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Sahyuddin

Dept. of Int. Medicine, Faculty of Medicine , Hasanuddin Univ.

cute Leukemia

cute Myelogenous Leukemia

cute Myelogenous Leukemia

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I.I. LeukemiaLeukemia

Is a malignant hematologic disorder characterized by a

proliferationof abnormal white cells, differentiatiob

block , that infiltratethe bone marrow, peripheral blood

& organs

4 main types of leukemia

Acute or chronic

Myelogenous or Lymphocytic

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ALLALL MMMMCLLCLL LymphomasLymphomas

Hematopoietic

stem cell

Neutrophils

osinophils

!asophils

Monocytes

"latelets

#ed cells

Myeloid

po!enito

Myelopolifeative disodesMyelopolifeative disodesAMLAML

Lymphoid

po!enito $%lymphocytes

"lasma

cells

!%lymphocytes

nanaveve

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II.II. "ypes of Leukemia"ypes of Leukemia

Acute

#apid !o$th of immatue

%lood cells

Mostly in childen,

youn! adults

&eeds immediate teatment

Chonic

'(cessive %uild up of el.

matue %lood cells

Mostly in olde patients

Monitoin! %efoe teatment

Lymphoid

Affects lymphocytes and

plasma cellsLymphocytic leukemia

Myeloid

Affects eosinophils,

neutophils, %asophilsMyelo!enous leukemia

Hence $e have

Acute Lymphocytic)Lympho%lastic Leukemia*ALL+

most common type in youn! childen-

also affects adults, /0

Acute Myelo!enous) Myeloid Leukemia*AML+

moe commonly in adults than in childen.

Chonic Lymphocytic leukemia *CLL+

most often affects adults ove the a!e of 00

Chonic Myelo!enous leukemia *CML+occus mainly in adults

123,2324 "otal num%e of leukemia patients today

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III. 5atho!enesis LeukemiaIII. 5atho!enesis Leukemia

5enampun!an ai

*SS"+

5ipa ai

*5D+

#umah

*6!an+

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differentiation

block

enhanced

proliferation

Acute

Leukemia

'ain of function mutations

of tyrosine kinases

eg( )L$*, c%+I$ mutations

N% & +%#A mutations

!-#%A!L $L%".')#

Loss of function of

transcription factors

needed for differen(

eg( AML/%$0

-!)%MM1- "ML%#A#

III.III. ""hee7hee7hit model of leukemo!enesishit model of leukemo!enesis

uppression

apoptosis

Loss of Apoptosis

eg(2

!cl%3 oer e5pression

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Myeloid matuationMyeloid matuation

myeloblast promyelocyte myelocyte metamyelocyte band neutrophil

MA"U#A"I6&MA"U#A"I6&

Adapted and modified from 6 7a website

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Acute LeukemiaAcute Leukemia

Accumulation of blasts in the marrow

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Ho$ to distin!uish AML vs CMLHo$ to distin!uish AML vs CML

fom lookin! at peipheal %loodfom lookin! at peipheal %lood

Myeloid cell CML AML nomal

!lasts q q

"romyelocytes q

Myelocytes q

Metamyelocytes q

!ands q

Neutrophils q # q

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I8.I8. Causes of acute leukemiasCauses of acute leukemias

Idiopathic 8most9

6nderlying hematologic disorders

-hemicals, drugs

Ionizing radiation

7iruses 81$L7 I9

1ereditary:genetic conditions

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8.8. Clinical manifestationsClinical manifestations

ymptoms due to 2

/( Marrow failure

3( Leukostasis*( $issue infiltration

4( -onstitutional symptoms

;( 0ther 8.I-9