Presentation on Leukemia Introduction A malignant progressive disease in which the bone marrow and other blood-forming organs produce increased numbers of immature or abnormal leucocytes. These suppress the production of normal blood cells, leading to anaemia and other symptoms. Types of leukemia ALL and CML in Bangladesh ALL and CML in global perspective Treatment Drugs : Imatinib (Glivec®) tablets Chemotherapy stem cell transplant (SCT) Elimination of the Ph chromosome. Supportive treatment : Blood and platelet transfusions, Antibiotic or antifungal medicines . References

1. Presentation on Leukemia

2. Introduction
A malignant progressive disease in which the bone marrow and other
blood-forming organs produce increased numbers of immature or
abnormal leucocytes. These suppress the production of normal blood
cells, leading to anaemia and other symptoms.
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3. Types of leukemia
Acute Chronic
MyeloidorganLymphoidorgan
Acute myeloid
leukemia
(AML)
Acute lymphocytic
leukemia
(ALL)
Chronic lymphocytic
leukemia
(CLL)
Chronic myeloid
leukemia
(CML)
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4. Generation of
Philadelphia chromosome
Chromosome 9
Chromosome 22
Chromosomal
breakage and
translocation
t(9;22)(q34;q11)
Derivative 9
Philadelphia
chromosome
abl
bcr
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5. Philadelphia
chromosome
Inhibit DNA repair
ATP
Proliferation of Immature
cell/uncontrolled proliferation of cells
Bcr-Abl
fusion
protein
Variants of Bcr-Abl fusion protein :
p210 (CML)
p185
p190 (ALL )
p230
Increased tyrosine kinase activity
and interaction with Interleukine-3
receptor beta subunit.
Molecular mechanism
of ALL and CML
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Fig : Pathophysiology of CML and ALL

6. ALL and CML in Bangladesh
0
20
40
60
80
100
Under 20 20-29 30-39 40-49
%ofoccurrence
Age
AML CML ALL Other HM
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Fig : Age-group specific distribution of
hematological malignancies in Bangladesh
AML
CML
ALL
CLL
Others
DISTRIBUTION
AML CML ALL CLL Others
Fig : Distribution pattern of hematological
malignancies in Bangladesh
Source : Hossain et al. BMC Cancer 2014, 14:438

7. ALL and CML in global perspective
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0 10 20 30 40 50 60 70 80
AML
CML
ALL
CLL
Median age
Hematologicalmalignancies
US India Bangladesh
Fig : Median age at diagnosis of hematological malignancies in Bangladesh as compared to India and US

8. Treatment
• Drugs : Imatinib (Glivec®) tablets
• Chemotherapy
• stem cell transplant (SCT)
• Elimination of the Ph chromosome.
• Supportive treatment :
Blood and platelet transfusions,
Antibiotic or antifungal medicines .
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9. References
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