THE CHILDHOOD LEUKEMIA站.pptxVIP

THE CHILDHOOD LEUKEMIA第一课件网站 / LeukemiaLeukemia is a disease characterized by proliferation of immature white cells and is the most common malignancy of childhood. Acute leukemias account for the majority (97%) of cases.Leukemia The leukemias are classified according to the white blood cell line involved:?Acute lymphocytic leukemia (ALL) ----- cells of lymphoid lineage Acute non-lymphocytic leukemia (ANLL) ----- cells of granulocytic or monocytic lineage.Acute lymphocytic leukemiaALL account for 80% of childhood leukemia and has a peak in incidence between age 3 and 6 years. It is slightly more common in boys than girls. Acute lymphocytic leukemiaChildren with Down syndrome, Fanconi anemia ,and ataxiatelangiectasia are at particular risk of ALL . Siblings, especially twins, of children with leukemia are approximately twice as likely to have leukemia than is the general population . . Acute lymphocytic leukemiaSome cases of childhood ALL may relate to hereditary or acquired mutation in the p53 gene. Taken in total , however , these predisposing circumstances or relationships account for only a small propotion of casesClinical featuresIn most children with ALL , there is an acute onset of symptoms and signs arsing from infiltration of the bone marrow or other organs with leukemic blast cells . Most will have one or more of the following :Clinical features “4 Ps” Pallor ---- anemia.Pyrexia ---- concomitant infection or the desease itself.Purpura ---- thrombocytopeniaPain ---- Bone pain (pelvis , vertebral bodies , legs ), due to expansion of marrow cavity . Abdominal pain , due to liver and spleen distension . Expansion of marrow cavityClinical featuresasymtomatic lymphadenopathy and hepatosplenomegaly the CNS , testes and the kidneys ---- the most commonly affected extramedullary sites Infection ---- due to neutropeniaClinical featureHepatosplenomegaly reticuloendotheelial cell infiltration.InvestigationsPeripheral blood investigations reveal :Anemia ---- normocytic ,