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Leukaemias

Leukaemias: Malignant Disease of WBC Forming tissue: Lymphoblastic (ALL) Acute Myeloid (AML) Lymphatic (CLL) Chronic Myeloid (CML)

Acute Leukaemias

Defind pathologically as blast cell leukaemia It is a malignancy of immature haemopoietic cells The bone marrow shows >30% blast cells

Types Of Acute leukaemia

1.Acute lymphoblastic leukaemia (ALL) 2.Acute Myeloblastic leukaemia (AML)

HOW TO DIFFERENTIAT BETWEEN THESE 2 TYPES

1.Morphological appearance 2.Cytochemical stains 3.Immunological study as monoclonal antibodies(McAb) 4.Cytogenetic analysis and rarely 5.Electron microscopy

leukaemias: ALL Childhood  AML Adults Acute

Aetiology: Unknown in individual case * Viral * Radiation * Chemicals and Drugs * Genetics factors


Pathology:
BLAST CELLS
Tissue invasion (L.N., spleen, liver, skin, C.N.S)
BLOOD Pancytopenia + Blastaemia Normal Haemopoiesis (Depressed)
Bone Marrow


Blood Picture: Hb Clinically (Normochromic - - - - Pallor, Tiredness Anaemia - - - - Dyspnea, etc. . . =4-9 g/dl) DIC (AProl) Platelet Count - - - Bleeding (Thrmbocytopenia Tendency = 10 – 80 x 109/L) Neutrophil - - - Infections count (Fever, septicoemia) ( 0.1 – 1.5 x 109/L)Organ infiltration: Lymphadenopathy (systemic) Hepatosplenomegaly - Gum Hypertrophy in Monocytic leukaemia (rarely, skin, bone, C.N.S) Viral Fungal Bacterial
Total WBC count Normal, low, or increased

Acute leukaemia

.Classification (FAB)I. Acute lymphoblastic leuk. ALL Morphological L1 – Monomorphic type . . . . Good riskL2 – Heterogenous type L 3 – Burkitt’s type Immunological 1) Non T, Non B ALL (common) good risk ALL2) T- ALL3) B- ALL

II. Acute Myeloid Leukaemia (AML) [ FAB]M0 AML . . . Poorly differentiated M1 AML . . . Without Maturation M2 AML . . . With Maturation M3 AproL . . . Promyelocytic M4 AMML . . . MyeloMonocyticM5 AMOL . . . Monocytic M6 A. ErythroLeukaemia M7 A. Megakaryoblastic LAge groups : ALL – mostly in children AML – mostly in Adults