Leukemia Overview

Leukemia is cancer of white blood cells that affect the bone marrow and circulating white blood cells, as well as organs such as the spleen and lymph nodes. Etiology An increased risk of developing leukemia is (post nuclear radiation in Nagasaki Hiroshima z. B.) or certain chemicals (eg., Benzene) Prior to treatment with certain cytotoxic drugs, particularly procarbazine, Nitroseharnstoffe upon exposure to ionizing radiation (cyclophosphamide , melphalan), and epipodophyllotoxins (etoposide, teniposide) infection with virus (for example, human T-lymphotropic viruses 1 and 2, Epstein-Barr virus) Chromosomal translocations pre-existing conditions such as immune deficiency syndromes, chronic myeloproliferative neoplasms and genetic defects (z. B. Fanconi anemia, Bloom syndrome, ataxia telangiectasia, down syndrome, infantile X-linked agammaglobulinemia) pathophysiology The malignant transformation usually occurs at the level of pluripotent stem cells, although sometimes deterministic stem cells, their differentiation ability is limited, are involved. Abnormal proliferation, clonal expansion and decreased apoptosis (programmed cell death) lead to a displacement of normal blood components by malignant cells. French-American-BRITISH (FAB) classification of acute leukemia FAB classification description Acute lymphoblastic leukemia L1 lymphoblasts with uniform, round nuclei and cytoplasm narrow L2 More variability of lymphoblasts occasionally irregularly shaped cores with wider cytoplasm than L1 L3 lymphoblasts finer nuclear chromatin u nd blue to dark blue cytoplasm with myeloid leukemia M1 Zytoplasmavakuolen Acute Acute undifferentiated myeloid leukemia No granulation in the cytoplasm M2 Acute myeloid leukemia with differentiation few to many cells with low pronounced granulation M3 Acute promyelocytic leukemia Typical Promyelozytengranula M4 Acute myelomonocytic leukemia Mixed Morphol ogy with myeloblastären and monocytic elements M5 Acute Mono Blast leukemia Pure Mono Blast morphology M6 Acute erythroleukemia predominantly immature erythroblasts that look sometimes megaloblastär M7 Acute megakaryoblastic cells with an irregular surface, can be identified by the constrictions The clinical presentation reflects the displacement of normal hematopoiesis and organ infiltration leukemia cells. Of the leukemia cells inhibitory factors produced, and the displacement of the bone marrow inhibit normal hematopoiesis; as a result there is anemia, thrombocytopenia and granulocytopenia. The infiltration of organs leads to hepatomegaly, splenomegaly, and lymphadenopathy. Occasionally, the kidneys or the gonads are affected. Meningeal infiltration can lead to brain pressure symptoms and cranial nerve palsies. Findings at the time of diagnosis of the most common forms of leukemia feature Acute Lymphocytic Leukemia Acute Myeloid Leukemia Chronic Lymphocytic Leukemia Chronic myeloid leukemia age peak childhood All Ages Middle and older age Young adult white blood cell count high at 50% normal or decreased at 50% High at 60% normal or decreased at 40% higher at 98% normal or decreased 2% higher at 100% differential blood count many lymphoblasts Many Myeloblasts Small lymphocytes Total myeloid series anemia In> 90%, difficult case of> 90%, difficult case about 50 %, slightly at 80%, slightly platelet Decreases in> 80% Reduced> 90% decreases in 20-30% high at 60% reduced at 10% lymphadenopathy Common Uncommon Common Rare splenomegaly At 60% At 50% Most present and moderate severity usually available and massively pronounced Other findings Without prophylaxis often CNS involvement Rare CNS involvement Occasionally Auer rods was originally made in the Myeloblasts Occasionally hemolytic anemia and hypogammaglobulinemia Decreased leucocyte alkaline phosphatase Philadelphia chromosome> 90% positive classification While the distinction between acute and chronic leukemia in terms of life expectancy, the classification is according to today Ausreifungsgrades of the cells made. Peripheral blood blasts with permission of the publisher. From Chang K., Forman S. In Atlas of Clinical Hematology. Edited by J. O. Armitage. Philadelphia, Current Medicine, 2004. var model = {thumbnailUrl: ‘/-/media/manual/professional/images/peripheral_blood_blast_cell_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/ – / media / manual / professional / ? images / peripheral_blood_blast_cell_high_de.jpg lang = en & thn = 0 ‘, title:’ Peripheral blood blasts ‘description:’ ‘credits’ with permission of the publisher. From Chang K., Forman S. In Atlas of Clinical Hematology. Edited by J. O. Armitage. Philadelphia, Current Medicine, 2004. ‘hideCredits: false, hideTitle: false, hideFigure: false, hideDescription: true}; var panel = $ (MManual.utils.getCurrentScript ()) Closest ( ‘image-element-panel.’). ko.applyBindings (model, panel.get (0)); Acute promyelocytic leukemia with permission of the publisher. From Chang K., Forman S. In Atlas of Clinical Hematology. Edited by J. O. Armitage. Philadelphia, Current Medicine, 2004. var model = {thumbnailUrl: ‘/-/media/manual/professional/images/acute_promyelocytic_leukemia_high_de.jpg?la=de&thn=0&mw=350’ imageUrl: ‘/ – / media / manual / professional / images / acute_promyelocytic_leukemia_high_de.jpg lang = en & thn = 0 ‘, title:’? Acute promyelocytic leukemia ‘description:’ u003Ca id = “v37895157 ” class = “”anchor “” u003e u003c / a u003e u003cdiv class = “”para “” u003e u003cp u003eAkute promyelocytic leukemia is usually the easiest to diagnose acute myeloid leukemia

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