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leukimia
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Myeloproliferative Disorders:
Leukemia
Susanto Nugroho
The Medical Study ProgramFaculty of Medicine University of Brawijaya
Clinical CompetenciesAfter this session:Students can describe the incidence, classification & diagnosis (based on clinical features and laboratory findings) of:
acute myelogenous leukemia (AML) acute lymphoblastic leukemia (ALL) chronic myelogenous leukemia (CML) chronic lymphoblastic leukemia (CLL)
Introduction
Leukemia A disease resulting from the neoplastic
proliferation of hemopoietic or lymphoid cells Lymphoid, myeloid and biphenotypic leukemias The clinical manifestations are due to the
proliferation of leukemic cells & their infiltration into normal tissues
Increased proliferation metabolic consequences(and infiltrating cells also disturb function)
Infiltration of the bone marrow: anemia, neutropenia and thrombocytopenia can lead infection and haemorrhage
Introduction…..
Acute leukemia A defect in maturation imbalance between
proliferation & maturation leukemic clone cells continue to proliferate without maturing immature leukemic cells
If untreated lead to death in weeks or months
Chronic leukemia An an expanded pool of proliferating cells that
retain their capacity to differentiate to end cells mature leukemic cells
If untreated lead to death in months or years
A
B
A. ErythrocyteC B. Large lymphocyte
C. Neutrophil (segment)
D E D. Eosinophil
H E. Neutrophil (segment)F. MonocyteG. Thrombocyte
F H. Small lymphocyteG I. Neutrophil (band)
J. Basophil
I J
Blast ≥ 30% of ANC Blast ≥ 30% of NEC
Perform peripheral blood differen1al counts and 500 cell differen1al counts on bone marrow
Assess % erythroblasts of all nucleated cells (ANC)
erythroblasts <50% erythroblasts ≥ 50%
Assses blasts as % of ANC & look for specific features of M3
Assses blasts as % of all non – erythroid cells ( NEC)
Blast < 30% of ANC Blast < 30% of NEC
M0, M1-‐M5, M7 M6MDS
Modul Task1. Describe definition, etiology & pathogenesis of
acute leukemia!2. Describe in brief the FAB & WHO classification
of acute myeloid leukemia (AML)!3. Describe clinical features & laboratory findings
to diagnose AML!4. Describe in brief the treatment of AML!5. Describe in brief classification of acute
lymphoblastic leukemia (ALL)!6. Describe clinical features & laboratory findings
to diagnose ALL!7. Describe in brief the treatment of ALL!
Modul Task8. Describe etiology, pathology & immunologic
abnormalities of chronic lymphoid leukemia (CLL)!
9. Describe clinical features & laboratory findings to diagnose CLL!
10. Describe the treatment of CLL!11. Describe etiology of chronic myelogenous leukemia
(CML)!12. Describe clinical features & laboratory findings
to diagnose CML!13. Describe the treatment of CML!
Please…….discuss this case in your group!!