天津医科大学内科学课件 Myelodysplastic.pptVIP

* MDS associated with isolated delete five q. its blood feature include anemia, less than blasts, platelet normal or increased. Bone marrow features are normal or increased megakaryocytes with hypolobated nuclei. Less than five percent blasts. No Auer rods. Isolated delete five q. * Next , we discuss the pathogenesis of MDS. In normal person, the cells in bone marrow produce and destroy are at banlance. So the count of peripheral blood is normal. * But in MDS patient, the production of bone marrow cell is normal. The apoptosis rate is inreased. Apoptosis also named programmed cell death. The increasement of apotosis lead to bone marrow. It appear cytopenia in blood. * Following we discuss the pathophysiology of MDS. The MDS clone can cause red-cell, white cell, and platelet abnormal. The red cell precursors deceased sensitivity to erythropoietin.neutrophils decreased myeloperoxidase and microbicidal activity. Platelets is functionally defective. * The onset of a myelodysplastic syndrome before the age of 50 years is rare, but the various forms of this disease are among the commonest hematologic cancers in patients over the age of 70 years, among whom the annual incidence exceeds 20 per 100,000 persons. Incidence rates are higher in men by a factor of approximately 1.8 * Now we discuss the clinical fingdings. MDS occur primarily in individual over fifty years old. The median age of occurrence is sixty-five years old. The most frequent presenting symptoms is anemia, next is hemorrhage and infection. * The MDS clone cause anemia , the patients fell fatigue. The MDS clone cause neutropenia, so the patients are easily infected and have fever. The MDS clone cause thrombocytepenia. The patients eaily bleed. * Then why the MDS patients have normal or increased cellularity, but peripheral blood is cytopenia? Increase apoptosis leading to ineffective hematopoiesis is the main cause. * Next we discuss the diagnosis of MDS. Although many new methods were used. The morphol