Chronic myeloid leukaemia
Upcoming SlideShare
Loading in...5
×
 

Chronic myeloid leukaemia

on

  • 398 views

 

Statistics

Views

Total Views
398
Views on SlideShare
398
Embed Views
0

Actions

Likes
0
Downloads
6
Comments
0

0 Embeds 0

No embeds

Accessibility

Upload Details

Uploaded via as Microsoft PowerPoint

Usage Rights

© All Rights Reserved

Report content

Flagged as inappropriate Flag as inappropriate
Flag as inappropriate

Select your reason for flagging this presentation as inappropriate.

Cancel
  • Full Name Full Name Comment goes here.
    Are you sure you want to
    Your message goes here
    Processing…
Post Comment
Edit your comment

Chronic myeloid leukaemia Chronic myeloid leukaemia Presentation Transcript

  • MYELOPROLIFERATIVE NEOPLASM CHRONIC MYELOID LEUKAEMIA
  • HISTORY 45 year old present with fatigue and abdominal distention for the past 6 months. O/E he is pale and his spleen 5cm below coastal margin. His CBC reveals Hb 10.5g/dl, TLC 120x109 /L and Platelet count of 550x109 /L.
  • Chronic myelogenous leukaemia Chronic granulocytic leukaemia Clonal disorder Acquired genetic change in pluripotent haemopoietic stem cell
  • Rare below 20 years of age Median age of onset is 50 – 60 years Biphasic or triphasics disease Intial chronic/indolent or stable phase which evolves into an advanced phase
  • Cytogenetics Translocation of chromosomal material between long arms of chromosome 22 and chromosome 9, an event referred to as t(9;22) (q34:q11) Generates BCR-ABL fusion gene on Philadelphia chromosome
  • Ph chromosome
  • Ph chromosome
  • bcr/abl translocation by FISH Normal nuclei (n) exhibiting 2 orange and 2 green signals. Ph chr. showing Yellow fusion signal of orange and green signals ( arrows
  • bcr/abl translocation by FISH
  • Presentation Abdominal discomfort or progressive enlargement Weight loss Lethargy Loss of energy Shortness of breath Visual disturbances
  • Presentations Spontaneous bruising Bleeding gums Infections
  • Diagnosis CBC Anaemia Raised TLC DLC Full spectrum of granulocytic cells ( Blast, myelocyte, metamyelocyte, band cell, Neutrophils)
  • Eosinophils Basophils Platelet count raised Bone marrow examination: Degree of fibrosis Cytogenetic analysis Exclude incipient transformation
  • Raise LDH Reduced LAP score Raised vit B12 levels Hypercalcaemia Raised serum uric acid
  • Phases Chronic Phase: Ability to reduce spleen size and restore and maintain a normal blood count with therapy Blast cell percentage is less than 10% Eosinophils and basophils are normal in number
  • Accelerated Phase: Blast 10 – 19% Persistent thrombocytopenia unrelated to therapy or thrombocytosis unresponsive to therapy Increasing spleen size and counts unresponsive to therapy Megakaryocyte proliferation and reticluin or collagen fibrosis
  • Blastic Phase: Blast >20% Extramedullary blast proliferation