内科学课件-白血病

1、白血病 (Leukemia)Pluripotential stem cellsMyeloid stem cellsLymphoid stem cellsUnipotential progenitor cellsImmature hematopoietic cellsmature hematopoietic cellsStem cell Progenitor cellImmature cellMature cell Etiology&Pathogenesis Environmental factors Acquired diseasesLesions to the DNAClonal expan

2、sionCytogenetic findingsDiagnosis & Classification Other newly developed methodsFlow CytometryImmunohistochemistry 免疫表型分型方案T 细胞B 细胞（4%）B 细胞前体 CD7（敏感），cCD3 （特异） CD19 (敏感), cCD79a (特异)成熟T 细胞 （18%）前 T 细胞（6%）前 B-细胞 （9%）早期前-B 细胞 （52%）前-前- B 细胞 （11%）sIg, sIgP118 types of translocationsCML AML-M2AML-M3AML-

3、M4AMLAML-M4E0 Other new developed methodsDifferential DiagnosisPseudoleukemia Myelodysplastic syndrome Nonleukemic pancytopenia TreatmentSupportive cares and preparation of the patientsAntileukemic therapyTherapy of the central nervous systemStem cell transplantationAnemia Hemorrhage Infection Hemat

4、ological supportTransfusion of Platelets Transfusion of packed red cells Transfusions of granulocytes Transfusions of IgG Infection controlSpecial precautions: protective isolation Elimination of contaminated foods Oral and digestive system care Broad spectrum antibiotics GM-CSF administration Antil

5、eukemic therapyChemotherapy to kill leukemia cells using strong anti-cancer drugs Treatment phasesInduction therapy: the aim is to bring about remission , that is leukemic cells are no longer found in the bone marrow and the recovery of normal hematopoiesisPost-remission therapy: to eliminate any le

6、ukemia cells potential hiding in the body Special subtypes Acute promyelocytic Leukemia (APL): because of the small particles (procoagulants) inside the APL cell, DIC are commonly seen in this type of AMLNormal APLGenes essential for differentiation are shut down by the fusion proteins PML-RARalphaDifferentiation agents (all-trans retinoic acid, arsenic trioxide)Intrathecal chemotherapyCranial ir