白血病(英文版）.pptVIP

LEUKEMIA Female, age 47 years, was admitted to hospital for feeling weak and subcutaneous bleeding for 1 week. Blood test: WBC 54×109/L, HGB 72g/L, PLT 15×109/L.Bone marrow aspiration: blasts 42%, MPO (-), CD19 (+), CD20 (+)Question:1. What’s the initial diagnosis of this patient and the evidences?2. What’s the principle of treatment?Case CONTENTSDEFINITION CLASSIFICATION ETIOLOGYMANIFESTATIONSLABORATORY EVALUATIONDIAGNOSISTREATMENT Origin: Hematopoietic system Level: Malignant clonal disease of stem cellNature: MalignancyWhat is leukemia? Concept of leukemiaLeukemia is the result of the tumor (malignant) proliferation of hematopoietic stem cells.Leukemia is a malignant blood disorder (not solid tumor).Leukemia is characterized by the accumulation of （immature） blast cells in the bone marrow and blood, white blood cells (leukocytes) are usually involved.　　　　　　　　 1. Maturity of the leukemia cells 2. Kinds of cells 3. The number of WBC 4. FAB classification 5. MICM classification (WHO) TheClassification According to the maturity of the leukemia cellsAcuteRapid growth of immature blood cellsMostly in children, young adultsNeeds immediate treatmentChronicExcessive build up of more mature blood cellsMostly in older patientsMonitoring before treatment Relationship between AL and CLAcute LeukemiaChronic Leukemia Acute Lymphocytic/Lymphoblastic Leukemia(ALL) : most common type in young children; also affects adults, 65 Acute Myelogenous/ Myeloid Leukemia(AML) more common in adults than in children. Chronic Lymphocytic leukemia (CLL) most often affects adults over the age of 55Chronic Myelogenous leukemia (CML) occurs mainly in adultsLymphoid Affects lymphocytes and plasma cellsLymphocytic leukemia MyeloidAffects eosinophils, neutrophils, basophilsMyelogenous leukemiaAccording to cell kinds Leukocytosis：WBC10×109/L (Leukocyte Leukemia )Non-leukocytosis ：WBC＜1×109/L (Non-leukocyte Leukemia )According to the number of WBC In 1976