临床血液学检验：慢性髓细胞白血病.pptVIP

MDS 5q- MDS with del(5q) as single aberration Blasts in BM : 5% MDS not classifiable Can not be classified in above categories Blasts in BM : 5% Diagnosis Signs and symptoms : Anemia gradual onset of fatigue and weakness Previous chemotherapy or radiation exposure Bone marrow morphology Cytogenetics Flow cytometry （Establishment of a specific flow cytometry signature to help diagnose MDS has been a significant target of researchers） dghhg * The Ph chromosome is the result of a translocation—or exchange of genetic material—between the long arms of chromosomes 9 and 22 . This exchange brings together two genes: the BCR (breakpoint cluster region) gene on chromosome 22 and the proto-oncogene ABL (Ableson leukemia virus) on chromosome 9. The resulting hybrid gene BCR-ABL codes for a fusion protein with tyrosine kinase activity, which activates signal transduction pathways, leading to uncontrolled cell growth 由Ph染色体→Bcr-Abl融合蛋白，分子量210 KDa。 (although an increased platelet count may also occur in CML). The Ph chromosome is named after the city where it was first recorded. The Ph chromosome is named after the city where it was first recorded. * 红细胞大小不一，球形、靶形、盔形红细胞，嗜多色红细胞， Peripheral blood from a patient with myelodysplastic syndrome shows a hypolobulated Pelger Huet cell Odd number 奇数核 * 病态造血特征：小巨核，淋巴样小巨核细胞 Anemia dominates the early course. Most symptomatic patients complain of the gradual onset of fatigue and weakness, dyspnea, and pallor, but at least half the patients are asymptomatic and their MDS is discovered only incidentally on routine blood counts. Previous chemotherapy or radiation exposure is an important historic fact. 红系病态造血： 红细胞大小不均 色素不均或双形性 核异常：核出芽，核间桥，核碎裂，多核，类巨幼样变等 胞质异常：PAS染色阳性 2. Granulocytic series 1）Hyposegmented neutrophils (Pseudo-Pelger-Huet) 2）Vacuole (空泡） 3）Hypogranular neutrophils （颗粒缺如） 4）Or large granules 5) Binuclear granulocyte（双核粒细胞） 6) Auer’s rods Nulear budding 3. Megakaryocytic series