Foreign students acute leukemia-zhou
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Foreign students acute leukemia-zhou

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    Foreign students acute leukemia-zhou Foreign students acute leukemia-zhou Presentation Transcript

    • Leukemia Department of Hematology, the First Affiliated Hospital ,Sun Yat-Sen University Zhenhai Zhou
    •   Overview
      • A heterogeneous group of hematopoietic malignancies characterized by infiltration of the blood ,bone marrow,and other tissue by leukemic cells which exhibit differentiation and apoptosis arrest in any stage of maturation.
      • Classification:
      • acute chronic
      • lymphoblastic myloid
      • Incidence
      • 2.76/100,00 in China
      • More acute leukemia
      • Etiology
      • ---heredity
      • ---Radiation
      • ---Chemical and other exposures
      • ---Drugs
      • ---virus
    • Acute Leukemia
      • classification
      • FAB
      • --- Acute myeloid leukemia(AML)
      • M0-M7
      • ---Acute lymphoblastic leukemia(ALL)
      • L1,L2,L3
      • WHO
      • MICM
    • Clinical feature
      • Decreased production of normal hematopoietic
      • ---anemia:pale,tired
      • ---bleeding: PLT, blood vessel wall, DIC
      • acute promyelocytic leukemia
      • ---fever: infection ,or?
      • Leukemic cells infiltration
      • ---Lymph node, liver spleen , Sternum…
      • ---central nervous system (CNSL)
    • CT-fungi infection
    • CT
    • Laboraory findings
      • Blood test : WBC ↑ , Hb ↓ , PLT ↓
      • Bone marrow- morphology
      • Hypercellular
      • Cytochemical reactions: POX(aml)PAS(all) NAE(aml)
      • Immunophenotypic analysis
      • Flow cytometrry-antigen CD
      • ---Myeloid lineage
      • MPO,CD117 ,CD33,CD13,CD14,CD15
      • ---Lymphoblastic lineage
      • B:CD79a,CD19,CD20,CD22…
      • T:CD7,CD3,CD5…
    •  
      • Cytogenetics :
      • Chromosome abnormality
      • Molecular genetics:
      • ---t(8,21) (q22;q22) AML1-ETO,M2
      • ---t(15,17) (q22;q21) PML-RARa M3t() t()
      • Low risk, high risk
      • FISH
    • Differential diagnosis
      • Myelodysplastic syndrome(MDS)
      • Myeloproliferative disorders
      • Chronic myelogenous leukemia
    • treatment
      • Supporting treatment
      • Antimicrobial therapy
      • Blood transfusion
      • Hyperleucocytosis therapy
      • Tumor lysis therapy
      • oral allopurinol
    • Antileukemic treatment
      • Treatment strategy --Complete remission(disapperance of all sign of cancer)
      • Treatment for ALL
      • ---Induction : DVLP(DNR,VCR,L-ASP,Prednisone)
      • ---Postremission therapy :Consolidation and maintain chemotherapy; Allogenetic BMT
      • CNS prophylasis :high dose systemic therapy iintrathecal drug
      • Relapsed ALL therapy
      • Treatment for AML
      • ---Induction : DA(DNR,Ara-c)
      • ---APL:ATRA(all trans-renotic acid),arsenic trioxide
      • ---Postremission therapy :Consolidation and maintain chemotherapy; Allogenetic BMT
      • Relapsed AML therapy
    • Prognosis
      • Adverse prognostic factors : unfavorable karyotype, age,high WBC,secondary AML…
    • Chronic myelogenous
      • Incidence
      • Clinical features
      • ---chronic phase: fatigue, night sweats,
      • low-grade fever
      • splenomegaly, leukostasis
      • ---accelerated phrase
      • ---blast phase
    • Laboratory findings
      • Blood
      • ---WBC Moderate-marked increase ,basophils,eosinophils
      • ---anemia , PLT
      • ---<5%blast,<10%blast and promyelocytes
      • Bone marrow
      • ---hypercellular, granulocytic
      • Cytogenetic findings
      • Philadephia chromosome
      • t(9,22)(9q,22q) Bcr/abl
    • Treatment
      • Leukophoresis
      • Hydroxyurea
      • ---hematologic remissiom
      • Interferon- α
      • Imatinb Mesylate
      • Stem cell transplantation
    • Chronic lymphocytic leukemia
      • Clinical features
      • Laboratory findings
      • The majority of patients with stage A have no symptoms and may be observed for a while to determine treatment.
      • Thank You !