内科学第六篇 第九章 白血病ppt课件.ppt

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;;Hematopoiesis composes of the options of commitment to different lineages and the progressive stages of maturation at which partial or complete arrest can occur, results in the wide array of malignant disease-Leukemia;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 s