Chronic leukemias أ. م. د. محمد شنين علي العبادي معاون عميد كلية الطب / جامعة كربلاء ورئيس فرع الامراض والطب العدلي M. B. Ch. B. & F. I. C. P.(Hematopathology)

Slides:



Advertisements
Similar presentations
Edoardo Pescarmona Dipartimento di Medicina Sperimentale
Advertisements

TA OGUNLESI (FWACP)1 CHILDHOOD LEUKAEMIA. TA OGUNLESI (FWACP)2 LEUKAEMIA Heterogenous group of malignant disorders Characterised by uncontrolled clonal.
Chapter 11 Disorders of White Blood Cells and Lymphoid Tissues
NEOPLASTIC DISORDERS OF THE BONE MARROW
Introduction To Haematological Malignancies
LEUKEMIA.
Leukaemia.
Chronic leukaemias Chronic myelogenous leukaemia Chronic myelogenous leukaemia Chronic lymphocytic leukaemia Chronic lymphocytic leukaemia.
LEUKEMIA—HEMATOLOGY {S1}
Chronic Lymphocytic Leukemia (CLL).
Leukemia and Lymphoma Dental Views By Fatin Al – Sayes MD, Msc,FRcpath Associate Professor Consultant Hematology Leukemia and Lymphoma Dental Views By.
Lymphoma Dr. Raid Jastania Dec By the end of this session you should be able to: –Discuss the basis of the classification of lymphomas –Know the.
Leukemia Maturation of Myeloid Cells Dr. Rania Alhady.
LEUKEMIAS Dr Mehboob Khan Pathologist
WHO CLASSIFICATION OF MYELOID NEOPLASMS 2000  Chronic myeloproliferative disorders (CMPD)  Myelodysplastic / myeloproliferative diseases (MDS/MPD) 
Chronic lymphocytic leukemia (1)
Lymphoma Nada Mohamed Ahmed , MD, MT (ASCP)i.
Chronic Lymphocytic Leukemia (CLL) DEFINITION CLL is a neoplastic disease characterized by proliferation and accumulation (blood, marrow and lymphoid.
Chapter 17 Chronic Leukemias.
Chronic Lymphocytic Leukemia. Definition Clonal B cell malignancy. Progressive accumulation of long lived mature lymphocytes. Increase in anti-apoptotic.
Chronic Leukemia Dr. Rania Alhady Chronic Lymphocytic leukemia (CLL):
Chronic leukemias. Chronic myelogenous (granulocytic) leukemia Is characterized by an unregulated proliferation of myeloid elements in the bone marrow,
O THER MALIGNANT LYMPHOPROLIFERATIVE DISORDERS The lymphomas and plasma cell problems.
3 rd Year – Level 5 – AY Dr. Walid ZAMMITI Msc, PhD MLT Faculty of Applied Medical Sciences Department Of Medical Lab. Technology HEMATOLOGY.
The acute Leukemias are clonal hematopoietic malignant disease that arise from the malignant T r a n s f o r m a t i o n of an early Hematopoietic stem.
Jan Żeromski Pathology 2010/2011.  Malignant proliferation of white cells of the hematopoietic system with infestation of blood and usually bone marrow.
C HRONIC LEUKEMIAS. Chronic myelogenous (granulocytic) leukemia Is characterized by an unregulated proliferation of myeloid elements in the bone marrow,
Chronic Leukemias. CMLCML CLLCLL CML A clonal disease results from an acquired genetic change in a pluri-potential hemopoietic stem cell within the BM.
INVESTIGATION OF LEUKOCYTES. CHANGES IN LETSKOTYC FORMULAS IN VARIOUS PATHOLOGICAL CONDITIONS. CLINICAL AND LABORATORY DIAGNOSIS OF HEMOBLASTOSIS.
Myeloproliferative Disorders (MPDs)
Hematopoietic and lymphoreticular system
Leukaemias and lymphomas. Etiology, pathogenesis. Diagnostics
Lymphoproliferative disorders. Several clinical conditions in which lymphocytes are produced in excessive quantities ( Lymphocytosis) Lymphoma Malignant.
Hematology and Hematologic Malignancies
Chronic leukemia 1. Chronic Lymphocytic leukemia (CLL) * Definition: Chronic neoplastic disorder characterized by accumulation of small mature-looking.
Chronic myeloid leukaemia (CML)
Lymphoma Rob Jones. Aim and learning outcomes Aim ◦ To revise the key points of lymphoma Learning outcomes ◦ Revise the basics of haemopoiesis ◦ Understand.
MLAB Hematology Keri Brophy-Martinez Lymphoid Malignancies.
CHRONIC LEUKEMIA Dr. Hayam Hebah Associate professor of Internal Medicine AL Maarefa College.
Leukaemias. Leukaemias: Malignant Disease of WBC Forming tissue or other hemopoietic elements: Lymphoblastic (ALL) Lymphoblastic (ALL)Acute Myeloid (AML)
..  Neoplastic proliferation of small mature appearing  lymphocytes and account 25% of leukemia  It is rare before 40 years of age, the median age.
MLAB Hematology Keri Brophy-Martinez
Myeloproliferative Lymphoproliferative & Immunoproliferative disorders.
Chronic Leukemias S. Sami Kartı, MD, Prof.. What are the Leukemias?  Cancers of leukocytes or their precursors  Accumulation or proliferation of leukocytes.
HEMATOPATHOLOGY MODULE Prepared by Emmanuel R. de la Fuente, M.D.
Acute Leukemia Kristine Krafts, M.D..
Copyright © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins Chapter 28 Disorders of White Blood Cells and Lymphoid Tissues.
Acute lymphoblastic leukemia in children
Hematology There are four lectures: 1.Acute leukemias (2 hours). 2.Chronic leukemias (2 hours).
Nada Mohamed Ahmed, MD, MT (ASCP)i. Objectives chronic myeloid leukaemia (CML) Haematopoietic malignancies Polycythemia vera (PV) Idiopathic myelofibrosis.
The Chronic Lymphoid Leukaemias
Associate professor of Internal Medicine
Acute Leukemia Kristine Krafts, M.D..
Malignancies of hematopoietic cells. Leukemia
Differential WBC Counting
Leukemia DR Ahmed Gamal Consultant Adult hematology and SCT , KKUH
LEUKEMIAS H.A. MWAKYOMA, MD.
CLINICAL PROGRESSION INTRODUCTION METHOD CONCLUSION REFERENCES
Lymphoproliferative disorders
Chronic leukemias CML CLL MDS.
Associate professor of Internal Medicine
Case Study ….
Chronic Leukemia Kristine Krafts, M.D..
Diagnostic Hematology
Hairy cell Leukemia Case study.
Acute Leukemia Dr. Noha Noufal.
Neoplastic disorder.
Chronic Leukemia Dr. Noha Noufal.
LYMPHOPROLIFERATIVE DISORDERS
MYELOID LEUKEMIAS Dr. B.V.Vydehi M.D PROFESSOR OF PATHOLOGY
Presentation transcript:

Chronic leukemias أ. م. د. محمد شنين علي العبادي معاون عميد كلية الطب / جامعة كربلاء ورئيس فرع الامراض والطب العدلي M. B. Ch. B. & F. I. C. P.(Hematopathology) الاثنين 2015/4/7 الساعة الحادية عشرة والنصف صباحا

Definition and classification of chronic leukemias Definition: Chronic leukemias are malignancies of mature hemopoietic cells. Classification: 1.Chronic myeloid (myelocytic) leukemia (CML). 2.Lymphoproliferative disorders (LPD) which include many forms like Chronic lymphoid (lymphocytic) leukemia (CLL) and others.

Classification of LPD 1.Leukemias: A.CLL (Chronic lymphocytic leukemia),(B-CLL and T-CLL). B.PLL (Prolymphocytic leukemia),(B-PLL and T-PLL). C. HCL (Hairy cell leukemia) D. Plasma cell leukemia. 2. Lymphomas: Follicular lymphoma, Mantle cell lymphoma, and splenic lymphoma. 3. Leukemia/lymphoma syndrome. NB: clinically you will see leukemias and lymphomas.

B-CLL Represents a B-cell leukemia in which there is a neoplastic proliferation of mature B cells in the bone marrow. Usual age is above 50 yr.

B-CLL Pathogenesis The neoplastic B-cells will reach the peripheral blood before infiltrating the whole bone marrow. So that peripheral blood lymphcytosis is diagnostic before the presence of 3P, then lymphocytes go to infiltrate lymph nodes leading to painless symmetrical lymphadenopathy like cervical, axillary and inguinal lymph nodes

B-CLL Pathogenesis, continue Then B-cells infiltrate the liver and spleen and may after that cause anemia with or without thrombocytopenia. So that 3P is not a feature of CLL unless the disease is advanced. Immunity is generally low due to low normal lymphocytes.

B-CLL Lab.diagnosis MIC features are very important 1.CBC, Blood film. Normal or low Hb, Lymphocytosis >5X10 9 /L with predominently mature looking lymphocytes with large nucleus, condensed nuclear chromattin and scanty cytoplasm, together with frequent smear cells. Platelets are usually normal unless advanced disease which leads to low platelets.

2. Bone marrow aspiration and biopsy The aspirate should show lymphocyte % of at least 40% of the total marrow nucleated cells. By the above morphology, differentiation between B-CLL and lymphoma can be done. Immunophenotyping CD 5 and CD 23 positive B-cells while SmIg (surface membrane immunoglobulin) is weakly Positive.

Immunophenotyping is very important when the morphology is unclear for the differentiation between B-CLL and lymphoma since SmIg is strongly positive in lymphoma with negative CD 5 and CD 23 Cytogenetics Defects in chromosomes no.11,12,&13 are found in 50% of cases. Trisomy 12 carries poor prognosis.

Please answer by T or F When there is generalized lymphadenopathies with hepatosplenomegaly and peripheral blood lymphocytosis, differential diagnosis will be Lymphoma, CLL, or PLL.

B-PLL B-PLL=B-prolymphocytic leukemia Usually in B-CLL, there are few circulating prolymphocytes (less than 10%) which are twice the size of lymphocytes. When the % of such cells is 10%-55% the condition is called CLL/PLL while when they constitute >55% the condition is called PLL.

Chronic myeloid leukemia (CML) It is a clonal disorder, resulting from an acquired genetic change in the pluripotential stem cell. All age groups are affected.

CML Pathogenesis Acquisition of philadelphia chromosome (chromosome number 22)due to reciprocal translocation t(9;22) is important for the development of CML and at the same time carries good prognosis. Neoplastic proliferation of such pluripotential stem cells leads to increase in myeloid series and platelets and decrease in erythroid series.

CML, Lab.diagnosis 1.CBC, b.film Low or normal Hb Very high WBC count, may be more than 100X10 9 /L, with all myeloid series, but mainly neutrphils and myelocytes. Platelets count is usually high (part of the malignant process). 2. Bone marrow is usually important for follow up of marrow fibrosis.

Thank you