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Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
Chronic leukemia
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Chronic leukemia

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  • 1. Chronic Leukemia
  • 2. Leukemias• Acute leukemias• Chronic leukemiasLymphomas• Hodgkin lymphoma• Non-Hodgkin lymphomaPlasma cell disorders• Multiple myelomaHematologic Malignancies
  • 3. Chronic myeloid leukemia Chronic lymphocytic leukemia
  • 4. Leukemias• Acute leukemias• Chronic leukemias• Chronic myeloproliferative disorders• Chronic lymphoproliferative disordersHematologic Malignancies
  • 5. Leukemias• Acute leukemias• Chronic leukemias• Chronic myeloproliferative disordersHematologic Malignancies
  • 6. • Malignant proliferation of myeloidcells (not blasts, but maturing cells) inblood, bone marrow• Four disorders: CML, PV, ET, MF• Occur only in adults• Long courseChronic Myeloproliferative DisordersThings You Must Know
  • 7. • Chronic myeloid leukemia• Polycythemia vera• Essential thrombocythemia• MyelofibrosisFour Chronic Myeloproliferative Disorders
  • 8. • Occur only in adults• Long clinical course•  WBC with left shift• Hypercellular marrow• Big spleenFeatures common to all 4 disorders:
  • 9. • Neutrophilic leukocytosis• Basophilia• Philadelphia chromosome• Three phasesChronic Myeloid LeukemiaThings You Must Know
  • 10. Chronic Myeloid Leukemia
  • 11. Chronic Myeloid Leukemia
  • 12. NormalchromosomesChromosomesin CML
  • 13. Cytogenetics
  • 14. Chronic phase• Stable counts• Easily controlled• 3-4 years (without therapy)Accelerated phase• Unstable counts• Fatal within monthsBlast crisis• Lots of blasts• Fatal within weeksPhases of CML
  • 15. Treatment• Used to be bone marrow transplant• Now, imatinib (Gleevec)Prognosis• Median survival used to be 5-6 years• Now: ??Treatment and Prognosis of CML
  • 16. • Panmyelosis…• …then marrow fibrosis• Extramedullary hematopoiesis• Teardrop red cellsChronic MyelofibrosisThings You Must Know
  • 17. Chronic myelofibrosis
  • 18. Chronic myelofibrosis
  • 19. • High RBC (makes blood sludgy)• Different from secondary polycythemia!Polycythemia VeraThings You Must Know
  • 20. Polycythemia vera
  • 21. • Very high platelet count in blood• Different from secondarythrombocythemia!Essential ThrombocythemiaThings You Must Know
  • 22. Essential thrombocythemia
  • 23. Leukemias• Acute leukemias• Chronic leukemias• Chronic myeloproliferative disorders• Chronic lymphoproliferative disordersHematologic Malignancies
  • 24. • Malignant proliferation oflymphocytes in blood, bone marrow• Many disorders; CLL most important• Occur only in adults• Long course; indolent but incurableChronic Lymphoproliferative DisordersThings You Must Know
  • 25. • Small, mature lymphocytes• = small lymphocytic lymphoma• Weird: B cells but CD5+• Long but inexorable courseChronic Lymphocytic LeukemiaThings You Must Know
  • 26. Chronic lymphocytic leukemia
  • 27. Chronic lymphocytic leukemia
  • 28. Treatment• Conservative• Reduce organomegaly, infectionsPrognosis• “Counts,” adenopathy• BM pattern, chromosomal abnormalities• Mean survival: 9 years• Death usually from infectionTreatment and Prognosis of CLL

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