:

Leukemia
( )Hyperplasia/Hypergenesis

, %4

 ) Causes of leukemia ( :

:
( ) Downs syndrome Fanconi Anemia
Papillomavirus , Epstein Barr Virus
.
( ) - .


Types of Leukemia

Chronic Leukemia

Myeloid

Lymphocytic

Acute Leukemia

Myeloblastic

Lymphoblastic

B
B-cell

T
T-cell


Acute Leukemia
( )Immature
( )Blast ,
,

.

Acute Lymphoblastic Leukemia

(ALL)

 :
-1
.
-2 ,
.
-3 .
-4 .

Classification :

ALL FAB
( )French-American-British

( )Cytochemistry stain :
-1 ( )Myeloperoxidase MPO .
-2 Sudan Black SBB .
-3 Periodic Acid Schiff PAS
.
-4 Specific Esterase .
-5 Nonspecific Esterase (.)T-Cell
-6 Acid Phosphatase
FAB ALL L3 L2 L1 :
. Lymphobalst

:
B-cell ALL

T-cell ALL

Early Pre-B

Pre-T ALL

Common ALL

Mature T-cell ALL

Pre-B ALL
Mature B-cell ALL
(Burkitt leukemia)

 : Laboratory Diagnosis
( )CBC : -1 . Leukocytosis
-2 ( ).
-3 Thrombocytopenia
( )Peripheral Blood Blast .
( )Bone Marrow : Blast 20% .

:
Cytochemistry Myeloid Leukemia Cells Lymphocytic Leukemia Cells
Flow Cytometric Immunophenotype Acute Lymphoblastic Leukemia
T-cells or B-cells
B-cell

TdT , HLA-DR , CD10 , CD19 , CD20 , CD24 , Cytoplasmic CD22 , and CD79a

T-cell

TdT , Cytoplasmic CD3 , CD7 , CD1 , CD2 , CD4 , CD8 and CD10

Cytogenetics .
Detect Philadelphia Chromosome and other genetics abnormalities

: )Prognosis(
. :
Age : Younger patients (especially those younger than age 50) have a better
prognosis than older patients
50000 mm3 :
.

Initial white blood cell (WBC) count : People diagnosed with a WBC count below
50,000 tend to do better than people with higher WBC counts.
Mature B-Cell ALL T-Cell ALL :

ALL subtype : patients with T-cell ALL tend to have a better prognosis than those
with mature B-cell ALL (Burkitt leukemia)

 Philadelphia Chromosome :

Chromosome translocations : People who have Philadelphia chromosomepositive ALL tend to have a poorer prognosis, although new treatments are
helping many of these patients achieve remission.
4-5 :

Response to chemotherapy : Patients who achieve complete remission
(disappearance of signs and symptoms of cancer) within 4 - 5 weeks of starting
treatment tend to have a better prognosis than those who take longer
. 10
Infants and children age 10 years and older tend to have a poorer outcome than
young children (ages 1 - 9 years).

 )(Treatment
:

-1 .
-2 .

-3 .
-4 .

Chemotherapy
Bone marrow transplant
Radiation
Biological therapy

 FAB-L1 /
( (FAB

14 -10 :
: ()Cleaved and Indented ,
.
: . ( )Cytochemistry Stain :
-1 MPO .
-2 SBB .
-3 Specific Esterase .
-4 Nonspecific Esterase .
-5 PAS .

 FAB-L2 /
,
,
. L1
22-14 .
: ( )Indented shape , 2-1
.
: . . L1

 FAB-L3 /
Burkitt Leukemia
18-14 .
: , , 2-1
. 1:4
: . L1
PAS .

Thank you