Leukemia Year 4 Internal Medicine Notes OmpathStudy

Leukemia Year 4 · Internal Medicine Collection: 4TH YEAR ALL NOTES / IMED / I MED BEAUTIFUL NOTES / HEMAT -- ACUTE & CHRONIC LEUKEMIA\n435 medicine teamwork\n\n [ Important Notes Extra Editing file ]\n\nLecture objectives:\n⇨ Definition\n⇨ Historic Perspective\n⇨ Etiology and Risk Factors\n⇨ Incidence\n⇨ Classification\n⇨ Comparison of Acute and Chronic Leukemia\n\n Done By: Atheer Alnashwan\nRevised By: Luluh Alzeghayer\nReferences: Doctors’ Slides + Kumar + Step-up\n\n No need to know the chemotherapy drugs and its details. \n\n Leukemia\nOsmosis videos are very helpful, u r recommended to watch them first video1,video2\n\n - A group of malignant disorders affecting the blood and blood-forming tissues of: Bone marrow, Lymph\nsystem, Spleen.\n- Occurs in all age groups. (ALL commonest seen in child) (males females, 1-2:1)\n- Results in an accumulation of dysfunctional cells because of a loss of regulation in cell division.\n- Fatal if untreated! (Acute leukemia,!‫ المريض بيجيني على الطوارئ مش بالعيادة‬.. Chronic: ‫بيجيني المريض‬ !‫)في العيادة ويكون اكتشاف المرض بالصدفة‬\n- Often thought of as a childhood disease, BUT! The number of adults affected with leukemia is 10 times that\nof children! (extremely unlikely to see child with chronic leukemia, they usually have the acute form) Etiology & pathophysiology:\n- The etiology is unknown, it might be caused by: oncogenes mutation & tumor suppressor gene alteration,\nhost factors, and environmental factors.\n- Host factors:\n1- congenital chromosomal abnormalities  increase in patients with congenital disorders that have\ntendency for chromosomal abnormalities e.g. Bloom’s syndrome, Fanconi syndrome, Down’s & Klinefelter\nsyndromes (30 times  incidence of AL in child with Down’s synd).\n2- Immunodeficiency:  incidence of lymphoid leukemia & lymphoma (with hereditary immunodeficiency e.g.\nataxia-telangiectasia & sex-linked agamaglobulinemia)  usually related to T & B lymphocyte gene\nrearrangement.\n3- Chronic bone marrow dysfunction (CBMD) syndrome have an  risk of acute leukemic transformation.\n- Environmental factors:\n1- Ionizing radiation: e.g. nuclear weapons in Hiroshima& Nagasaki. Both acute & chronic forms of leukemia\nincluding AML, ALL, CML were associated.!‫ننتبه للصغار لما يروحون لعيادة األسنان واألشعة اللي يتعرضون لها‬\n2- Chemical drugs: e.g. Benzene, Chloramphenecol, Phenylbutazone and Cytotoxic alkylating\nchemotherapeutic agents (AML occur after tx with alkylating agents e.g. melphalan). The presence of RAS\nmutations in patients with AML has been associated with specific occupational exposure to chemicals.\n3- Viruses: The human T-cell leukemia-lymphoma virus-I (HTLV-I) has been implicated as a causative agent of\nadult T-Cell leukemia-lymphoma (now it has a vaccine, it is mandatory in the some countries). Another\nrelated virus HTLV-II has been isolated from patients with atypical hairy cell leukemia (CLL). The Epstein’s\nBarr virus (EBV) has been linked to Burkitt’s lymphoma. \nComparison of acute & chronic leukemia\nAcute Chronic\n1- Acute Lymphoblastic Leukemia (ALL) 1- Chronic Lymphocytic Leukemia (CLL)\nTypes\n2- Acute Myelogenous Leukemia (AML) 2- Chronic Myelogenous Leukemia (CML)\nAge All ages Adults (old age usually)\nClinical onset Sudden Insidious (onset is more gradual)\nImmature (Large in size, 20% blasts either in\nperipheral blood or BM)\nLeukemic cells\nClonal proliferation of immature Mature forms of WBC\nmaturity\nhematopoietic cells (the formation of\nblood or blood cells).\nAnemia Mild to severe Mild\nThrombocytopenia Mild to severe Mild\nWBCs Variable Increased\nOrganomegaly Mild Prominent \n\nMyelogenous Leukemia:\n- Leukemia characterized by proliferation of myeloid tissue (as of the bone marrow and spleen) and an\nabnormal increase in the number of granulocytes, myelocytes, and myeloblasts in the circulating blood. ‫حطوا‬\nfirst step to dx ‫مليون خط على السيركليتنق بلود! ألنها‬\n- Myeloid tissue is a biologic tissue with the ability to perform hematopoiesis. It is mainly found as the red\nbone marrow in bones, and is often synonymous with this. However, myeloid can also be present in the liver\nand spleen. = myeloid tissue.\n- A myelocyte is a young cell of the granulocytic series, occurring normally in bone marrow, but not in\ncirculating blood (except when caused by certain diseases).\n- Granulocytes are a category of WBC characterized by the presence of granules in their cytoplasm. They are\nalso called polymorphonuclear leukocytes (PMN or PML) because of the varying shapes of the nucleus, which\nis usually lobed into three segments.\n- The myeloblast is a unipotent stem cell, which will differentiate into one of the actors of the granular series.\ngranulocytes, myelocytes, ‫ وزيادة غير طبيعية في الـ‬myeloid tissue ‫ في‬proliferation ‫ يقول لكم إنه الميلوجينس لوكيميا هي عبارة عن‬،‫الزبدة من الكالم كله‬\n‫ الميلوسايت هي خلية صغيرة منها تتكون‬+.leukemia ‫ الزم نعرف إنه في السركليتنق بلووود!! عشان كذا اسمها‬myel