1. ANEMIAS LEUKEMIAS Professor Yu.I. Bondarenko

2. ANEMIA

3. SCHEME OF BLOOD FORMATION

4. DEFINITION OF ANEMIA Anemia is decrease of erythrocytes amount and hemoglobin contents in unite of blood volume which is accompanied also with qualitative changes of erythrocytes Anemia is decrease of erythrocytes amount and hemoglobin contents in unite of blood volume which is accompanied also with qualitative changes of erythrocytes

5. Pathogenic classification of anemias 1. Posthemorrhagic anemia 1. Posthemorrhagic anemia 2. Hemolytic anemia 2. Hemolytic anemia 3. Anemia as a result insufficiency of blood formation 3. Anemia as a result insufficiency of blood formation

6. Acute posthemorrhagic anemia Reasons: 1. Wounding of vessels 1. Wounding of vessels 2. Gastro-intestinal bleeding 2. Gastro-intestinal bleeding 3. Dysmenorrhea 3. Dysmenorrhea 4. Bleeding stomach ulcer 4. Bleeding stomach ulcer 5. Lung tuberculosis 5. Lung tuberculosis

7. Chronical posthemorrhagic anemia Causes : Causes : 1. Stomach ulcer 1. Stomach ulcer 2. Stomach tumor 2. Stomach tumor 3. Hemorrhoid 3. Hemorrhoid 4. Uterine bleeding 4. Uterine bleeding 5. Renal bleeding 5. Renal bleeding 6. Nose bleeding 6. Nose bleeding By colour index - hypochromic By colour index - hypochromic

8. Equired hemolytic anemia 1. Toxic 1. Toxic 2. Immune 2. Immune 3. Mechanical 3. Mechanical 4. Equired membranopathy 4. Equired membranopathy

9. Toxic hemolytic anemia Poisoning by hemolytic poisons: Arsine Arsine Acetic lead Acetic lead Phosphorus Phosphorus Nitrobenzene Nitrobenzene Phenylhydrazine Phenylhydrazine Biliary acids Biliary acids Mushroom poison Mushroom poison Snake venom Snake venom

10. Immune hemolytic anemia 1. Autoimmune anemia 1. Autoimmune anemia 2. Posttrasfusion anemia 2. Posttrasfusion anemia а) transfusion of АВ0-uncompatible blood а) transfusion of АВ0-uncompatible blood б) transfusion of Rh- uncompatible blood б) transfusion of Rh- uncompatible blood 3. Hemolytic anemia of new-born 3. Hemolytic anemia of new-born

11. Equired hemolytic anemia Reticulocytosis

13. Hereditary hemolytic anemia 1. Enzymopathy 1. Enzymopathy 2. Hemohlobinopathy 2. Hemohlobinopathy 3. Membranopathy 3. Membranopathy

14. Enzymopathies 1. Deficit of glucoso-6- 1. Deficit of glucoso-6- dehydrogenase dehydrogenase 2. Deficit of pyruvate kinase 2. Deficit of pyruvate kinase

15. Medicine drug cause hemolyse in the G-6-PhDG insuficiency Sulfanilamides Sulfanilamides Antimalaric drugs Antimalaric drugs Aminosalycilic acid Aminosalycilic acid Phenacetin Phenacetin Vitamines C and K Vitamines C and K Aspirin in large doses Aspirin in large doses

16. Hemolytic anemia due to pyruvate kinase insefficiency. Reticulocytosis

17. Hemohlobinopathies Sickle-cell anemia Sickle-cell anemia Thalassemia: Thalassemia: α-thalassemia α-thalassemia ß-thalassemia ß-thalassemia

18. Sickle-cell anemia - blood

19. Sickle-cell anemia – blood: at the left – sickle erythrocytes at the right – test to hypoxia

20. Minor (heterozygotic) thalassemia – blood

21. Minor (Heterozygotic) thalassemia – blood

22. Major (Homozygotic) thalassemia – blood

23. Major (homozygotic) Cooley’s anemia – blood

24. Membranopathies Hereditary microspherocytosis Hereditary microspherocytosis Hereditary eliptocytosis Hereditary eliptocytosis Hereditary pyropoikilocytosis Hereditary pyropoikilocytosis Hereditary stomatocytosis Hereditary stomatocytosis Hereditary acanthocytosis Hereditary acanthocytosis Hereditary echinocytosis Hereditary echinocytosis

25. Membranopathy Hereditary microspherocytosis - blood

26. Membranopathy Hereditary eliptocytosis – blood

27. Megaloblastes. Megalocytes.Jolly’s bodies. Cabot’s rings.

28. LEUKEMIA

29. Leukemia definition Leukemia – it is tumor arising from bloodforming cells and primary lesion bone marrow Leukemia – it is tumor arising from bloodforming cells and primary lesion bone marrow

30. Classification of leukemias Acute leukemias Acute leukemias myeloblastic myeloblastic lymphoblastic lymphoblastic Chronical leukemias Chronical leukemias myeloid myeloid lynphoid lynphoid

31. Acute myeloblastic leukemias Undifferentiated Undifferentiated Myeloblastic without maturing Myeloblastic without maturing Myeloblastic with maturing Myeloblastic with maturing Promyelocytic Promyelocytic Myelomonoblastic Myelomonoblastic Monoblastic Monoblastic Erythroblastic Erythroblastic Megacaryoblastic Megacaryoblastic

32. Histochemical signs of differentiation of acute leukemias 1. Reaction for peroxidase 1. Reaction for peroxidase 2. Reaction for acidity phosphatase 2. Reaction for acidity phosphatase 3. Reaction for uncpecific esterases 3. Reaction for uncpecific esterases 4. Reaction for lipides 4. Reaction for lipides 5. Reaction for compoud carbohydrates 5. Reaction for compoud carbohydrates

33. Reaction of myeloblastes and other of neutrophil cells for peroxidase

34. Reaction of monoblastes for α-naphtylacetateestherase

35. Reaction of myeloblastes and monoblastes for acidity phosphatase

36. Acute lymphoblastic leukemia - blood

37. Acute В-lymphoblastosis – bone marrow Big vacuolized lymphoblastes

38. Acute lymphoblastic leukemia – bone marrrow

39. Acute lymphoblastic leukemia – bone marrrow. Initial stage.

40. Acute lymphoblastosis – bone marrow. Total lymphoblastic metaplasia

41. Chronical myeloid leukemias Myelocytic Myelocytic Monocytic Monocytic Eosinophilic Eosinophilic Erythroblastic Erythroblastic Megacaryocytic Megacaryocytic

42. Chronical myelocytic leukemia – blood. Chronical phase

43. Chronical myelocytic leukemia – blood.

44. Chronical myelocytic leukemia – blood Stage of blastic crisis

45. Chronical lymphoid leukemias В-lymphocytic В-lymphocytic Т- lymphocytic (1,5 %) Т- lymphocytic (1,5 %) Haircell Haircell

46. Chronical В-cell lymphocytic leukemia - blood

47. Chronical lymphocytic leukemia – blood. Gumprecht’s bodies.

48. Chronical lymphocytic leukemia – bone marrow. Total lymphoid metaplasia.

50. Chronical haircell leukemia - blood

52. Haircell leukemia - blood. Reaction for acidity phosphatase

53. Chronical monocytic leukemia - blood

54. Mechanisms of cellular oncogenes activating Point mutations Point mutations Chromosomal abnormalities Chromosomal abnormalities Virual transduction Virual transduction Insertion mutagenesis Insertion mutagenesis Genes amplification Genes amplification

55. Clinical manifestation of leukemia Metaplastic anemia Metaplastic anemia Thrombocytopenia Thrombocytopenia Hemorrhagic syndrome Hemorrhagic syndrome Secondary immunedeficiency Secondary immunedeficiency Decrease of resistance Decrease of resistance