This document discusses acute leukemia, including definitions of blast cells, leukemia, and the differences between lymphoid and myeloid cells. It covers the pathophysiology of acute leukemia, techniques for diagnosis, classifications of acute lymphoblastic leukemia (ALL) and acute myelogenous leukemia (AML), treatment approaches, and prognosis. Key points include that ALL is most common in children while AML is more common in adults, cytogenetics help determine prognosis and treatment for both, and the cure rate for ALL can be as high as 90% in children but only 30% in adults.
Chronic Lypmhocytic leukemia/SLL/B-PLL/T-PLL/ATLL By SOLOMON SUasb by SOLOMON SUASB
the following presenation include
Introduction/Background
• Etiology of CLL
• Symptoms
• Test and Diagnosis
• Staging
• Prognosis
• Treatment
• B Cell diseases BPLL
• T cell diseases
T-PLL
ATLL
LGLL
Chronic Lypmhocytic leukemia/SLL/B-PLL/T-PLL/ATLL By SOLOMON SUasb by SOLOMON SUASB
the following presenation include
Introduction/Background
• Etiology of CLL
• Symptoms
• Test and Diagnosis
• Staging
• Prognosis
• Treatment
• B Cell diseases BPLL
• T cell diseases
T-PLL
ATLL
LGLL
Thrombotic Microangiopathies are diverse group of disorders wherein thrombocytopenia, hemolytic anemia and organ dysfunction such as Kidney and brain occur . Major recent advances in this field have occurred which opens up oppurtunities to effectively manage its clinical challenges .
acute leukemia
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Chronic myelogenous leukemia (CML) - pluripotential stem cell disease
A malignancy the treatment of which has been revolutionised over the last decade.
Here is a comprehensive discussion on the disease
This presentation is about chronic lymphocytic leukemia (CLL), its epidemiology and incidence, staging, molecular characteristics, clinical features and management.
Thrombotic Microangiopathies are diverse group of disorders wherein thrombocytopenia, hemolytic anemia and organ dysfunction such as Kidney and brain occur . Major recent advances in this field have occurred which opens up oppurtunities to effectively manage its clinical challenges .
acute leukemia
For More Medicine Free PPT - http://playnever.blogspot.com/
For Health benefits and medicine videos Subscribe youtube channel - https://www.youtube.com/playlist?list=PLKg-H-sMh9G01zEg4YpndngXODW2bq92w
Chronic myelogenous leukemia (CML) - pluripotential stem cell disease
A malignancy the treatment of which has been revolutionised over the last decade.
Here is a comprehensive discussion on the disease
This presentation is about chronic lymphocytic leukemia (CLL), its epidemiology and incidence, staging, molecular characteristics, clinical features and management.
AML:ACUTE MYELOID LEUKAEMIA
for medical colleges teaching faculty and students as well. it includes AML causes , histopathological slides of subclasses of Acute myeloid leukemia, classification , diagnosis, management modalities, complications .Acute leukemias are stem cell disorders characterized by malignant neoplastic proliferation and accumulation of immature and non functional hematopoietic cells in the bone marrow.
The neoplastic cells show increased proliferation and/or decreased apoptosis.
If the defect primarily affects the common myeloid progenitor (CMP) then it is called Acute myeloid leukemia.
Acute myeloid leukemia (AML) is a neoplastic disease characterized by infiltration of the blood, bone marrow, and other tissues by proliferative, clonal undifferentiated cells of the hematopoietic system.
AML is the result of a sequence of somatic mutations in a multipotential primitive hematopoietic cell or, in some cases, a more differentiated progenitor cell.
It can be slow growing or rapidly fatal.
AML is the predominant form of leukemia during the neonatal period
Incidence : 1.5/100,000/year in infants decreases to approximately 0.4 per 100,000 children ages 5 to 9 years, increases gradually to 1.0 persons per 100,000 until age 25 years, and thereafter increases exponentially until the rate reaches approximately 25/100,000 persons.
AML accounts for 15 to 20 percent of the acute leukemias in children and 80 percent of the acute leukemias in adults.
Men > Women (4.5 : 3)
HEREDITY
1) Chromosomal aneuploidy like Trisomy 21 noted in Down syndrome
2) Defective DNA repair, e.g., Fanconi anemia, Bloom syndrome, and Ataxia telangiectasia
3) Congenital neutropenia ie Kostmann syndrome
4) Germline mutations of CCAAT/enhancer-binding protein α (CEBPA), runt-related transcription factor 1 (RUNX1), and tumor protein p53 (TP53) have also been associated with a higher predisposition to AML
RADIATION
Peaks after 5 to 7 yrs of exposure.
Therapeutic radiation alone seems to add little risk of AML but can increase the risk in people also exposed to alkylating agents.
CHEMICAL AND OTHER EXPOSURES
Exposure to benzene, plastic, rubber, petroleum products, paint, ethylene oxide, herbicides and pesticides can increase the risk.
Smoking can also increase the risk
DRUGS
Anticancer drugs are the leading cause of therapy-associated AML.
Alkylating agent–associated leukemias occur on average 4–6 years after exposure, and affected individuals have aberrations in chromosomes 5 and 7.
Topoisomerase II inhibitor–associated leukemias occur 1–3 years after exposure, and affected individuals often have aberrations involving chromosome 11q23.
Other agents like Chloramphenicol, phenylbutazone, and, less commonly, chloroquine and methoxypsoralen.
SYMPTOMS :
Present with nonspecific symptoms initially.
Fatigue is the first symptom
Fever with or without infection will be present in approximately 10% patients
Bleeding, easy bruising
occasional
The French Revolution, which began in 1789, was a period of radical social and political upheaval in France. It marked the decline of absolute monarchies, the rise of secular and democratic republics, and the eventual rise of Napoleon Bonaparte. This revolutionary period is crucial in understanding the transition from feudalism to modernity in Europe.
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2024.06.01 Introducing a competency framework for languag learning materials ...Sandy Millin
http://sandymillin.wordpress.com/iateflwebinar2024
Published classroom materials form the basis of syllabuses, drive teacher professional development, and have a potentially huge influence on learners, teachers and education systems. All teachers also create their own materials, whether a few sentences on a blackboard, a highly-structured fully-realised online course, or anything in between. Despite this, the knowledge and skills needed to create effective language learning materials are rarely part of teacher training, and are mostly learnt by trial and error.
Knowledge and skills frameworks, generally called competency frameworks, for ELT teachers, trainers and managers have existed for a few years now. However, until I created one for my MA dissertation, there wasn’t one drawing together what we need to know and do to be able to effectively produce language learning materials.
This webinar will introduce you to my framework, highlighting the key competencies I identified from my research. It will also show how anybody involved in language teaching (any language, not just English!), teacher training, managing schools or developing language learning materials can benefit from using the framework.
Embracing GenAI - A Strategic ImperativePeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Safalta Digital marketing institute in Noida, provide complete applications that encompass a huge range of virtual advertising and marketing additives, which includes search engine optimization, virtual communication advertising, pay-per-click on marketing, content material advertising, internet analytics, and greater. These university courses are designed for students who possess a comprehensive understanding of virtual marketing strategies and attributes.Safalta Digital Marketing Institute in Noida is a first choice for young individuals or students who are looking to start their careers in the field of digital advertising. The institute gives specialized courses designed and certification.
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June 3, 2024 Anti-Semitism Letter Sent to MIT President Kornbluth and MIT Cor...Levi Shapiro
Letter from the Congress of the United States regarding Anti-Semitism sent June 3rd to MIT President Sally Kornbluth, MIT Corp Chair, Mark Gorenberg
Dear Dr. Kornbluth and Mr. Gorenberg,
The US House of Representatives is deeply concerned by ongoing and pervasive acts of antisemitic
harassment and intimidation at the Massachusetts Institute of Technology (MIT). Failing to act decisively to ensure a safe learning environment for all students would be a grave dereliction of your responsibilities as President of MIT and Chair of the MIT Corporation.
This Congress will not stand idly by and allow an environment hostile to Jewish students to persist. The House believes that your institution is in violation of Title VI of the Civil Rights Act, and the inability or
unwillingness to rectify this violation through action requires accountability.
Postsecondary education is a unique opportunity for students to learn and have their ideas and beliefs challenged. However, universities receiving hundreds of millions of federal funds annually have denied
students that opportunity and have been hijacked to become venues for the promotion of terrorism, antisemitic harassment and intimidation, unlawful encampments, and in some cases, assaults and riots.
The House of Representatives will not countenance the use of federal funds to indoctrinate students into hateful, antisemitic, anti-American supporters of terrorism. Investigations into campus antisemitism by the Committee on Education and the Workforce and the Committee on Ways and Means have been expanded into a Congress-wide probe across all relevant jurisdictions to address this national crisis. The undersigned Committees will conduct oversight into the use of federal funds at MIT and its learning environment under authorities granted to each Committee.
• The Committee on Education and the Workforce has been investigating your institution since December 7, 2023. The Committee has broad jurisdiction over postsecondary education, including its compliance with Title VI of the Civil Rights Act, campus safety concerns over disruptions to the learning environment, and the awarding of federal student aid under the Higher Education Act.
• The Committee on Oversight and Accountability is investigating the sources of funding and other support flowing to groups espousing pro-Hamas propaganda and engaged in antisemitic harassment and intimidation of students. The Committee on Oversight and Accountability is the principal oversight committee of the US House of Representatives and has broad authority to investigate “any matter” at “any time” under House Rule X.
• The Committee on Ways and Means has been investigating several universities since November 15, 2023, when the Committee held a hearing entitled From Ivory Towers to Dark Corners: Investigating the Nexus Between Antisemitism, Tax-Exempt Universities, and Terror Financing. The Committee followed the hearing with letters to those institutions on January 10, 202
Model Attribute Check Company Auto PropertyCeline George
In Odoo, the multi-company feature allows you to manage multiple companies within a single Odoo database instance. Each company can have its own configurations while still sharing common resources such as products, customers, and suppliers.
A Strategic Approach: GenAI in EducationPeter Windle
Artificial Intelligence (AI) technologies such as Generative AI, Image Generators and Large Language Models have had a dramatic impact on teaching, learning and assessment over the past 18 months. The most immediate threat AI posed was to Academic Integrity with Higher Education Institutes (HEIs) focusing their efforts on combating the use of GenAI in assessment. Guidelines were developed for staff and students, policies put in place too. Innovative educators have forged paths in the use of Generative AI for teaching, learning and assessments leading to pockets of transformation springing up across HEIs, often with little or no top-down guidance, support or direction.
This Gasta posits a strategic approach to integrating AI into HEIs to prepare staff, students and the curriculum for an evolving world and workplace. We will highlight the advantages of working with these technologies beyond the realm of teaching, learning and assessment by considering prompt engineering skills, industry impact, curriculum changes, and the need for staff upskilling. In contrast, not engaging strategically with Generative AI poses risks, including falling behind peers, missed opportunities and failing to ensure our graduates remain employable. The rapid evolution of AI technologies necessitates a proactive and strategic approach if we are to remain relevant.
Introduction to AI for Nonprofits with Tapp NetworkTechSoup
Dive into the world of AI! Experts Jon Hill and Tareq Monaur will guide you through AI's role in enhancing nonprofit websites and basic marketing strategies, making it easy to understand and apply.
Welcome to TechSoup New Member Orientation and Q&A (May 2024).pdfTechSoup
In this webinar you will learn how your organization can access TechSoup's wide variety of product discount and donation programs. From hardware to software, we'll give you a tour of the tools available to help your nonprofit with productivity, collaboration, financial management, donor tracking, security, and more.
Macroeconomics- Movie Location
This will be used as part of your Personal Professional Portfolio once graded.
Objective:
Prepare a presentation or a paper using research, basic comparative analysis, data organization and application of economic information. You will make an informed assessment of an economic climate outside of the United States to accomplish an entertainment industry objective.
Synthetic Fiber Construction in lab .pptxPavel ( NSTU)
Synthetic fiber production is a fascinating and complex field that blends chemistry, engineering, and environmental science. By understanding these aspects, students can gain a comprehensive view of synthetic fiber production, its impact on society and the environment, and the potential for future innovations. Synthetic fibers play a crucial role in modern society, impacting various aspects of daily life, industry, and the environment. ynthetic fibers are integral to modern life, offering a range of benefits from cost-effectiveness and versatility to innovative applications and performance characteristics. While they pose environmental challenges, ongoing research and development aim to create more sustainable and eco-friendly alternatives. Understanding the importance of synthetic fibers helps in appreciating their role in the economy, industry, and daily life, while also emphasizing the need for sustainable practices and innovation.
Biological screening of herbal drugs: Introduction and Need for
Phyto-Pharmacological Screening, New Strategies for evaluating
Natural Products, In vitro evaluation techniques for Antioxidants, Antimicrobial and Anticancer drugs. In vivo evaluation techniques
for Anti-inflammatory, Antiulcer, Anticancer, Wound healing, Antidiabetic, Hepatoprotective, Cardio protective, Diuretics and
Antifertility, Toxicity studies as per OECD guidelines
2. BLAST CELL: DEFINITON
Blast cells are immature cells found in the bone
marrow. They are not fully developed, and
therefore, do not carry out any normal function
in the blood. More than 5% of these cells in the
bone marrow is abnormal and need to be
evaluated for the possibility of a malignant
disorder of the hematopoietic system.
3. LEUKEMIA: DEFINITION
Leukemia is a malignant clonal condition of the
bone marrow and blood. It is characterized by
the acumulation of blast cells in the marrow,
usually more than 20%. These blast cells are
frequently seen in the peripheral blood.
4.
5. LYMPHOID VS. MYELOID
CELLS
Immature lymphoid cells have minimal
differentiation
Myeloid blast has some differentiation
Cytoplasmic granules in myeloid cells (auer
rod)
Cytochemical stains (mpo and pas)
Immunological markers, Ig and TCR
8. PATHOPHYSIOLOGY OF AL
Leukemias typically fill up the marrow with abnormal
cells, displacing normal hematopoiesis. The marrow here
is essentially 100% cellular, but composed almost
exclusively of leukemic cells. Normal hematopoiesis is
reduced via replacement (a "myelophthisic" process) or by
suppressed stem cell division. Thus, leukemic patients are
prone to anemia, thrombocytopenia, and
granulocytopenia and all of the complications that ensue,
particularly complications of bleeding and infection.
Bone marrow failure secondary to leukemic infiltration
producing anemia, neutropenia and thrombocytopenia
Maturation arrest and lineage infidelity
Chromosomal abnormalities involving oncogenes and
tumor suppressor genes
9. TECHNIQUE FOR ACUTE
LEUKEMIA DIAGNOSIS
Morphologic features
Cytochemical stains
Flow cytometry and markers
Chromosomal analysis
Fluorescence In Situ hybridization (FISH)
PCR (polymerase chain reaction)
10. ACUTE LYMPHOBLASTIC
LEUKEMIA
This a clonal disorder of hematopietic cells
There is accumulation of immature cells
and tissue infiltration.
Risk factors (chemicals, family history,
radiation and chemotherapy)
13. ACUTE LYMPHOBLASTIC
LEUKEMIA
Accumulation of lymphoblast
Most common in children and better
prognosis than adults (3-7years)
Disease in children is different than the
adults
Rise incidence after 40 years with a very
poor prognosis
14. CLASSIFICATION: ALL B VS.
T
•
Precursor
B
cell
lymphoblastic
leukemia/lymphoma, also called precursor B
cell acute lymphoblastic leukemia (precursor B
cell ALL)
•
Precursor
T
cell
lymphoblastic
leukemia/lymphoma (precursor T-LBL), also
called precursor T cell acute lymphoblastic
leukemia (precursor T cell ALL)
15. CLASSIFICATION OF ALL
FAB
(L1, L2 and L3)
Immunological (B vs. T lineage)
B cell 80% of all ALL. Tcell 20% of all
ALL.
B cell precursor ALL (80% ALL)
CD10,CD19,CD20
and CD22) markers
Early pre-B, CD10 neg (infant). Usually CD34+
Pre-B, CD10+ (common ALL)
B-ALL (Burkitt’s type or L3, large vacuole and
surface immunoglobulin). Its now consider a
lymphoma
T-cell
ALL (TdT, CD3, CD5 and CD7)
16. DIAGNOSIS OF ALL
Peripheral
smear with blast cells
Bone marrow with >20% of blasts
Immunophenotype
B
vs. T cell, markers
Help to differentiate from myeloid
Chromosomal
analysis (Hyper
vs.hypodiploidy, t(9;22) or Ph+,
t(4;11), t(v;11q23),t(12;21) and t(1;19))
17. SPECIAL TEST IN ALL
Due to high incidence of CNS involvement a
lumbar puncture is usually required and
intrathecal treatment
CT’s Scan for T cell and Burkitt
Testicular us
Tumor lysis syndrome
18. CYTOGENETICS IN ALL
Philadelphia Chromosome present in 30% of
adult ALL with a very poor prognosis.
T(4;11) association with secondary leukemia
T(v;11q23),t(12;21) and t(1;19)
TEL and AML1 genes are present in 30% of
childhood ALL and is associated with a good
proognosis.
Tyrosine Kinase inhibitors are included in
treatment strategies
19. TREATMENT OF ALL
Cytotoxic
chemotherapy include
induction, consolidation,
intensification and maintenance
Complete response after induction is
80%
Cure 35-40% in the adult population
T cell and L3 ALL require special
consideration
Response and cure in children could
be as high as 90%
20. PROGNOSIS IN ALL
Cure
rate of 75-90% in children’s
Cure rate in adults of 30%
CD10 negative ALL has worse
prognosis
A presentation with a WBC >
30,000/m3 is associated with a poor
prognosis
Cytogenetics
Slow response to induction is
considered a poor prognosis feature
24. CLINICAL OVERVIEW
Acute myeloid leukemia (AML) is the most common acute
leukemia in the adult
AML is cancer of the blood-forming tissue (bone marrow).
Normal bone marrow produces red cells, white cells, and
platelets.
AML causes bone marrow to produce too many immature
white blood cells (blast cells) .
Suppresses normal blood cell production.
Anemia, leucopenia, thrombocytopenia
25. RISK FACTORS
Age
Older adults are more likely to develop AML
Smoking
20% of AML cases are linked to smoking
Doubles the risk of disease in people > 60 y/o
Genetic disorders
High doses of radiation
Long-term survivors of atomic bombs
Previous chemotherapy treatment
Down syndrome, Fanconi’s anemia
Breast cancer, ovarian cancer, lymphoma
Exposure to industrial chemicals
Benzene long term exposure
26. STATISTICS
Incidence:
3-5 new cases expected per 100,000 population
Mortality:
8,900 estimated deaths/year M:54%, F:46%
Prognosis:
5-year survival rate in adults under 65 is 33%
Prognosis:
5-year survival rate in adults over 65 is 4-5%
Prognosis:
20-30% experience remission or are cured
Sources: American Cancer Society; The Leukemia & Lymphoma Society,
27. CLINICAL FEATURES
OF
AML
Bone
marrow failure
Coagulopathy (DIC) specially in
APL
Tumor infiltration of monocytic
leukemia
Tumor lysis syndrome specially
with the initial chemotherapy
28.
29. CLASSIFICATION BY FAB
Mo
Undifferentiated(5%)
M1 no maturation(20%)
M2 maturation(30%)
M3 Promyelocytic (7%)
M4 myelomonocytic
M5 monocytic
M6 Erythroleukemia
(very rare)
M7 Megakarioblast
(very rare)
31. THE WHO
CLASSIFICATION
Reduce
the percentage of
blast to 20%
Emphasis in the Cytogenetic
characteristics
Recognize therapy related
leukemia's
Recognize AML from
previous Myelodyplasia
32. CYTOGENETIC IN AML
Good
prognostic
group
T(15;17)
T(8;21)
Inv (16)
(p13q22) with
eosinophilia
Poor prognostic
group
Deletion of
chromosome 5/7
t(11;q23)
t(6;9)
+8
Complex
rearrangement
33. CYTOCHEMICAL STUDIES
AND MARKERS
MPO
or Sudan black
Nonspecific esterase
Periodic Acid Shift (PAS)
Markers CD13, CD33 an CD15 are
only helpful for diagnosis of AML
35. Acute Myelogenous Leukemia M2
T(8;21)
(q22;q22) RUNX1-RUNX1T1
(TEL and AML1 genes)
Constitute 7% of AML
Auer rods are easily identified and
cytoplasm is generally basophilic
Favorable prognosis in adults but not
in children
38. ACUTE MYELOGENOUS
LEUKEMIA M4
Approximately
20% of AML but 5% of
them are AML M4 with eosinophilia
and inv(16)
Mixture of blast with myeloid and
monocytic features
Better prognosis with the inv(16)
expression.
40. ACUTE PROMYELOCYTIC
LEUKEMIA
DIC very frequent
t(15;17) is present in almost every case
RAR gene present in chromosome 17
juxtaposition with PML gene in chrom 15
producing a maturation arrest
All transretinoic acid (ATRA) induce maturation
43. ACUTE PROMYELOCYTIC
LEUKEMIA
Retinoid
acid syndrome is
associated with an increase in WBC
counts with respiratory problems,
fever and hypotension
Arsenic trioxide is active in this
leukemia
Antracyclines are essential in the
treatment
44. Proliferation: FLT3, Normal
Cytogenetics
A receptor tyrosine
kinase expressed in 70 –
100% of AML cases.
Activating mutations in
FLT3 are seen in ~30%
of AML cases.
Tandem duplication
of the
juxtamembrane
region.
Point mutation
within the activation
loop of the kinase
domain.
Activation of FLT3
leads to deregulated
proliferation of AML
cells.
45. MANAGEMENT OF
AML
Supportive treatment similar to all AL
AML M3 need special attention to DIC
Monocytic leukemia's can infiltrate CNS,
gingival and skin
Induction chemotherapy produce 70% CR
Usually 3 consolidation treatments
Cure between 35 to 40% of the patients
MUGA scan is necessary as one of the initial
test for evaluation of cardiovascular
function
48. FAB CLASSIFICATION IN
MDS
Refractory
Chronic
anemia
RA with ring
sideroblast
RA excess of
blast
myelomonocytic
leukemia
RA with excess
of blast in
transformation
(RAEBT)
53. PROGNOSIS OF MDS
Presence of blast indicate poor prognosis
Uniformly fatal disorder due to infection and
bleeding
Chromosomal abnormalities are frequent
including partial loss of chromosome 5, 7 and
trisomy 8
5q- syndrome usually involve band q13 to q33
with anemia but no thrombocytopenia
The International Prognostic Index ( % blasts
cells, cytogenetic and number of cytopenias)
54. PATHOGENESIS OF MDS
Toxic exposure and genetic predisposition
Immune response
Hypermethylation and angiogenesis
RAS mutation as a late effect
Transformation
55. TREATMENT OF MDS
BY RISK
STRATIFICATION
Cytogenetics
Blast %
No. cytopenias
Antiangiogenic
Factor( Lenalidomi
de and thalidomide)
Hypomethylating
agents Azacytidine
and dezacitidine)
Bone Marrow
Transplantation
Editor's Notes
While EXACT Sciences’ technologies may someday be used to detect other common cancers, our first target is colorectal cancer.
Colorectal cancer is prevalent, deadly and expensive.
Importantly, though, colorectal cancer is treatable IF detected early. This is a CRITICAL part of our story.
Genomics is essentially the operating system for the human body. Because the genomics underlying colorectal carcinogenesis is well-understood – as you will see- EXACT Sciences is able to use this knowledge to detect cancers early in their development.