慢性粒单核细胞白血病诊治进展演示文稿.pptVIP

慢性粒单核细胞白血病诊治进展演示文稿本文档共42页；当前第1页；编辑于星期二\15点14分 本文档共42页；当前第2页；编辑于星期二\15点14分 本文档共42页；当前第3页；编辑于星期二\15点14分 1Definition 2Diagnosis 3Risk stratification 4Therapeutic options Contents本文档共42页；当前第4页；编辑于星期二\15点14分 Definition本文档共42页；当前第5页；编辑于星期二\15点14分 WHO Classification of MDS/MPN 1CMML 2Atipical CML, BCR-ABL1 negative 3JMML 4MDS/MPN, U (RARS-T, refractory anemia with ringed sideroblasts associated with thrombocytosis)本文档共42页；当前第6页；编辑于星期二\15点14分 Definition A clonal hematopoietic stem cell disorder that is characterized by the presence of an absolute monocytosis (1×109/L) in the peripheral blood and the presence of myelodysplastic and myeloproliferative features in the bone marrow.(WHO classification of myeloid neoplasms)本文档共42页；当前第7页；编辑于星期二\15点14分 Diagnosis本文档共42页；当前第8页；编辑于星期二\15点14分 Clinical manifestationMDS-typeFatigue and dyspnea due to anemiasusceptibility to infectionsrarely bleedingMPN-typesignificant weight lossdrenching nigh sweatsleft upper quadrant pain from significant splenomegaly本文档共42页；当前第9页；编辑于星期二\15点14分 Morphology (PB)PB monocytes usually range from 2 to 5 × 109/L, but may exceed 80 × 109/L.The monocytes generally are mature, but can exhibit abnormal granulation or unusual nuclear lobation or chromatin patten. (abnormal monocytes)Dysgranulopoiesis is present in most cases.本文档共42页；当前第10页；编辑于星期二\15点14分 Morphology (BM)hypercellular in over 75% of casesnormalcellular and hypocellular also occurdysgranulopoiesis, dyderythropoiesis, micromegakaryocytes and megakaryocytes with abnormally lobated nuclei (in up to 80% of patients)monocytic proliferation can be difficult to appreciate (cytochemistry and immunohistochemistry)本文档共42页；当前第11页；编辑于星期二\15点14分 Monocytosis with morphologicallynormal monocytes (PB)Monocytes with nuclear andCytoplasmic abnormalities (PB)CMML-1 (BM)CMML-2(BM)Representative peripheral blood and BM smears distinction between promonocytes and abnormal monocytes may be problematicPromonocytes typically have a light-gray cyt