2. Definition
Leukemia:
Is a group of malignant disorders, affecting the blood and
blood –forming tissue of the bone marrow lymph system
and spleen.
01
3. Etiology:
• Combination of predisposing factors including genetic and
environmental influences.
• Chronic exposure to chemical such as benzene
• Radiation exposure.
• Cytotoxic therapy of breast, lung and testicular cancer.
• Congenital anomaly
• The presence of primary immunodeficiency
• Infection with the human T –cell leukemia virus type-1
Leukemia
4. o Immature and undifferentiated leukocytes or blast cells replaces
normal bone marrow
o Abnormal immature leukocytes then circulates in the blood and
infiltrate the blood forming organs ( liver , spleen, lymph nodes)
and other sites throughout the body.
Pathophysiology
5. Problems caused by bone marrow failure
• overcrowding by abnormal cells
• Inadequate production of normal marrow elements
• Anemia, thrombocytopenia, reduction in the number and function of WBCs
Problems caused by Leukemic cells infiltrate patient’s organs
• Splenomegaly and Hepatomegaly
• Lymphadenopathy
• Bone pain
• Meningeal irritation
• Oral lesions (chloromas)
Sequelae to this:
6. Acute vs. Chronic
o Acute leukemia gets worse very fast and may make feel sick right
away.
o Chronic leukemia gets worse slowly and may not cause symptoms
for years.
Types
7. In adults
The most common types are: chronic lymphocytic leukemia (CLL) and
acute myelogenous leukemia (AML)
In children,
The most common type is acute lymphoblastic leukemia (ALL).
Incidence
9. • Coagulopathy (impaired blood clotting)
• Suppression of the immune system
• Anemia
• Other symptoms
Nausea, fever chills, night sweats, flu-like symptoms, weight loss,
bone pain,.
If the liver or spleen becomes enlarged the patient may feel full and
will eat less, resulting in weight loss.
Leukemia symptoms
10. Complete blood count (CBC)
• ALL: Low RBCs count, Hb, Hct, low platelet count , low normal or high
WBC count.
• AML: Low RBC, Hb, Hct, low platelet count, low to high WBC count with
myeloblasts.
• CLL: low Hb and platelet counts, the WBC count is elevated to a level
between 20,000 to 100,000.
• CML: Lower RBC count, Hb, Hct, high platelet count early, lower count
later. Normal number of lymphocytes and normal or low number of
monocytes in WBC
Diagnosis
11. Blood smear
• ALL: show immature lymph blasts
• AML: immature myeloblasts
• CLL: greatly increased number of mature lymphocytes in peripheral
blood smear and bone marrow
• CML: characterized by increasing number of granulocytes in the
peripheral blood.
12. • Chest x ray and CT scan
Showed enlarged lymph nodes
Chest or infection in your chest.
• Cytogenetics – a lab test to look at the chromosomes (strands of
DNA) of cells from samples of blood, bone marrow, or lymph nodes.
13. • Treatments depend on what type of leukemia they have, the patient's age
and his state of health.
• Treatment for patients with acute leukemias should start as soon as
possible.
• The mainstay of treatment is still chemotherapy, which will be tailored to
the type of cancer a patient has.
• Sometimes, chemotherapy may be given in three phases: induction,
consolidation and maintenance.
• In some cases, a bone marrow transplant may be warranted (allogeneic
stem cell transplantation).
Management
14. Nutrition and Physical Activity
• It's important for you to take care of eating well and staying as active.
• Right amount of calories to maintain a good weight.
• Enough protein.
• Eating well may help to feel better and have more energy.
15. Comparing the epidemiology, clinical characteristics and prognostic factors of acute
myeloid leukemia with and without acute promyelocytic leukemia
Data collection
Data on acute myeloid leukemia and patient characteristics were collected from two
sources: a population-based cohort and a clinical (hospital-based) validation cohort.
Population-based cohort
New York State Cancer Registry (NYSCR) data were obtained from the publicly available
website, New York State Public Access Cancer Epidemiology Data (NYSPACED) (17).
The study sample consisted of NYSCR patients diagnosed with AML from 1995 to 2014,
based on the variable Site recode ICD-O-3/WHO 2008. AML was defined as Site recode
ICD-O-3/WHO 2008 ‘acute myeloid leukemia’ or ‘acute monocytic leukemia’; cases
were further defined as ‘acute promyelocytic leukemia’ (APL) if ICD-O3 histology/
behavior code = 9866/3.
16. 1 short ,N.J. et al. (2018)Acute myeloid leukaemia. Lancet,392,593-606.
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2. American cancer Society.(2018) Cancer Fscts &Figures 2018.American
Cancer Society,Atlanta,GA
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References