内科学-白血病-谢毅

2020/5/31,xieYi,HuaShanHospital,1,Leukemia(白血病),谢毅（Xieyi）Dep.Hematology，HuashanHospitalFuDanUniversity,2020/5/31,xieYi,HuaShanHospital,2,Conceptofleukemia,DefinitionLeukemiaisamalignantblooddisorder(notsolidtumor),whichistheresultsofthetumorproliferationofheamotopoieticstemcells.（造血干细胞）,2020/5/31,xieYi,HuaShanHospital,3,2020/5/31,xieYi,HuaShanHospital,4,HematopoieticStemCell(HSC)istheprimarycellofhematopoieticandimmunesystem,2020/5/31,xieYi,HuaShanHospital,5,TumorproliferationofHSC,Proliferationisoutofcontrolandapoptosisisinhibited.Leukemiacellisclonedandaccumulatedinagreatquantity,thenormalhemapoiesisisihibited.DifferentiationofHSCisblocked.LeukemiacellsarestoppedonadifferentiationstageofHSC&lackofthenormalfunction.infiltrationandmetastasis,2020/5/31,xieYi,HuaShanHospital,6,malignantblooddisorders,2020/5/31,xieYi,HuaShanHospital,7,Accordingtotheacutemyeloidleukemia（AML）Differentiation&M0M1M2.M7KindofcellblastcrisisofCML，mastcellleukemia，acuteeosinophilicleukemia，basophilicleukemiaacutelymphocyteleukemia（ALL）L1，L2，L3TALL、BALLchronicleukemia：CML、PLL、CLL、HCL、,leukemia,thetraditionclassification(FAB)ofleukemia,2020/5/31,xieYi,HuaShanHospital,8,WHOclassification(2001)1,Acutemyeloidleukemia(AML),2020/5/31,xieYi,HuaShanHospital,9,WHOclassification(2001)1,Acutemyeloidleukemia(AML),2020/5/31,xieYi,HuaShanHospital,10,WHOclassification(2001)2,chronicmyeloidleukemia,2020/5/31,xieYi,HuaShanHospital,11,WHOclassification(2001)3,Lymphoidneoplasms,2020/5/31,xieYi,HuaShanHospital,12,Epidemiology:incidence,3/105，increasewithyears?acutechronic,AMLALLSpecialdistribution:Sexman：female2：1AgeALL,adolescent80thecountrysideChinaSingaporeJapanUSAunitedKingdomSweden(7.59/105)Inorderofthemortalityofmalignanttumorsin114y，leukemiaismosthighin1544y，leukemiaisthirdhigh(200mmH20,sugar，protein（40mg/dl),WBC10/mm3couldfindleukemiacells,2020/5/31,xieYi,HuaShanHospital,44,ThetreatmentofCNSleukemia,ThepreventionofCNSleukemiaAfterCR,MTX510mgsheathrejectionqw6IncidenceofCNSleukemia,200109/L,Leukostasis(白细胞淤滞)immaturegranulocytesatallstagesofdevelopmentarepresentinblood（幼粒细胞血症）orPLT1000109/LoranemiaBMproliferate，Granulo