Sie sind auf Seite 1von 20

white blood

A neoplastic proliferation of one particular


cell type
Defect originates in the hematopoietic
stem cell, the myeloid, or the lymphoid
stem cell.
Common feature: unregulated proliferation
of leukocytes in the bone marrow.
Classification
Stem cell involved
Lymphoid
Myeloid
Based on time it takes for symptoms to
evolve
- Acute
- Chronic

Acute Myeloid Leukemia (AML)

Results from a defect in the hematopoietic stem
cell that differentiates into all myeloid cells
All age groups are affected
Incidence rises with age; 65 y.o
Most common non-lymphocytic leukemia
Clinical Manifestations
Fever
Infection
Weakness
Fatigue from anemia
Bleeding tendencies from
thrombocytopenia
Pain from an enlarged liver or spleen
Hyperplasia of the gums
Bone pain from expansion of marrow
Assessment and Diagnostic
Findings
CBC, erythrocytes and
platelets
Leukocyte: varies
Normal cells is usually decreased
Bone Marrow Analysis: Excess of
immature blast cells, more than
30 percent

Complications
Bleeding and infection
Ecchymosis
Petechiae
Infection

Medical Management
Objective of treatment is to achieve
complete remission
Induction therapy
High doses of cytarabine and daunorubicin
Or mitoxantrone or idarubicin
Supportive therapies
Use of granulocytic growth factors: G-CSF
or GM CSF
Cx of Tx
tumor lysis syndrome:( )
Uric acid
Potassium
phosphate
Anorexia, N & V , diarrhea,
severe mucositis
serious infection and increased
risk of bleeding
Chronic Myeloid Leukemia
Arises from a mutation in the
myeloid stem cell.
90 95 %percent of patients, a
section of DNA is missing from
chromosome 22.
Uncommon in people younger than
20 years old
Incidence increases with age,
median age 55-to 65
Life expectancy, 3 to 5 years
Clinical Manifestations
Asymptomatic
Leukocytosis is detected by a CBC
personnel for other reason
Leukocyte exceeds: 100 000/mm3
SOB or slightly confused from leukostasis
Enlarge, tender spleen
Malaise, anorexia, weight loss
Medical Mgt
Oral formulation of tyrosine
kinase inhibitors, imatinib
Interferon-alfa , Roferon A and
cystosine, often in combination
Oral chemo drugs:, hydroxyurea
or busulfan
Leukaphereis, BMT, PBSCT
Induction therapy
Clinical Manifestations
WBC, RBC,
platelets
enlarged liver or
spleen
bone pain
headache
vomiting
Medical Management
Expected outcome is complete
remission
Costeriods and vinca alkaloids
Prophylaxis with cranial irradiation or
intrathelal chemotx
Imatinib
Alemtuzumab
BMT or PBSCT
Chronic Lymphocytic Leukemia
A common malignancy of older adults,
older than 60 y.o
Survival ranges from 14 years (to 2 years
More often in males
Survival shorter in males
Pathophysiology


Clinical Manifestations
Asymptomatic, diagnosed incidentally
Increased lymphocyte count
Erythrocytes and platelets may be
normal;or decreased in late stages
Lymphadenopathy
B symptoms
Fevers
Sweats
Unintentional weight loss

Medical Management