This document provides information on various types of hematological cancers and disorders. It discusses chronic lymphocytic leukemia (CLL), the most common leukemia in adults. It affects B cells and can cause immune incompetence. Prolymphocytic leukemia (PLL) and hairy cell leukemia (HCL) are also summarized. Multiple myeloma (MM) is described as plasma cell proliferation in bone marrow causing anemia and bone pain. Myeloproliferative disorders include polycythemia vera (PV), essential thrombocythemia (ET), idiopathic myelofibrosis (IM) and chronic myelogenous leukemia (CML). Diagnosis and clinical features are summarized for each condition.
acute leukemia
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acute leukemia
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ACUTE MYELOID LEUKEMIA is a neoplastic disease characterized by
infiltration of the blood,
bone marrow, and
proliferative, clonal undifferentiated cells of the hematopoietic system.
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The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
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Anti-ulcer drugs are medications used to prevent and treat ulcers in the stomach and upper part of the small intestine (duodenal ulcers). These ulcers are often caused by an imbalance between stomach acid and the mucosal lining, which protects the stomach lining.
||Scope: Overview of various classes of anti-ulcer drugs, their mechanisms of action, indications, side effects, and clinical considerations.
7. Chronic lymphocytic leukaemia
CLL
Normally, B cells produce antibodies
In CLL , they can’t !!!
immuno incompetent cells
Effect immunity, other cell lineage!!!
8. CLL- Clinically
Most patients are diagnosed by couinsidence!!
fatigue
Night
sweats
Weight
loss
Anemia
infection
Splenomegaly
Adenolympho-
pathy
bleeding
24. Classification
• HL
• NHL
• CML
• PV
• ET
• IM
• ALL
• AML
• CLL
Leukemia
Myeloprolif
-erative
disorder
lymphoma
MM
MDS
HCL
25.
26. Myeloproliferative
Syndromes Monoclonal proliferation of myeloid cells
Classified according to the affected lineage :
megakaryocytes megakaryocytes
erythroid
precursor
granulocyte
idiopathic
myelofibrosis
(IM)
essential
thrombocythemia
(ET)
CML
polycythemia
rubra vera (PV)
They may
interfere
One could
transform to other
27. Myeloproliferative
Syndromes Monoclonal proliferation of myeloid cells
Classified according to the affected lineage :
megakaryocytes megakaryocytes
erythroid
precursor
granulocyte
idiopathic
myelofibrosis
(IM)
essential
thrombocythemia
(ET)
CML
polycythemia
rubra vera (PV)
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للعودة للحالة المنتجة للدم عند الحاجة كما في فقر الدم الانحلالي
حتى أن الكبد و الطحال قادران
الاضطرابات التكاثرية النقوية
اول تنين
هذه الخلايا اللمفية صغيرة نسبياً و الكروماتين.
في اللطاخة خلايا مشوهة ناتجة عن تخرب الخلايا اللمفاوية الشاذة اثناء تحضير اللطاخة , حيث يكون هيكل هذه الخلايا ضعيف جداً فتتحطم ميكانيكياً.
فقر دم انحلالي
55% على الاقل من لمفاويات الدم هي طلائع ورمية للمفاويات
وهي خلايا اكبرمن اللمفاويات في CLL ذات نويات واضحة و تدعى B-PLL
55% على الاقل من لمفاويات الدم هي طلائع ورمية للمفاويات
وهي خلايا اكبرمن اللمفاويات في CLL ذات نويات واضحة و تدعى B-PLL
.و هي اكبر من اللمفاويات الطبيعية مع وجود مناطق شعرية في السيتوبلاسما.
الخلايا البائية عند تعرضها للمستضد تصبح بلازمية وتفرز الاضداد
لأن الخلايا البلازمية تحرض عمل هادمات العظم
الكلوي بسبب بروتين ( سلاسل خفيفة حرة من الغلوبولين المناعي) الذي يحتجز في الانابيب البولية و يخربها.
زيادة تلون المساحة بين الخلايا بالصباغ , ذلك نتيجة ارتفاع تراكيز الغلوبولينات المناعية بالدم.
جزيء نقل الاشارة المنظمة للتكاثر
مهمة في تشخيص
% من حالات PV و 50% من حالات ET و 50% من حالات IM
العامل المشتق من الصفيحات
بسبب فرط الصفيحات
بسبب عدم فعالية الصفيحات
بسبب ارتفاع الهستامين
نهايات محمرة و متورمة
بسبب ارتفاع الهستامين
نهايات محمرة و متورمة
translocation
22 Break point cluster
9 ABL
جين جديد يدعى BCR-ABL
فيلاديلفيا يرمز لبروتين اندماجي جديد يملك فعالية التيروزين كيناز و بالتالي يفعل النمو الخلوي و يثبط الموت الخلوي و ينقص انتاج جزيئات الالتصاق
ناتجة عن فرط الاستقلاب المرافق للعبء الورمي مثل التعب, نقص الوزن, التعرق الليلي, انقطاع النفس و الحمى , ضخامة الطحال التي تسبب تخمة مبكرة و ألم بطني احياناً , ممكن وجود الحكة أو النزوف عند بعض المرضى.
الكريات البيض لا تقوم بعملها بشكل طبيعي
الخلايا الأكثر تواجداً هي myelocytes و neutrophils مع وجود بعض metamyelocytes , promyelocytes , blast .
الارومات لكنها دون 15% ,تعداد الارومات يفيد في التشخيص و تحديد المرحلة.
