再生障碍性贫血宣讲培训.ppt

LOGO LOGO Aplastic Anemia Aplastic Anemia Contents Introduction 1 Etiology and Pathogenesis 2 Presentation and laboratory evaluation 3 Diagnosis and Treatment 4 Introduction Aplastic anemia (AA) ,the paradigm of bone marrow failure syndromes , is most simply defined as peripheral blood pancytopenia and hypocellular bone marrow. That affects all the hematopoietic lineages, granulocyte, platelet, and red blood cell (RBC) levels Introduction The study of bone marrow failure is traditionally dated to 1888, when Paul Ehrlich, a pathologist ,described a young woman who died after an explosive short illness marked by severe anemia, bleeding, and high fever. Introduction AA is far more common in Asia than in the West. The overall annual incidence of AA was 0.74 /105 (2 cases /106 the West). Most patients presenting at age 15-25 or after age 60. Etiology and Pathogenesis Pathophysiologic Pathways Leading to Aplastic Anemia Immune-Mediated Marrow Failure CD4+/CD8+ Radiation Drugs and Chemicals Cytotoxic Agents Benzene Chloramphenicol Viruses Presentations Most patients with AA seek medical attention for symptoms that occur as a result of low blood counts Bleeding A gradual reduction in hemoglobin concentration Infection--agranulocytosis Presentations and Laboratory evaluation Severe aplastic anemia (SAA-Ⅰor Ⅱ) Peripheral Blood pancytopenia ANC0.5×109/L Ret15×109/L, 1% PLT20×109/L Bone Marrow aspiration and biopsy BM cellularity25% fat cells increase others Non Severe aplastic anemia (NSAA or chronic AA) Bone marrow Normal AA A patient’s peripheral blood routine test A patient’s bone marrow figure Diagnosis ang differential diagnosis Pancytopenia, Ret decreases Bone marrow cellularity decreases at least one site Liver and splee