Introduction课件.ppt

Acute Leukemia Clinic Manifestation manifestation related to pancytopenia （1）Infection 1）general feature： 2）infection site ： 3）Infective pathogens ： Acute Leukemia （2）Anemia early of onset develope progressively Acute Leukemia （3）Bleeding mainly caused by thrombocytopenia ,but also related to dysfunction of blood vessel that associated with infections and anemia. Acute Leukemia manifestations caused by involvement of organs outside BM 1）Peripheral WBC： 2）Enlargement of liver,spleen,and lymphonode: 3）Ifiltration of oral mucous and gum : 4）Infiltration of skin: Acute Leukemia 5）CNS-L common in ALL(50%),only 5~7% in AML Many are asymptomatic. present with intracranial hypertension颅内高压、stiff-neck颈强直、papilledema视乳头水肿、nervous lesion第VI对颅神经损害. CNS-L can be diagnosed by determine of cerebrospinal fluid cytology. 6）Involvement of other organs: Bone pain is common. eyes, lung, pleura, heart, pericardium, kidney can also be involvement. Acute Leukemia Leukostasis The high number (50000/mm3 specially M5)of circulating bastcells increase blood viscosity and is associated with small vessel leukoblastic emboli ,resulting in leukostasis. Acute Leukemia manifestatoins related to metabolic abnormality： hyperuricemia hypercalcinemia 其他： tumor lysis syndrome is characterized by the rapid development of hyperuricemia, hyperkalemia ,hyperphosphatemia and hypocalcemia etc. Acute Leukemia Laboratory Findings Blood Routine Examination 1） WBC count 2）leukemic cells can be found in 90% patients Acute Leukemia Bone Marrow Aspiration 1）Cellularity . found in 90% patients . 2）Leukemic cells ≥30% nonerythroid cells 3） Auer rods (spindle-shaped)can only be found in AML Acute Leukemia Cytochemical Stain Lymphoblast myeloblast monoblast peroxydase - + ~ +++