内科学-白血病-谢毅.ppt

xie Yi,Hua Shan Hospital Concept of leukemia Definition Leukemia is a malignant blood disorder (not solid tumor),which is the results of the tumor proliferation of heamotopoietic stem cells.（造血干细胞） 　　　　　　　　 Tumor proliferation of HSC Proliferation is out of control and apoptosis is inhibited. Leukemia cell is cloned and accumulated in a great quantity, the normal hemapoiesis is ihibited. Differentiation of HSC is blocked. Leukemia cells are stopped on a differentiation stage of HSC lack of the normal function . infiltration and metastasis According to the acute myeloid leukemia（AML） Differentiation M0 M1 M2 ……………….. M7 Kind of cell blast crisis of CML，mast cell leukemia， acute eosinophilic leukemia，basophilic………… leukemia acute lymphocyte leukemia（ALL） L1，L2，L3 T－ALL、B－ALL chronic leukemia： CML、P－LL、CLL、HCL、 …… WHO classification (2001) 1, Acute myeloid leukemia(AML) WHO classification (2001) 2, chronic myeloid leukemia WHO classification (2001) 3, Lymphoid neoplasms Epidemiology : incidence 3/105 ， increase with years? acutechronic , AMLALL Special distribution: Sex man：female＝2：1 Age ALL, adolescent 80％20y; AML, adult CML, 20~50 years old; CLL ,50~70 years old Area adult T lymphocytic leukemia CML, eastern countries CLL, western countries Epidemiology: mortality 2.51/105 Area city the countryside ChinaSingaporeJapanUSAunited Kingdom Sweden(7.5～9/105) In order of the mortality of malignant tumors in1～14y，leukemia is most high in15～44y，leukemia is third high(stomach Ca liver Ca) in all person, leukemia is sixth or eighth high Etiology radiation 1、atom bomb 1Km 1.5km 2km （长 崎） × 100 ×22 × 2.6 2、high dose X radiotherapy、32P therapy C