Leukemia

What Is Leukemia?
• Cancer of the white blood cells
• Acute or Chronic
• Affects ability to produce normal blood
cells
• Bone marrow makes abnormally large
number of immature white blood cells
called blasts
 Symptoms
• When there are excessive white blood
cells --> Infections
• When there are few red blood cells:
Paleness --> Anemia
• When there are few platelets -->
Excessive bleeding
 Pictures Of Blood
Platelet Platelet
White Cell Red Cell Red Cell Blasts
White Cell

Normal human blood Blood with leukemia

Sources from beyond2000.com
Sources from Arginine.umdnj.edu
 Classification
• Classified based on cell type involved
and the clinical course
• 1. Acute :
• ALL
• AML

2. Chronic :
• CLL
• CML
Subclassification
• ALL
– Common type(
pre-B)
– B-cell
– T-cell
– Undifferentiated
AML
French-American-British (FAB) Classification

M0: Minimally differentiated leukemia

M1: Myeloblastic leukemia without maturation
M2: Myeloblastic leukemia with maturation
M3: Hypergranular promyelocytic leukemia
M4Eo: Variant: Increase in abnormal marrow
eosinophils
M4: Myelomonocytic leukemia
M5: Monocytic leukemia
M6: Erythroleukemia (DiGuglielmo's disease)
M7: Megakaryoblastic leukemia
Ref-Harrison’s Principle of Internal Medicine
• CLL
– B-cell: common
– T-cell: rare
• CML
AML
CML
Normal Peripheral Smear
Echinocytes (“burr cells”)
Iron Deficiency Anemia
Folate Deficiency
Thalassemia
Sickle Cell Anemia
Spherocytosis
TTP / HUS – microangiopathic hemolysis
with schistocytes
Malaria
hematopoiesis
Eritropoiesis
Mielopoiesis
Case #