第六篇第九章白血病.pptx

第六篇 血液系统疾病 第九章白血病(Leukemia)周剑峰学时数：3学时讲授目的和要求1.掌握急、慢性白血病的临床表现，实验室检查及诊断标准，治疗原则2.熟悉急性白血病FAB分型，联合化疗的原则，完全缓解的概念讲授主要内容概述病因和发病机制临床表现实验室检查诊断标准鉴别诊断治疗Erythrocytes: transport oxygenNeutrophilBasophilEosinophilMonocytes/MacrophageDefense against infectionPlatelets: Mediate blood clottingT-lymphocytes: antigen presenting B-lymphocytes Plasma cell:Source of antibodiesPluripotential stem cellsLymphoid stem cellsMyeloid stem cellsUnipotential progenitor cellsImmature hematopoietic cellsmature hematopoietic cellsHematopoiesis composes of the options of commitment to different lineages and the progressive stages of maturation at which partial or complete arrest can occur, results in the wide array of malignant disease-LeukemiaProgenitor cellImmature cellStem cell Mature cell Accumulation of mutations of DNA within a pluripotential stem cell or very early progenitor cell gives rise to leukemic stem cellsLeukemic stem cellNormal stem cellEtiologyPathogenesis Environmental factors Acquired diseasesClonal expansionLesions to the DNAEnvironmental factorscause leukemiaA lot of environmental factors has been reported to cause leukemia. However, only four of them are firmly established causal agents. They are:Irradiation exposure Chronic benzene exposure Chemotherapeutic agents Leukemia virus infectionInherited syndromes predispose to leukemiaInherited syndromes such as ataxia-telangiectasia, down syndrome predispose to subsequent development of leukemia. Usually, these kinds of syndromes share the common features that they all have heretic defects in their genome gave by their parentsAcquired disease predispose to leukemiaLeukemia may also develop from the progression of other clonal disorders of hematopoietic stem cells. Ploycythemia vera, idiopathic myelofibrosis, etc Leukemia ClassificationThere are at least dozens of varieties of leukemia. They are classified by how quickly it progresses. Acute leukemia is fast-growing and can overrun the body within a few weeks or months. By Contra