All blood cells arise from one kind of

multipotent stem cell

 Blood is a complex
connective tissue
with lots of cell types
and extensive fluid
“matrix” (the
plasma). Light
micrograph of a
blood smear,
showing many
erythrocytes (pale
pink), four kinds of
white blood cells,
and some platelets.
LEUKEMIA
 Content

• Definition
• Classification
• Morphology
• Investigations
 What Is Leukemia?
• Cancer of the white blood cells
• Leukemias are cancers of white blood cells
or of cells that develop into white blood
cells.
• Acute or Chronic
• Affects ability to produce normal blood cells
• Bone marrow makes abnormally large
number of immature white blood cells called
blasts
 History
• Means “white blood” in Greek
• Discovered by Dr. Alfred Velpeau in
France, 1827
• Named by pathologist Rudolf Virchow
in Germany, 1845
 Pictures Of Blood
Platelet Platelet
White Cell Red Cell Red Cell Blasts
White Cell

Normal human blood Blood with leukemia

Sources from beyond2000.com
Sources from Arginine.umdnj.edu
 AETIOLOGY
• The cause of most types of leukemia is not known.

• Exposure to radiation or to some types of chemotherapy

increases the risk of developing some types of leukemia

• Certain hereditary disorders, such as Down syndrome and

Fanconi's syndrome, increase the risk as well.

• A virus known as HTLV-I (human T-cell lymphotropic virus

type I), which is similar to the virus that causes AIDS, is
strongly suspected of causing a rare type of lymphocytic
leukemia called adult T-cell leukemia.

• Infection with the Epstein-Barr virus has been associated

with an aggressive form of lymphocytic leukemia called
Burkitt's leukemia.
 Causes
• High level radiation/toxin exposure
• Viruses
• Genes
• Chemicals
• Mostly unknown
• Can’t be caught
 Classification of Leukemia
LEUKEMIA

ACUTE
• Arrest of development of
Marrow proliferative cells
• Relatively immobile cells
confined to bone marrow
• Characterized by abrupt
onset of clinical symptoms
(fever, haemorrhage and
weakness)
• Occurs both in children and
adults
CHRONIC
• Arrest of development of
Marrow differentiating cells
• Mobile cells circulate to
peripheral haemopoeitic
tissues
• Characterized by insidious
onset of symptoms
( weakness,pallor,
enlargement of spleen and
liver)
 Main Types

• Acute Lymphocytic Leukemia (ALL)

• Acute Mylogenous Leukemia (AML)
• Chronic Lymphocytic Leukemia (CLL)
• Chronic Mylogenous Leukemia (CML)
* according to how quickly they progress and the type of cell that
becomes cancerous.
 Tests For Diagnosis

• FBC
• PBF
• Bone marrow sample – BMA & BMT
 ACUTE & CHRONIC LEUKEMIA :
COMPARISON OF CLINICAL &
LABORATORY MANIFESTATIONS
PRESENTATION ACUTE LEUKEMIA CHRONIC
LEUKEMIA
1.ONSET ABRUPT INSIDIOUS
2.DEATH MONTHS YEARS
3.AGE ALL ADULT
4.WBC LOW, NORMAL, INCREASED
INCREASED
5.APPERANCE OF BLASTS MATURE
CELLS (IMMATURE)
6.NEUTROPENIA PRESENT ABSENT
7.ANEMIA PRESENT PRESENT
8.ORGANOMEGALY MILD TO MARKED
MODERATE
 Development of Leukemia in
the Bloodstream

Stage 1- Normal Stage 2- Symptoms Stage 3- Diagnosis

Legend
White Cell Stage 5a- Anemia

Red Cell
Platelet Stage 4- Worsening
Blast
Germ Sources from Leukemia, by D. Newton and D. Siegel
Stage 5b- Infection
 Effects On the Body
• Attacks the immune system
• Infections
• Anemia
• Weakness
• No more regular white blood cells, red
blood cells, and platelets
• Blasts clog blood stream and bone
marrow
 Treatment
• Chemotherapy
• Immunotherapy
• Radiation
• Bone marrow transplant