白血病英文课件.ppt
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- 白血病 英文 课件
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1、THE CHILDHOOD LEUKEMIA LeukemiaLeukemia is a disease c h a r a c t e r i z e d b y proliferation of immature white cells and is the most common malignancy of childhood.Acute leukemias account for the majority(97%)of cases.Leukemia The leukemias are classified according to the white blood cell line i
2、nvolved:Acute lymphocytic leukemia(ALL)-cells of lymphoid lineage A c u t e n o n-l y m p h o c y t i c leukemia(ANLL)-cells of granulocytic or monocytic lineage.Acute lymphocytic leukemiaALL account for 80%of childhood leukemia and has a peak in incidence between age 3 and 6 years.It is slightly mo
3、re common in boys than girls.Acute lymphocytic leukemiaChildren with Down syndrome,Fanconi anemia,and ataxiatelangiectasia are at particular risk of ALL.Siblings,especially twins,of children with leukemia are approximately twice as likely to have leukemia than is the general population.Acute lymphoc
4、ytic leukemiaSome cases of childhood ALL may relate to hereditary or acquired mutation in the p53 gene.Taken in total,however,these predisposing circumstances or relationships account for only a small propotion of casesClinical featuresIn most children with ALL,there is an acute onset of symptoms an
5、d signs arsing from infiltration of the bone marrow or other organs with leukemic blast cells.Most will have one or more of the following:Clinical features“4 Ps”Pallor-anemia.Pyrexia-concomitant infection or the desease itself.Purpura-thrombocytopeniaPain-Bone pain(pelvis,vertebral bodies,legs),due
6、to expansion of marrow cavity.Abdominal pain,due to liver and spleen distension.Expansion of marrow cavityClinical featuresasymtomatic lymphadenopathy and hepatosplenomegaly the CNS,testes and the kidneys-the most commonly affected extramedullary sites Infection-due to neutropeniaClinical featureHep
7、atosplenomegaly reticuloendotheelial cell infiltration.InvestigationsPeripheral blood investigations reveal:Anemia-normocytic,normochromic.Thombocytopenia.Neutropenia-total WBC may be low,normal,or high.Blast cells.InvestigationsBone marrow examination reveals:Replacement of normal elements by leuke
8、mic cells.A diagnosis of leukemia should always be confirmed by bone marrow aspiration.Morphologies and histochemical classificationUnder light microscope,the system developed by FAB divides lymphablasts into 3 categories:L1:small,scanty cytoplasm and inconspicuous nucleoli.(85%of cases)L2:generally
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