Presentation is loading. Please wait.

Presentation is loading. Please wait.

Chronic Leukemia Dr. Rania Alhady Chronic Lymphocytic leukemia (CLL):

Similar presentations

Presentation on theme: "Chronic Leukemia Dr. Rania Alhady Chronic Lymphocytic leukemia (CLL):"— Presentation transcript:

1 Chronic Leukemia Dr. Rania Alhady Chronic Lymphocytic leukemia (CLL):
Definition: Chronic neoplastic disorder characterized by accumulation of small mature-looking lymphocytes which are immunologically immature in blood, bone marrow and lymph nodes. • It is of either B- or T-cell type. • Chronic persistent of lymphocytosis. • Subtypes of CLL are distinguished by morphology, immunophenotyping and cytogenetics. Dr. Rania Alhady

2 Chronic Leukemia Dr. Rania Alhady
B-cell Chronic lymphocytic leukaemia (B-CLL): Affects people between years of age. • The tumor cell appears to be a relatively mature B cell with weak surface expression of immunoglobulin (Ig)M. • The cells accumulate in the blood, bone marrow, liver, spleen and lymph nodes. • Tumor cells have long survival with impaired apoptosis. Dr. Rania Alhady

3 Chronic lymphoid leukemia
Clinical features of B-cell CLL: 1- The disease occurs in older subjects (> 50 years old). 2- Most cases are diagnosed when a routine blood test is performed. 3- Enlargement of cervical, axillary or inguinal lymph nodes is the most frequent clinical sign (Generalized lymphadenopathy) 4- Features of anemia may be present. 5- Bruising or purpura may occur due to thrombocytopenia. 6- Splenomegaly and, less commonly, hepatomegaly. 7- Immunosuppression is a significant problem. Bacterial infections followed by viral and fungal infections such as herpes zoster are also seen. Dr. Rania Alhady

4 Chronic lymphoid leukemia
Clinical features of B-cell CLL Cervical lymphadenopathy Herpes zoster infection Dr. Rania Alhady

5 Chronic lymphoid leukemia
Laboratory findings of B-cell CLL 1- Peripheral blood: WBCs: Absolute lymphocytosis (↑↑↑ > ) Morphology: - Small mature looking lymphocytes - Dense chromatin - Small rim of cytoplasm RBCs: Normocytic normochromic anaemia is present in later stages. Platelets: ↓ . 2- Bone marrow: shows lymphocytic replacement of normal marrow elements (> 40%) 3- L.N.: Diffuse infiltration by mature looking lymphocytes. 4- Immunophenotyping: cells express CD5 (+ve in 90% of cases) Pan B markers +ve: CD19, CD20, CD22 5- Cytogenetics. Dr. Rania Alhady

6 Chronic lymphoid leukemia
Blood film in B-cell CLL Dr. Rania Alhady

7 Chronic Myeloid Leukemia
Chronic Myeloid leukemia (CML): Definition: It is a clonal disorder of a stem cell. • Accounts for around 15% of leukemias and may occur at any age. • The main feature is the presence of Philadelphia chromosome (Ph) which occurs due to t(9,22) translocation. Dr. Rania Alhady

8 Chronic Myeloid Leukemia
Clinical features CML most frequently affect people between the ages of 40 and 60 years. However, it may occur in children. Symptoms include: 1- Symptoms related to hyper-metabolism (e.g.weight loss, anorexia-poor appetite- or night sweats). 2- Splenomegaly. 3- Features of anemia may include pallor, dyspnoea and tachycardia. 4- Gout or renal impairment caused by elevated levels of uric acid may be a problem. 5- Rare symptoms include visual disturbances. 6- In up to 50% of cases the diagnosis is made incidentally from a routine blood count. Dr. Rania Alhady

9 Chronic Myeloid Leukemia
Lab findings in CML 1- Peripheral blood: WBCs: - ↑↑↑ >50.000 - The levels of neutrophils and myelocytes exceed those of blast cells and promyelocytes - Increased circulating basophils. RBCs: Normocytic normochromic anaemia. Platelets: ↑↑ 2- Bone marrow: Aspirate: Hypercellular with predominance of granulopoiesis Biopsy: No fat spaces & ↑↑ reticulin 3- Cytogenetics: Ph chromosome 4- Serum uric acid is usually high. Dr. Rania Alhady

10 Chronic Myeloid Leukemia
CML: peripheral blood film showing various stages of granulopoiesis Dr. Rania Alhady

Download ppt "Chronic Leukemia Dr. Rania Alhady Chronic Lymphocytic leukemia (CLL):"

Similar presentations

Ads by Google