much faster, this is especially important in the acute form, since the frequency of courses is higher due to the high rate of development of the disease.

Nutrition for leukemia

Cannot be consumed

• Fast food
• Fried, smoked food
• Alcohol
• Highly salted food
• Coffee and caffeinated products and food

Must be consumed

• Fruits: apples, oranges, pears.
• Carrots, tomatoes
• Garlic, onion
• Berries: strawberries, blueberries, currants
• Sea kale
• Mussels
• Nuts
• Buckwheat, oatmeal
• Selenium
• Legumes

Despite the fact that in our century medicine has achieved enormous positive results in the treatment of complex and deadly diseases, it is not always possible to completely get rid of them. If a patient is diagnosed with acute blood leukemia, how long they live with it is the main question for the sick person. With such a mutation of blood cells, the pathological process develops in the bone marrow, but the victim can lead a completely normal existence.

Why does the patient’s quality of life deteriorate and what determines its duration?

To improve a person’s survival rate if he is diagnosed with leukemia, it is necessary to identify the pathology in time, as well as begin the correct treatment. Leukemia is one of the most common malignant blood pathologies. There are many varieties of the disease, so life expectancy in each specific episode is calculated separately.

In any case, blood cancer is characterized by a violation of cell proliferation, in which the number of leukocytes and lymphocytes increases sharply. ALL is characterized by a direct relationship between symptoms and how long a person will live.

The patient’s quality of life deteriorates due to the following factors:

• increased blood viscosity;
• enlargement of internal organs (especially the liver and pancreas);
• deterioration of vision function;
• change in the mechanism of blood supply along the periphery;
• development of secondary failure of most internal organs.

These factors significantly affect the quality of life. With leukemia, the prognosis is determined by several factors:

1. Form of the disease. If a person has chronic lymphocytic leukemia, he may live longer.
2. Stage of development of the pathology.
3. Patient's age. It has long been noted that young people can more quickly achieve stable remission and defeat the disease. In children, the disease can be overcome faster and easier. For older people, the prognosis is more pessimistic: the older the person, the lower his level of natural immunity.

It should be taken into account that the following factors can provoke the development of pathology:

• constant presence of a person under the influence of ionizing radiation;
• hereditary predisposition or some congenital pathologies;
• viruses characterized by increased oncogenicity;
• regular exposure to chemical carcinogens;
• some food products that contain preservatives and other additives;
• bad habits;
• smoking.

If these factors affect a person during a course of AML therapy, the patient’s life time will be significantly reduced. The patient needs to pay attention in time to the appearance of sudden weakness, causeless bruises on the skin, frequent nosebleeds, joint pain, and poor wound healing. Thanks to timely diagnosis, it is possible to improve the condition and increase a person’s life expectancy.

Statistics

In general, when diagnosed with acute myeloid leukemia, the prognosis for women is less optimistic than for men. Statistics show the following:

1. 70% of men live for about a year, 50% live for more than 5 years. For women, these figures correspond to 65% and 50%.
2. If the disease is detected on time and treatment is effective for 10 years, then 48% of male and 44% of female patients will be able to live.
3. The prognosis also depends on age. For example, many patients are interested in how long people who have not yet turned 40 years old with such a diagnosis live. Here the survival rate is 70%, while for the elderly population this figure decreases to 20%.
4. After 10 years of constant and effective therapy, 4 out of 10 patients survive and continue to live. Moreover, the presented indicator is still very good.

In any case, how long a person can live depends not only on drug treatment. The prognosis is also determined by the general emotional mood of the patient, the strength of the immune system, adherence to the correct diet and rest.

What prognosis is possible for acute form of leukemia (lymphocytic leukemia)?

If a person is diagnosed with acute leukemia, the prognosis for life can be positive if the disease is diagnosed on time. It has the following symptoms: fatigue, mild malaise, change in basal temperature, headache. That is, it is impossible to immediately determine cellular lymphocytic leukemia. The patient may mistake such signs for a cold.

Patients with acute lymphocytic leukemia require chemotherapy treatment. It involves the use of several cytotoxic drugs. Most often there are 3 of them. Therapy should last several years. Only with the right treatment can the patient live longer.

The therapy involves the initial destruction of pathological cells not only in the blood, but also in the bone marrow. Next, you need to kill less active atypical lymphocytes. This will prevent relapse or complication of the disease. After this, the acute form of leukemia requires preventive treatment. It is aimed at preventing the development of metastases.

If the patient's nervous system is affected, radiation therapy is required. In order to completely overcome cancer, the patient may be prescribed polychemotherapy with high doses of drugs, as well as a bone marrow transplant. This is done if standard treatment is ineffective or the disease recurs. The operation can slightly improve the patient's survival up to 10 years. During remission, the symptoms of the pathology practically do not appear.

Prognosis for acute myeloblastic blood lesions

If a patient has been diagnosed with acute myeloblastic leukemia, the prognosis of life depends on the correctness of therapy. Treatment uses strong chemicals and antibiotics. The course of the disease is further complicated by the risk of developing a serious infection, which can lead to sepsis.

If acute myeloid leukemia is treated correctly, then a patient up to 60 years old can live only 6 years (at best). Further, the possibility of a long-term remission decreases. Only 10% of older people can live up to 5 years.

With the development of sepsis, there cannot be a comforting prognosis. With effective treatment and no relapse within 5 years, doctors conclude that the patient has recovered.

How long can a person live with a chronic form of pathology?

Chronic lymphocytic leukemia occurs secretly. A person may not even suspect that he has blood cancer for many years. To make an accurate diagnosis in this case, you need to undergo a general blood test, which will include an increased level of lymphocytes, abnormal hemoglobin levels, and a bone marrow biopsy.

There have been cases where chronic lymphocytic leukemia developed over 10 years, and the patient experienced minimal discomfort. This disease is practically resistant to traditional treatment, although drugs help control the development of CLL. Life expectancy is at least 5 years. If circumstances go well, this period can be extended to 10 years or more.

Since chronic lymphocytic leukemia occurs secretly, it cannot always be diagnosed on time. With an advanced form of the pathology, the patient will live no more than 3 years. Chronic lymphocytic leukemia is a complex disease with serious consequences.

People living with chronic myeloid leukemia have a much better outlook. There is an opportunity to significantly increase the duration of remission. This compares unfavorably with chronic lymphocytic leukemia. A person can live more than 15 years. Although in the later stages the prognosis becomes much worse.

When will the forecast be disappointing?

Sometimes medicine is powerless and cannot defeat acute leukemia. The forecast will be disappointing if:

1. Along with blood cancer, some kind of infection develops in the patient’s body, especially a fungal one. Since human immunity is very weak, it cannot fight such pathologies at the same time. In this case, the fungus becomes resistant to even the most powerful antibacterial drugs. Such people, as a rule, do not live long.
2. Genetic mutations occur in the patient’s body, that is, acute lymphoblastic leukemia in adults (or other types of pathology) can degenerate and take on a form unknown to medicine. In this case, both chemical and radiation therapy will be ineffective. There is no time left to select new treatment tactics, and bone marrow transplantation cannot be performed.
3. The patient developed an infectious complication when it was impossible to isolate him in the hospital.
4. A person develops a cerebral aneurysm and extensive internal bleeding.
5. The treatment turned out to be ineffective or incorrect.
6. The diagnosis was made too late.
7. The patient is elderly.

With a diagnosis such as lymphocytic leukemia, the prognosis may vary. Basically, leukemia is considered a very dangerous, rapidly developing disease, which is not characterized by the presence of stages. Pathology has a negative impact on all human organs and systems, since cancer cells are spread in large numbers throughout the body through the blood.

Chronic lymphocytic leukemia, like acute lymphocytic leukemia, significantly reduces a person’s life expectancy. However, correctly selected treatment tactics will allow you to control the development of pathology.

A patient with leukemia can live a full life for many years. The main thing is to diagnose the disease in time and choose the right treatment tactics.

Leukemia is the most common form of malignant blood disease. There are many types of leukemia, each of which differs in course and other characteristics. The survival prognosis for leukemia is calculated individually and depends on many factors, primarily on the type of leukemia. In general, early detection of pathology often allows us to talk about a favorable outcome - long-term remission and even complete recovery.

Prognosis for acute lymphocytic leukemia

Treatment mainly comes down to chemotherapy courses. As a rule, several cytotoxic drugs are used (usually 3). Treatment of acute lymphocytic leukemia is long and lasts several years.

Initially, induction chemotherapy is performed, the main goal of which is to destroy cancer cells in the bone marrow and blood. Then consolidation chemotherapy is carried out, which is necessary to destroy less active atypical cells, which is necessary to prevent a possible relapse of the disease. The last stage of treatment is preventive chemotherapy, which destroys residual malignant cells to prevent metastases.

Radiation therapy for acute lymphocytic leukemia is used in cases where the nervous system is affected.

In some cases, high-dose chemotherapy is performed, after which the patient undergoes a bone marrow transplant. Transplantation is resorted to in cases where the disease is recurrent, and standardized methods of conservative treatment do not have the desired therapeutic effect.

It is a rather complex procedure that requires high precision of treatment, as well as positive survival rate of the donor material.

Acute lymphocytic leukemia is a disease in which it is difficult to predict the patient’s survival. Some patients go into remission for many years and live full lives. Sometimes the disease returns after a short period of time. With a successful bone marrow transplant, the prognosis for long-term remission is usually favorable, especially for children under 10 years of age. During the period of remission, there are almost no symptoms of the disease.

Survival prognosis for acute myeloid leukemia

Treatment of acute myeloid leukemia comes down to the use of powerful chemotherapy drugs that destroy cancer cells, as well as antibiotics, since when treating this pathology there is an increased likelihood of serious infections, including the onset of sepsis.

As in the case of acute lymphocytic leukemia, it is combined and involves the use of 2-3 types of cytostatic drugs.

The survival of a patient with acute myeloid leukemia is influenced by several factors: the patient’s age, the type of cells that have undergone pathological changes, the correctness of the chosen treatment tactics, and others.

If the patient is no more than 60 years old, then with standard treatment, survival for acute myeloid leukemia is no more than 6 years. With age, the likelihood of long-term remission decreases. So, if we are talking about patients over 60 years of age, then five-year survival rate is observed in 10% of patients.

If sepsis develops in acute leukemia, it often ends in the death of the patient. If after 5-6 years of remission there is no relapse of the disease, then we can talk about the patient’s complete recovery. If the treatment was successful, and the patient takes care of himself, adhering to all the doctors’ recommendations, then the survival rate is often 10 years or more.

Survival prognosis for chronic myeloid leukemia

As for chronic forms of leukemia, the prognosis here, as a rule, is much more favorable than for acute forms of pathologies.

In chronic myeloid leukemia, the patient's survival prognosis depends on a number of factors that are determined at the stage of diagnosis of the disease. On average, 5-year survival for chronic myeloid leukemia is observed in more than 90% of cases. With the advent of modern methods of biological and targeted therapy, the likelihood of recovery or achieving long-term (for many years) remission has increased significantly.

In cases where standard courses of chemotherapy, biotherapy and targeted treatment do not lead to the desired results, bone marrow stem cell transplantation is resorted to. Such treatment, if successful, gives good results and allows one to achieve remission for 15 years or more. However, such a favorable outcome is possible when the disease is detected at an early stage. As for the treatment of late-stage chronic myeloid leukemia, the prognosis is often unfavorable.

Prognosis for chronic lymphocytic leukemia

Chronic lymphocytic leukemia is a disease that cannot be cured. However, with the help of modern pharmacological drugs used in oncohematology, the disease can be kept under control for many years. Approximately 50% of patients live at least 5 years after diagnosis. Under favorable circumstances and successful treatment, survival can be 10 years or more.

The prognosis for chronic lymphocytic leukemia depends on the stage of the disease at which treatment was started. So, at stage A (initial stage), survival is 10 years or more. If treatment is started at stage B, the patient lives from 5 to 8 years. At stage C - from 1 to 3 years.

Of course, the above figures are conditional. The prognosis for this pathology is calculated individually with the doctor.

It should be noted that serious clinical trials are currently being conducted with the latest drugs for the targeted destruction of malignant blood cells in chronic forms of leukemia. The introduction of such treatment methods into practice will significantly improve prognosis for chronic leukemia.

Prognosis for hairy cell leukemia

This is a fairly rare blood disease, which is one of the variants of chronic leukemia. In hairy cell leukemia, B cells are affected and the cancer cells have ragged or hairy edges, giving the disease its name.

The good news is that hairy cell leukemia develops quite slowly, and once diagnosed, patients live at least 10 years. In approximately 40% of patients, after 10 years of remission, the disease relapses. And with secondary treatment of the disease, the prognosis is 5 years or more.

As you understand, survival rate for cancer of the blood and hematopoietic organs greatly depends on the stage at which the disease was detected. Timely diagnosis and correct treatment tactics make it possible to achieve long-term, stable remission and even complete recovery. Modern technologies of biotherapy and targeted treatment have significantly increased the life expectancy of patients with blood cancer, and most importantly, improved the quality of life, which allows the patient to live in his usual rhythm and be useful to his family and society.