Anem|a

- Abnormally low number of 88C or Pb levels

- 8educed oxygen carrylng capaclLy
Causes
- 8lood loss
- lncreased raLe of red cell desLrucLlon
nemo|yt|c anem|a
- ueflclenL or lmpalred red cell producLlon
k|sk factors
- oor dleL
- lnLesLlnal dlsorders
- MensLruaLlon
- regnancy
- Chronlc condlLlons
- lamlly hlsLory
- nC1 A ulSLASL" buL a sympLom
- uependenL on severlLy speed of developmenL
age healLh sLaLus and compensaLory mechanlsms
- AssoclaLed wlLh lmpalred C2 LransporL
alLeraLlon ln 88C sLrucLure or wlLh chronlc lllness
- noL expressed unLll 30 of 88C mass ls losL
S|gns and symptoms
1he maln sympLom of mosL Lypes of anemla ls
faLlgue
- Weakness
- ale skln
- 1achycardla
- ShorLness of breaLh
- ChesL paln
- ulzzlness
- CognlLlve problems
- numbness or coldness ln your exLremlLles
- Peadache
Iron Def|c|ency Anem|a
- MosL common form of anemla
- AffecLs abouL one ln flve women
- Palf of pregnanL women and 3 percenL of men
ln Lhe unlLed SLaLes
- 1he cause ls a shorLage of Lhe elemenL lron
- nuLrlLlonal lmbalance
- Slow chronlc bleedlng dlsorders
- lnablllLy Lo recycle plasma lron
V|tam|n Def|c|ency Anem|a
- lolaLe and vlLamln 812 deflclency
- lnLesLlnal dlsorder LhaL affecLs Lhe absorpLlon
of nuLrlenLs
- lall lnLo a group of anemlas called
megaloblasLlc anemlas ln whlch Lhe bone marrow
produces large abnormal red blood cells
Anem|a of Chron|c D|sease
- lnLerfere wlLh Lhe producLlon of red blood
cells resulLlng ln chronlc anemla
- kldney fallure also can be a cause of anemla
- 1he kldneys produce a hormone called
eryLhropoleLln whlch sLlmulaLes your bone
marrow Lo produce red blood cells
- A shorLage of eryLhropoleLln whlch can resulL
from kldney fallure or be a slde effecL of
chemoLherapy can resulL ln a shorLage of red
blood cells
Ap|ast|c Anem|a
- LlfeLhreaLenlng anemla caused by a decrease
ln Lhe bone marrows ablllLy Lo produce all Lhree
Lypes of blood cells red blood cells whlLe blood
cells and plaLeleLs
- Cause of aplasLlc anemla ls unknown
- auLolmmune dlsease
- ChemoLherapy
- 8adlaLlon Lherapy
- LnvlronmenLal Loxlns
Anem|as assoc|ated w|th bone marrow d|sease
- Leukemla and myelodysplasla can cause
anemla by affecLlng blood producLlon ln Lhe bone
marrow
- LffecLs vary from a mlld alLeraLlon ln blood
producLlon Lo a compleLe llfeLhreaLenlng
shuLdown of Lhe bloodmaklng process
- Myelodysplasla ls a preleukemlc condlLlon
LhaL can cause anemla
- CLher cancers of Lhe blood or bone marrow
such as mulLlple myeloma myeloprollferaLlve
dlsorders or lymphoma can cause anemla
nemo|yt|c Anem|as
- 8ed blood cells are desLroyed fasLer Lhan
bone marrow can replace Lhem
- AuLolmmune dlsorders can produce
anLlbodles Lo red blood cells desLroylng Lhem
premaLurely
PemolyLlc anemlas may cause yellowlng of Lhe
skln ([aundlce) and an enlarged spleen
nered|tary Spherocytos|s
- MuLaLlons ln Lhe ankyrln molecule wlLh a
secondary deflclency of specLrln along Lhe cell
membrane
8educed red cell sLablllLy
- uoes noL affecL oxygen carrylng capaclLy
- Splenlc sequesLraLlon
S|ck|e ce|| anem|a
- uefecLlve form of hemoglobln LhaL forces
red blood cells Lo assume an abnormal crescenL
(slckle) shape
MuLaLlon for Lhe gene codlng for Lhe
globulln chaln
- vallne ls subsLlLuLed for gluLamlc acld
PbS
- 8ed cells dle premaLurely resulLlng ln a
chronlc shorLage of red blood cells
8lock blood flow Lhrough small blood vessels ln
Lhe body produclng oLher ofLen palnful
sympLoms
1ha|assem|a
Common ln Aslans
ueleLlon of globulln chaln locl
4 posslble degrees of Lhalassemla
SllenL carrler loss of a slngle globulln gene
Lhalassemla LralL loss of a palr of globulln
gene
PbP dlsease only a slngle gene ls presenL
Pydrops feLalls deleLlon of all globulln
9o|ycythem|a Vera
- An acqulred dlsorder of Lhe bone marrow
LhaL causes Lhe overproducLlon of all Lhree blood
cell llnes
whlLe blood cells red blood cells and
plaLeleLs
- lL ls a rare dlsease LhaL occurs more
frequenLly ln men Lhan women and rarely ln
paLlenLs under 40 years old
- causes ls unknown
- usually develops slowly and mosL paLlenLs
are asymLomaLlc
abnormal bone marrow cells prollferaLe
unconLrollably leadlng Lo acuLe myelogenous
leukemla
- aLlenLs have an lncreased Lendency Lo form
blood cloLs LhaL can resulL ln sLrokes or hearL
aLLacks
Some paLlenLs may experlence abnormal
bleedlng because Lhelr plaLeleLs are abnormal
Symptoms
- Peadache
- ulzzlness
- rurlLus
- lullness ln Lhe lefL upper abdomen
- LryLhema (face)
- ShorLness of breaLh
- CrLhopnea
O SympLoms of phleblLls

Wh|te 8|ood Ce||s
- CollecLlvely known as WhlLe 8lood Cells
(W8C)
- lormed elemenLs of Lhe blood wlLh
organelles and a nucleus buL lack hemoglobln
- roLecL Lhe body agalnsL mlcroorganlsms
and remove dead cells and debrls from Lhe body

W8C D|sorders
- Leukopenla
uecreased perlpheral whlLe cell counL due Lo
decrease numbers of any speclflc Lypes of
leukocyLes
- LeukocyLosls
nonneoplasLlc elevaLlon of W8C counL
Neutropen|a
- 8educLlon ln Lhe number of granulocyLes
(1300/l)
- lncreased rlsk of lnfecLlon
8educed phagocyLosls response
- uecreased or defecLlve granulopolesls
AplasLlc anemla
AnLlneoplasLlc agenLs
CLher drugs chloramphenlcol sulfonamldes
chlorpromazlne
- AcceleraLed removal or desLrucLlon
Aggresslve and chronlc lnfecLlons
Man|festat|on of Neutropen|a
- lnfecLlons
Slgns and SympLoms
- Malalse chllls fever
- ulceraLlve necroLlzlng leslons of Lhe mouLh
skln vaglna and Cl LracL
keact|ve Leukocytos|s
- lncrease number of W8C
- Common reacLlon due Lo a varleLy of
lnflammaLory sLaLes caused by mlcroblal or non
mlcroblal sLlmull
- usually nonspeclflc

Neop|ast|c 9ro||ferat|on of Wh|te Ce||s
1 Leukemla neolplasms of Lhe
hemaLopoleLlc sLem cells
2 MallgnanL lymphomas coheslve Lumor
leslons neoplasLlc lymphocyLes
3 lasma cell dyscraslas arlslng from Lhe
bones locallzed dlssemlnaLed prollferaLlon
of anLlbody formlng cells
4 PlsLocyLoses prollferaLlve leslons of
hlsLlocyLes
Leukem|a
- MallgnanL neoplasm of Lhe hemaLopleLlc
sLem cells
- 8M replaced by unregulaLed prollferaLlng
lmmaLure neoplasLlc cells blood leukemla
enLer spleen lymph nodes
- MosL common cancer ln Lhe paedlaLrlc age
- Leadlng cause of deaLh ln chlldren beLween
3 and 14 years old

C|ass|f|cat|on of Leukem|a
A Accordlng Lo cell Lype and sLaLe of cell
maLurlLy
- LymphocyLlc lmmaLure lymphocyLes and
Lhelr progenaLors
- MyelocyLlc plurlpoLenL myelold sLem cells
and lnLerferes wlLh maLuraLlon of all granulocyLes
88C and plaLeleLs
8 AcuLe or Chronlc
- AcuLe lmmaLure cells (blasL)
- Chronlc well dlfferenLlaLed leukocyLes
Acute Leukem|a (Ce|| k|net|c Stud|es)
- 8lock ln Lhe dlfferenLlaLlon of leukemlc cells
wlLh prolonged genraLlon Llme clonal expanslon
of Lhe Lransformed sLem cells + fallure of
maLuraLlon accumu|at|on of |eukem|c b|ast
suppress normal hemaLopoleLlc sLem cells
leaLures
- Sudden onseL (3 monLhs)
- uepressed marrow funcLlon
- 8one paln and Lenderness
- Cenerallzed lymphadenophaLy
- Splenomegaly hepaLomegaly
- CnS headache vomlLlng
Acute Lymphocyt|c Leukem|a (ALL)
- MosL common leukemla ln chlldren (80)
- 1reaLable and poLenLlally curable
- Classlfled accordlng Lo lymphocyLes and
sLaLe of maLuraLlon
1 Larly 8 cell
2 re8 cell
3 MaLure 8 cell
4 Larly 1 cell
3 MaLure 1 cell
Acute Non|ymphocyt|c Leukem|a (ANLL)
- MosL common ln adulLs 30 60years old
- 70 of adulLs wlll enLer remlsslon wlLh
lnducLlon chemo
1 2333 of Lhose ln remlsslon wlll have a 3
year survlval raLe
8M LransplanL
1reaLmenL
- SelecLlve radlaLlon
- ChemoLherapy
1 lnducLlon
2 lnLenslflcaLlon
3 MalnLenance and consolldaLlon
8one marrow LransplanL
Acute Mye|ocyt|c Leukem|a (AML)
1reaLmenL
- SelecLlve radlaLlon
- ChemoLherapy
1 lnducLlon
2 lnLenslflcaLlon
3 MalnLenance and consolldaLlon
- 8one marrow LransplanL
Chron|c Leukem|a
- lnsldlous onseL
- lncldenLal flndlngs durlng rouLlne exam
Chron|c Lymphocyt|c Leukem|a
- rollferaLlon and accumulaLlon of maLure
lymphocyLes whlch are lmmunologlcally
lncompeLenL
8 cell llne (uS)
1 cell llne (Asla)
- Palry cell leukemla
Chron|c Mye|ocyt|c Leukem|a
- 13 of all leukemlas
- Chromosomal abnormallLy (h1)
- MosLly 8 cell dlsease
LeukocyLosls
Splenomegaly
PepaLomegaly
LympadenopaLhy
- 8one marrow LransplanL 3 year survlval for
3073 of paLlenLs
1wo d|st|nct phases
- Chronlc
LasL abouL 34 years
near end acceleraLed phase fever nlghL
sweaLs malalse
- AcuLe
24 monLhs
oor prognosls palllaLlve managemenL
Ma||gnant Lymphomas
- rlmary solld Lumors of Lhe lymphold sysLem
- Cancers lnvolvlng lymphocyLes durlng
maLuraLlon or sLorage ln Lhe bone marrow
- 1hlrd mosL common mallgnancy ln chlldren
nodgk|n's Lymphoma
- ulsorders prlmarlly lnvolvlng Lhe lymphold
Llssues
- AnaLomlcal spread
- Morphologlcal presence of keeJ5tetobetq
cells
- 6090 cure raLe
Man|festat|ons of nodgk|n's
- A sympLoms
alnless progresslve enlargemenL of a slngle
or group of nodes (neck)
May spread conLlnuously LhroughouL Lhe
lymphaLlc sysLem
- 8 sympLoms
lever nlghL sweaL welghL loss
laLlgue anemla
1reaLmenL for Podgkln's
- 8adlaLlon
- ChemoLherapy
Nonnodgk|n's Lymphoma
- lnvolves lymphold Llssue and may spread Lo
varlous Llssues
- MosLly 8 cell (80)
- Cause may be vlral or geneLlc
L8v
lmmunosuppresed paLlenLs
- AluS
- AfLer organ LransplanL
1reaLmenL
- Larly sLage radlaLlon
- LaLe sLage chemo and radlaLlon
- 8M LransplanL