血液系统疾病白血病课件.pptVIP

* * 第六篇 血液系统疾病 第九章 白血病 (Leukemia) 学时数：2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 oxygen Neutrophil Basophil Eosinophil Monocytes/Macrophage Defense against infection Platelets: Mediate blood clotting T-lymphocytes: antigen presenting B-lymphocytes Plasma cell: Source of antibodies Leukemia Classification There 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 Contrast, chronic leukemia is slow-growing and progressively worsen over years Acute versus chronic leukemia Acute: the blood cells of acute leukemia remain in an immature state, so they reproduce and accumulate very rapidly. Therefore, they need treatment immediately, otherwise the disease may be fatal within few months Chronic: in Chronic leukemia, the blood cells eventually mature, or partially mature. But they are not “normal”. They remain in the blood much longer than normal blood cells and they can not act functional cells well Myelogenous versus lymphocytic leukemia If the leukemic cells arise from myeloid pluripotential stem cells: myeloid leukemia If the leukemic cells arise from lymphocytic pluripotential stem cells: lymphocytic leukemia Clinical manifestations Leukemic hematopoiesis Normal hematopoiesis marrow failure Infiltration Marrow failure Anemia (loss of erythocytes): fatigues, pallor weakness, reduced exercise tolerance Fever and infection (Poor infection fighters) Abnormal bleeding (loss of platelets) Infiltrations Oral tissue: swollen painful, and bleeding gums Splenomegaly and hepatomegaly Lymph node enlargement Bone or joint pain CNS-headaches, seizures, weakness, blurred vision and vomiting Blood test findings Anemia is a constant feature.Nucleated red cells or immature red blood cell may be presen