(精选)内科学第六篇 第九章 白血病课件.pptVIP

第六篇 血液系统疾病 ;讲授目的和要求;讲授主要内容;Erythrocytes: transport oxygen;Accumulation of mutations of DNA within a pluripotential stem cell or very early progenitor cell gives rise to leukemic stem cells;;;EtiologyPathogenesis ;;;;Acquired disease predispose to leukemia;Leukemia Classification;Acute versus chronic leukemia;Myelogenous versus lymphocytic leukemia;Clinical manifestations ;Marrow failure;Infiltrations;;;Marrow findings;Cytogenetic findings;Diagnosis Classification ;Morphology : the bone marrow cells are evaluated according to their size,shape, and content of granules and then they are classified with respected to maturity Cytochemistry staining: identification of the chemical components of cells is conducted to distinguish different types of leukemia. Cytochemistry often use special colored dyes ;Acute leukemia;;P142 (CD tables);Flow Cytometry; Immnuophenotyping panel used in St. Jude Children’s research hospital U.S.A. CD13 CD33 CD19 CytoCD79a CD7 CytoCD3 AML - - - - B-ALL - - - - T-ALL - - - -;免疫表型分型方案;;Insert table ;P118 types of translocations;;;; Other new developed methods;Differential Diagnosis; Treatment;Anemia Hemorrhage Infection; Hematological support Transfusion of Platelets Transfusion of packed red cells Transfusions of granulocytes Transfusions of IgG; Infection control Special precautions: protective isolation ; Antileukemic therapy; Treatment phases; Special subtypes ;Normal;Differentiation agents (all-trans retinoic acid, arsenic trioxide);Hyperleukecytosis: cause a batch of complications and should be treated using leukapheresis ( exchanging transfusion) or preinduction tr