LEUKEMIA

Malignant disorders
of the hematopoietic
stem cell
compartment
associated with no.
of white cells in bone
marrow and/or
peripheral blood.
LEUKEMIA
Introduction to leukemia
Leukemia is a malignant disease characterized
by unregulated proliferation of one cell type.
It may involve any of the cell lines or a stem cell
common to several cell lines.
Leukemias are classified into 2 major groups
Chronic in which the onset is insidious, the disease is
usually less aggressive, and the cells involved are usually
more mature cells
Acute in which the onset is usually rapid, the disease is
very aggressive, and the cells involved are usually poorly
differentiated with many blasts.
Introduction to leukemia
Both acute and chronic leukemias are further classified
according to the prominent cell line involved in the
expansion:
If the prominent cell line is of the myeloid series it is a
myelocytic leukemia (sometimes also called
granulocytic)
If the prominent cell line is of the lymphoid series it is a
lymphocytic leukemia
Therefore, there are four basic types of leukemia
Acute myelocytic leukemia AML- (includes myeloblastic,
promyelocytic, monocytic, myelomonocytic, erythrocytic, and
megakaryocytic)
Acute lymphocytic leukemia ALL- (includes T cell, B cell, and
Null cell)
Chronic myelocytic leukemia CML - (includes myelocytic and
myelomonocytic)

HEMATOPOIESIS


RISK FACTORS
IONISING
RADIATION
After atomic bombing of Japanese cities-myeloid leukemia
Radiotherapy for ankylosing spondylitis
Diagnostic X-ray of the fetus in pregnancy
CYTOTOXIC DRUGS
Alkylating agents-myeloid leukemia
Industrial exposure to benzene
RETROVIRUSES
One rare form of T-cell leukemia/ lymphoma appears to be a/w a retrovirus similar to the
viruses causing leukemia in cats and cattle
GENETIC
Identical twin of pts with leukemia
Downs syndrome and certain other genetic disorders
IMMUNOLOGICAL
Immune deficiency states ( hypogammaglobulinaemia)
Comparison of acute and chronic leukemias:
Acute Chronic
Age all ages usually adults
Clinical onset sudden insidious
Course (untreated) 6 mo. or less 2-6 years
Leukemic cells immature >30% blasts more mature cells
Anemia prominent mild
Thrombocytopenia prominent mild
WBC count variable increased
Lymphadenopathy mild present;often
prominent
Splenomegaly mild present;often
prominent