Leukemia is Cancer of wahit blood cells

1. LEUKEMIA
DR.AHMED ELNEMR

3. Leukemia
Definition:
➢ Malignant proliferation of white blood cell precursors.
➢ Manifested by the appearance of blast cells in blood and BM.
Classification:
According to the cell type: According to clinical behavior:
 Lymphoid leukemia.
 Myeloid leukemia.
- Acute: - Chronic:
 Rapid course.
 Formed of undifferentiated cells
 Slow course.
 Formed of moderately
differentiated cells.

4. Pathological effects:
Changes in the peripheral blood:
WBCs ▪ Total leucocytic count
▪ The differential count
platelets ▪
RBCs ▪

5. Acute Leukemia:
Incidence: It is the most common malignancy in the children. ( ‫هام‬ MCQ)
Types: May be either Acute myeloblastic or Acute lymphoblastic.
Pathological features:
Bone Marrow:
 Replaced by undifferentiated malignant cells as
▪ Myeloblasts,
▪ Lymphoblasts And
▪ Normoblasts.
Peripheral Blood:
 WBCs ▪ High leucocytic count (50,000 - 100,000 /c. mm).
▪ The differential count:
✓ about 50% of the leucocytes either
o Lymphoblasts,
o Myeloblasts or
o Monoblasts.
✓ Neutrophils are decreased.
 platelets ▪ Severe thrombocytopenia: leads to bleeding tendencies.
 RBCs ▪ Anemia due to bleeding & destruction of the erythrocytic series.
Other Tissues:
 Leukemic infiltrate in various tissues as lymph nodes, spleen, liver.

6. Chronic Myeloid Leukemia:
➢ Malignant proliferation of the myelocytic series
➢ affecting young and middle ages.
Pathological features:
Bone Marrow:
 Replaced by proliferating myeloblasts and myelocytes
with a large number of normoblasts.
Peripheral Blood:
 WBCs ▪ High leucocytic count (200,000 - 500,000/c.mm).
▪ The differential count:
✓ about 50% of the leucocytes either
o Metamyelocytes,
o Promyelocytes and
o Myelocytes
✓ Neutrophils are decreased.
 platelets ▪ Thrombocytopenia.
 RBCs ▪ Anemia due to destruction of the erythrocytic series.
Lymph Nodes:
 Are moderately enlarged due to infiltration by leukemic cells.
Splenomegaly:
 Due to diffuse infiltration by the myelocytes.
Liver:
 Is enlarged due to diffuse leukemic infiltrate.

7. Chronic Lymphocytic Leukemia:
➢ Malignant proliferation of the lymphocytic series affecting usually old people.
Pathological features:
Bone Marrow:
 Is replaced by leukemic cells.
Peripheral Blood:
 WBCs ▪ High leucocytic count (50,000 - 200,000 /c. mm).
▪ The differential count:
✓ immature lymphocytes make up to 90% or more of the white
cells.
 platelets ▪ Thrombocytopenia.
 RBCs ▪ Anemia due to destruction of the erythrocytic series.
Lymph Nodes: generalized enlargement
Splenomegaly & Hepatomegaly: d ue to leukemic infiltration.

8. QUESTIONS:
1) All of the following are types of leukemia except
a) Acute lymphoblastic leukemia
b) Acute myeloblastic leukemia
c) Chronic myeloblastic leukemia
d) Chronic myeloid leukemia
2) In bone marrow biopsy, the abundant cells in leukemia are
a) Lymphoblast
b) Myeloblast
c) Neutrophil
d) A & c
e) A & b
3) All are effects of leukemia except
a) Generalized lymphadenopathy
b) Splenomegaly & Hepatomegaly
c) Bleeding.
d) High resistance
4) The most common malignant tumor of children
a) Lymphoma
b) CLL
c) CML
d) Acute leukemia

9. 5) The most common malignant tumor of children
a) AML
b) CLL
c) CML
d) ALL
6) A child has recurrent infection & bleeding tendency. a bone marrow
biopsy is taken to sure the diagnosis of leukemia and now he is in
chemotherapy. That biopsy may show increase in
a) Differentiated malignant cells
b) Undifferentiated malignant cells
c) Myelocyte
d) Lymphocyte
7) The age of CML
A) Child
B) Old age
C) Adult
D) Middle age
8) The age of ALL
A) Child
B) Old age
C) Adult
D) Middle age

10. 9) The age of CLL
A) Child
B) Old age
C) Adult
D) Middle age
1 C
2 E
3 D
4 D
5 D
6 B
7 D
8 A
9 B