Question

Explain Features of; ALL, AML, CLL, SML (Leukemias)

Features to explain include:

1. Classic Signs and Symptoms

2. Specialized Populations

3. Out Come of treatment Option

4. Protein for the Diagnosis

Answer 1

- Feute Lymphoblastic Leukemia (ALL) SPECIALIZED POPULATION! _* Most common Cance of CHLII REW. 2 * More common in whites as in blacks I * fore frequent in (boys! * Occurs in individuals younger than 15. I *B-ALL peaks at the age of 3. - * T-ALL in adolescents. - CLASSICAL SIGNS & Symptoms. - Symptoms related to depression cel marrow * Anaemia, L function] * feves, neutropenia. * Bleeding due to thrombocytopenie * Due to Ineo plastic infiltration done pain, lymphadenopathy, splenomegala + Hepatomegaly, testicular enlargement: it Cenkat nervos system Manifestibiana ) Headache ? =) Vomiting =) feningeal a) Nenue Palsies spread.

OUTCOME OF TREATMENT: Wira agressive chemotherapy 95), of children with Alle obtain complete remission factors with worse, prognosis Kage younger than 2. * presentation in adolescence * peripheral blood blast count 100,000 factors with good prognosis.. * age (2-10 yrs) + low white cell count * hyperdiploidy. trisomy el chiomosome u 1.10. e presence of tCla; an When All present with t(9:22) a gene that encodes BCR-ABL tyrosine kinare Treatment includes BUR - ABLkinase inhibitor with conventional chemotherapys) Highly - effective Protein for diagnosis : * Terminal deosey-nucleotidyl Transferase (felt) =) positive. in 95% of case * B-ALLS express PAX5 , cola, coio. * I- Aus ->express COL, CO2, CO 5460%.

Hmi (Acute myelogenous Leukemia). ago Develop at any age usually 15-60. Sune TOMS Bone Mongow Pomuro Oncemia) Jatigue and weakness Neukopenia -) infections by bacteria and opportunistic fungi. Thrombocytopenia > Bleeding to Disseminated Sokaudaculous congulation in Amma Bone paing Tenderness... EXTRAMEO V LLARY IN FILIBAT.CON.. =) Gingival Hypertrophy (my & M5) " leukemia cutts. a) Hepatospleeno megaly PROGNOSIS ! - 60% achieve complete remission but only 15 to 30% remain free of disease for 5 yrs. *Amu wicht(15;11) 80% ewable. - * +(8, 21) and inv (16) good prognosts with conventional therapy - Ame which follow mys or genotoxic Therapy - that occur in older people are at high risk.

DACwOSIS 1. Ame. St is difficult to distinguisha mueloblast and lymphoblast so AML confirmed by performing stains for myeloid specific antigen. * Stein positive with Myeloperoxidase and Sudan Slack + Monoblast stain non-specific esterase myeloid blast express - CB 34, CU 33. and a subset express = 6015

- cm Ismi (Smoldering Ryan Myelogenous ferkem), Sndividuale exposed to making adication - and benlone. & usually 40 to 60 yrs. & Hales are more affected. Suws a Sumpioms. Monspusfie, Fatigue, weakness weight loss. = مار همسه - 2 - Spleenomegaly (80-90%) Hepatomegaly ( 60-40%). Tullous of abdomen. OUT COME OF TREATMENT. * Treatment with BCR-ABL inhibitors. results in hematologic remissions in gof * Emergence of resistant to Ber-Arstinhibiku. In 50% of cases. So and and gud generation Ben-Hauicläbitowwed.- & Hematopoietic stem cell transplantation, performed in stable phase in curative in about "75% of cases.

DIAGNOSIS of (me .يهلاليا معينا + * elevated eosinophils & basophils. Negakaryo ay tu increased & Scattered macrophages with abundant wrinkled, green blue cytoplasm called. Sea blue histocytes.. leukocytosis exceedling 100,000 ulls/mms. which consist of neutrophils, band forms, myclocytu, metamyelweyles

- SIGNS Syndroms. CHRONIE LYMPHOCYTIC LEUKEMIA (eu). Specialized populations -). Common leukemia of adults * Median age => 60yrs. * 2:1 Hale predominance. ce less common in Japan and Asian countries than in West. & easy fatigability, weight loss, anorexia. * Generalized lymphadenopathy thepatu spleenomegaly (50-60-1.) * Monoclonal Ig "spike" in blood of patients + Hypogamma globulinemia with increased susceptibility - to infections. & 10 to 15% as Hemolytic anaemia, thrombocytopenia ducto OCT Come Of TREATMENT :. autantibodies. » Median survival is Cutosurs) =) Hore than lours for individuals with minimal tumor burden. FACTORS THAT WORSE THE OUT COME a) presence of deletions of natp. b) lack of somatic hypermutation. c) Expression of ZAP-70. d) Presence of NOTCHI Autations SYMPTOMATIC PATIENTS . Chemotherapy & immunotherapy. Hematopoietic stem cell hansplantation. BTK inhibitors. => promising therapy. When all transforms to harge B-cell lymphoma it is omnious and survival is less than 10yrs. DIAGNOSIS - ALL Tumors express => Cola and co2o. as well as (123 & cos. Low level expression of surface Ig also typical.