六篇九章白血病.pptxVIP

第1页/共65页六篇九章白血病第2页/共65页第六篇 血液系统疾病 第九章白血病(Leukemia)第3页/共65页讲授目的和要求1.掌握急、慢性白血病的临床表现，实验室检查及诊断标准，治疗原则2.熟悉急性白血病FAB分型，联合化疗的原则，完全缓解的概念第4页/共65页讲授主要内容概述病因和发病机制临床表现实验室检查诊断标准鉴别诊断治疗第5页/共65页Erythrocytes: transport oxygenNeutrophilBasophilEosinophilMonocytes/MacrophageDefense against infectionPlatelets: Mediate blood clottingT-lymphocytes: antigen presenting B-lymphocytes Plasma cell:Source of antibodies第6页/共65页Pluripotential stem cellsLymphoid stem cellsMyeloid stem cellsUnipotential progenitor cellsImmature hematopoietic cellsmature hematopoietic cells第7页/共65页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-LeukemiaProgenitor cellImmature cellStem cell Mature cell 第8页/共65页Accumulation of mutations of DNA within a pluripotential stem cell or very early progenitor cell gives rise to leukemic stem cellsLeukemic stem cellNormal stem cell第9页/共65页第10页/共65页第11页/共65页EtiologyPathogenesis Environmental factors Acquired diseasesClonal expansionLesions to the DNA第12页/共65页Environmental factorscause leukemiaA lot of environmental factors has been reported to cause leukemia. However, only four of them are firmly established causal agents. They are:Irradiation exposure Chronic benzene exposure Chemotherapeutic agents Leukemia virus infection第13页/共65页第14页/共65页Inherited syndromes predispose to leukemiaInherited syndromes such as ataxia-telangiectasia, down syndrome predispose to subsequent development of leukemia. Usually, these kinds of syndromes share the common features that they all have heretic defects in their genome gave by their parents第15页/共65页Acquired disease predispose to leukemiaLeukemia may also develop from the progression of other clonal disorders of hematopoietic stem cells. Ploycythemia vera, idiopathic myelofibrosis, etc 第16页/共65页Leukemia ClassificationThere are at least dozens of varieties of leukemia. They are clas