《白血病――血液系统疾病――内科学》由会员分享，可在线阅读，更多相关《白血病――血液系统疾病――内科学（34页珍藏版）》请在金锄头文库上搜索。
1、白血病 (Leukemia),第六章 血液系统疾病,讲授目的和要求,1.掌握急、慢性白血病的临床表现，实验室检查及诊断标准，治疗原则 2.熟悉急性白血病FAB分型，联合化疗的原则，完全缓解的概念,Pluripotential stem cells,Myeloid stem cells,Lymphoid stem cells,Unipotential progenitor cells,Immature hematopoietic cells,mature hematopoietic cells,Stem cell,Progenitor cell,Immature cell,Mature cell
2、,Etiology&Pathogenesis,Environmental factors Acquired diseases,Lesions to the DNA,Clonal expansion,Cytogenetic findings,Diagnosis & Classification,Other newly developed methods,Flow Cytometry,Immunohistochemistry,免疫表型分型方案,T 细胞,B 细胞（4%）,B 细胞前体,CD7（敏感），cCD3 （特异）,CD19 (敏感), cCD79a (特异),成熟T 细胞 （18%）,前 T
3、 细胞（6%）,前 B-细胞 （9%）,早期前-B 细胞 （52%）,前-前- B 细胞 （11%）,sIg, sIg,P118 types of translocations,CML,AML-M2,AML-M3,AML-M4,AML,AML-M4E0,Other new developed methods,Differential Diagnosis,Pseudoleukemia,Myelodysplastic syndrome,Nonleukemic pancytopenia,Treatment,Supportive cares and preparation of the patient
4、s Antileukemic therapy Therapy of the central nervous system Stem cell transplantation,Anemia Hemorrhage Infection,Hematological support Transfusion of Platelets Transfusion of packed red cells Transfusions of granulocytes Transfusions of IgG,Infection control Special precautions: protective isolati
5、on,Elimination of contaminated foods,Oral and digestive system care,Broad spectrum antibiotics,GM-CSF administration,Antileukemic therapy,Chemotherapy to kill leukemia cells using strong anti-cancer drugs,Treatment phases,Induction therapy: the aim is to bring about remission , that is leukemic cell
6、s are no longer found in the bone marrow and the recovery of normal hematopoiesis Post-remission therapy: to eliminate any leukemia cells potential hiding in the body,Special subtypes,Acute promyelocytic Leukemia (APL): because of the small particles (procoagulants) inside the APL cell, DIC are comm
7、only seen in this type of AML,Normal,APL,Genes essential for differentiation are shut down by the fusion proteins PML-RARalpha,Differentiation agents (all-trans retinoic acid, arsenic trioxide),Intrathecal chemotherapy,Cranial irradiation,复习思考题,1.慢性粒细胞白血病与类白血病反应的鉴别要点？ 2.白血病完全缓解的标准？为何要进行巩固、 强化化疗？ 3.骨髓增生异常综合征的分型、临床表现、与急性 白血病的关系？,谢谢！,
