LEUKEMIA - PowerPoint PPT Presentation

Loading...

PPT – LEUKEMIA PowerPoint presentation | free to view - id: 1c71ce-ZDc1Z



Loading


The Adobe Flash plugin is needed to view this content

Get the plugin now

View by Category
About This Presentation
Title:

LEUKEMIA

Description:

general aspects of lymphoid neoplasms. 1. histologic examination ... common acute lymphoblastic leukemia antigen (CALLA) T-cell antigen (T) --- mostly negative ... – PowerPoint PPT presentation

Number of Views:1677
Avg rating:3.0/5.0
Slides: 24
Provided by: masatosh3
Category:
Tags: leukemia | calla

less

Write a Comment
User Comments (0)
Transcript and Presenter's Notes

Title: LEUKEMIA


1
LEUKEMIA
  • Masatoshi Kida, M.D.
  • Dept. of Pathology
  • University of Vermont

2
leukoproliferative disorders
  • lymphoid lymphoid neoplasms acute
  • chronic
  • myeloid myeloid neoplasms acute
  • chronic

3
Lymphoid Neoplasms
  • general aspects of lymphoid neoplasms
  • 1. histologic examination is required for
    diagnosis
  • 2. wide range of behavior
  • 3. majority are of B-cell origin (80-85)
  • 4. disruption of normal immune regulatory
    mechanisms
  • 5. deriving from a single transformed cell
    (monoclonal)
  • 6. homing to and growing in the areas of origin
  • 7. tends to spread through lymphatics and
    peripheral blood to distant lymphoid tissue

4
Acute Leukemia
  • monoclonal proliferation of immature blast
    cells that fail to participate in the normal
    maturation process
  • as the cells accumulate, they spill over into the
    peripheral blood
  • morbidity and death are rarely caused by
    leukemic cells

5
Acute Leukemia
  • general overview
  • abrupt stormy onset
  • depression of marrow function
  • fatigue ? anemia
  • fever, infection ? ?WBC
  • bleeding ? ?platelet
  • bone pain and tenderness ? marrow expansion

6
Acute Leukemia
  • - generalized lymphadenopathy
  • splenomegaly ALL gt AML
  • hepatomegaly
  • - testicular involvement ALL gt AML
  • - CNS involvement ALL gt AML
  • headache
  • vomiting
  • nerve palsie

7
Acute Lymphocytic Leukemia/Lymphoma (ALL)
  • 40 of acute leukemia
  • children, young adults
  • most frequent malignancy of childhood
  • 80 of childhood acute leukemia
  • 50 of cancer deaths in children lt15 y/o
  • white non-white 2 1
  • male gt female

8
Acute Lymphocytic Leukemia/Lymphoma (ALL)
child ALL almost curable adult ALL recent
improvement in prognosis, but still with
significant mortality
9
Acute Lymphocytic Leukemia/Lymphoma (ALL)
  • BM failure (pallor, lethargy, abnormal bleeding)
  • bone joint pain
  • peripheral lymphadenopathy
  • splenomegaly
  • CNS involvement
  • CSF increased pressure and cellularity
  • decreased glucose
  • normal protein

10
Acute Lymphocytic Leukemia/Lymphoma (ALL)
  • Peroxidase-granule negative (? AML)
  • terminal deoxynucleotidyl transferase (TdT)
  • common acute lymphoblastic leukemia antigen
    (CALLA)
  • T-cell antigen (T) --- mostly negative
  • surface Ig (sIg) --- mostly negative
  • cytoplasmic Ig (cIg)
  • PAS-pos cytoplasmic aggregate

11
ALL peripheral
blood smear
  • normocytic, normochromic anemia
  • thrombocytopenia
  • WBC may be low, normal, or high

peripheral B-cell
pre B-cell
pre T-cell
12
ALL
clinical course
  • Remission in the majority of children
  • 5 yrs disease free period in 50 of cases
  • complete cures possible
  • significant recent improvement in survival rate
    for T-cell type

13
ALL
prognostic factors
  • good bad
  • age 2-10 y/o lt1 y/o adult
  • sex female male
  • WBC gt50,000 blast/mL
  • phenotype early precursor B-cell mature B-cell,
    null cell
  • cytogenetics high hyperploidy pseudo-diploid
  • t(922)
  • 3 of pediatric ALL
  • 25 of adult ALL
  • t(814)

14
(No Transcript)
15
leukoproliferative disorders
  • lymphoid lymphoid neoplasms acute
  • chronic
  • myeloid myeloid neoplasms acute
  • chronic

16
Lymphoproliferative Disorders
  • clonal expansions of antigen stimulated
    lymphocytes
  • maturation arrest due to molecular derangements
  • primarily B cell origin
  • may be induced by chromosomal translocations,
    retrovirus, or oncogene activation
  • 1. chronic lymphocytic leukemia (CLL)
  • 2. hairy cell leukemia

17
Chronic Lymphocytic Leukemia (CLL)
  • most common form of leukemia in North America and
    Northern Europe
  • essentially identical to small lymphocytic
    lymphoma (SLL)
  • M gt F (2 1)
  • elderly (gt60 y/o)
  • considered incurable
  • mostly asymptomatic
  • hepatosplenomegaly may be present
  • peripheral lymphocytosis (gt200,000)
  • increased susceptibility to bacterial infection
    (most frequent cause of death)
  • may associated with autoimmune hemolytic anemia

18
Chronic Lymphocytic Leukemia (CLL)
  • Indolent clinical course
  • median survival 4-6 yrs
  • occasional transformation to large non-Hodgkins
    lymphoma (Richters syndrome) --- 3 to 5

19
Hairy Cell Leukemia
  • uncommon variant of peripheral B-cell neoplasm
  • clinically middle age to elderly (younger than
    CLL) splenic red pulp involvement
  • histologically lymphocyte with finger-like
    projections
  • phenotypically TRAP (Tartrate Resistant Acid
    Phosphatase)
  • CD19, CD20

20
Hairy Cell Leukemia
clinical
  • M gt F (3-5 1)
  • splenic red pulp involvement ? red pulp lake
  • tends to follow an indolent course
  • pancytopenia - most prominent feature
  • - granulocytopenia ? recurrent bacterial
    infection
  • - anemia ? fatigue
  • - thrombocytopenia ? bleeding
  • good response to some chemotherapy regimen

21
(No Transcript)
22
(No Transcript)
23
(No Transcript)
About PowerShow.com