Symptoms, causes and treatments of acute promyelocytic leukemia which can be fatal even for the very young
There is no greater tragedy than seeing a very young person or even a child die. Unfortunately the fulminant leukemia it’s one of those sudden illnesses that doesn’t even give you time to realize you’re sick and can be fatal.
There are “famous” cases of young deaths due to this pathology. The world of sport still remembers with a lot of pain, despite the fact that almost 13 years have already passed, the death of the tennis player Federico Luzzi at the age of 28, today, unfortunately, at the same age, it is singer Michele Merlo died, also known as Mike Bird.
A few days ago a sixteen year old from Forlì also passed away, Leonardo Monaco, for the same reason. Both Merlo and Monaco have had a brain hemorrhage, which is a consequence of fulminant leukemia and the real cause of the death of the two boys.
What is fulminant leukemia –
The scientific name of fulminant leukemia is leucemia promielocitica acuta, a particular form of acuta myeloid leukemia. In Italy there are about 400 cases of leukemia among children per year. In 90% of cases they are affected by acute lymphoblastic leukemia and 95% of them recover completely. 10% of cases, on the other hand, are acute myeloid leukemias. Even these can be healed, they are not a death sentence. In some cases, however, it is acute promyelocytic leukemia, which in simplification is called fulminant leukemia, which makes the blood denser in some places because the white blood cells are altered.
Acute promyelocytic leukemia is very severe in the first days of onset, but if caught early, it can be cured even without chemotherapy, thanks to a treatment with derivatives of vitamin A and arsenic, as explained by Professor Andrea Pession, director of the Pediatric Department of the Sant’Orsola Hospital in Bologna and of the Postgraduate School of Pediatrics at Unibo in an interview with Rest of the Carlino.
In 2% of cases, Unfortunately, fulminant leukemia is fatal, usually if it is diagnosed late. The reasons are mainly two:
- the named complication Massive tumor lysis syndrome, due to which the kidney fails to dispose of the blast cells in time and causes problems for the whole organism;
- the hyperleukocytosis, when blast cell infiltration occurs in the central nervous system. The blood becomes thick and thus circulation problems occur and bleeding. Bleeding usually occurs in the brain or kidneys.
Precisely in the two very recent cases of young people Leonardo Monaco and Michele Merlo the cause of death was hemorrhages caused by hyperleukocytosis.
Fulminant leukemia in the case of Federico Luzzi –
Even in the case of Federico Luzzi the tragedy was consumed in a few days. On 19 October 2008 he returned to the field after a suspension and played a Serie A mach in Olbia. He felt ill and was diagnosed with fulminant leukemia four days later. Before the match on October 19, Luzzi said he felt exhausted for days and during the match against Tomas Tenconi he retired because he felt faint. That same evening he had returned to Arezzo and had a little fever. Admitted to the San Donato Hospital it was initially thought of bronchopneumonia.
Even Federico Luzzi had felt better and had sent an email to his club with a photo saying he was recovering, instead the tests showed that he had leukemia and was transferred to the ward of hematology, but did not react to treatment. The liver and kidneys stopped responding and he went into a coma. Chemotherapy was tried, but it proved useless. The 25 October 2008 Federico Luzzi known as Chicco died. His friends Fabio Fognini and Flavia Pennetta they named their eldest son Federico in his honor.
Acute promyelocytic leukemia: causes, symptoms, treatment –
The leucemia fulminante o leucemia promielocitica acuta is the most aggressive form of blood cancer. Nine out of ten patients recover and what makes the difference is the speed of diagnosis.
Between the symptoms of fulminant leukemia There are:
- skin bleeding;
- nosebleed or gentle;
- fatigue;
- general malaise;
- disorders of the digestive system;
- complaints of the urinary tract;
- central nervous system disorders.
To have proper diagnosis it is recommended to go to a hospital that has a hematology department, because there they have tools that allow a quick diagnosis which in these cases is equivalent to the patient’s salvation.
The causes of fulminant leukemia they are not yet clear. It is known that those affected are carriers of an acquired translocation, therefore not present from birth, between chromosomes 15 and 17, but it is not yet understood which mechanism this alteration derives from.
If it is discovered in time fulminant leukemia can be treated with at least four courses of arsenic and retinoic acid treatments, avoiding chemotherapy. Once healed the possibility of a recurrence is very rare, under 2% and only affects more patients Senior citizens.
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