PRESENTATION ON
LEUKEMIA
Leukemia
2017
Leukaemia
• Leukaemia is a cancer which starts in
blood-forming tissue, usually the
bone marrow.
• It leads to the over-production of
abnormal white blood cells, the part of
the immune system which defends
the body against infection.
DEFINITION
• It is a malignant proliferation
precursors by the bone marrow.
It results in the uncontrolled
production of leukocyte (WBC)
History Leukaemia
• Leukaemia (from the Greek
leukos - white, and haima - blood)
is a type of cancer of the blood or
bone marrow characterized by an
abnormal increase of white blood
cells.
CAUSES
• Unknown
• Radiation (Ionizing): X-ray,
Radioactive isotopes: Ionizing
radiation can cause changes in the
chemical balance of cells. Some of
those changes can result in cancer.
• Genetics
• Chemical substances.
RISK FACTORS
• Chromosomal abnormalities have a
greater risk of leukemia.
• Down syndrome have a significantly
increased risk of developing forms of
acute leukemia and
• Anemia is a risk factor for developing
acute myeloid leukemia.
Normal blood cells
Blood cells are
formed in the
bone marrow,
the spongy
tissue found
inside the bones.
Normal blood cells
physiology
• Blood cells form in the bone marrow. Bone
marrow is the soft material in the center of
most bones.
• Immature blood cells are called stem cells
and blasts.
• Most blood cells mature in the bone marrow
and then move into the blood vessels.
Normal blood cells production
Normal blood cells
physiology
• Blood that flows through the blood vessels
and heart is called the peripheral blood.
• The bone marrow makes different types of
blood cells.
• Each type has a special function
PATHOPHYSIOLOGY
Normally, cells grow and divide
to form new cells as the body
needs them.
When cells grow old, they die,
and new cells take their place.
Condit..
• Sometimes this orderly process goes
wrong.
• New cells form when the body does
not need them, and old cells do not
die when they should.
• Leukemia is cancer that begins in
blood cells.
Condit..
• In leukemia there is a failure of cell maturation
which leads to an increasing accumulation of
useless cells which take up more and more
marrow space at the expense of the normal
haemopoietic elements.
• Eventually this proliferation spills into the
blood.
Types
• Acute lymphoblastic leukemia(ALL)
It is the most common type of
leukemia in young children.
• Acute myeloid leukemia (AML)
It occurs in both adults and children.
Types
• Chronic lymphoblastic leukemia( CLL)
Occurs between age 45 years with a peak
at 65 years. It almost never affects children.
• Chronic myeloid leukemia (CML).
Occurs between age 30-80 years with a
peak at 55 years
Clinical feature
• Features of anemia:
• Fatigue
• Pallor
• Palpation
• Tachycardia
• Dyspnoea
• Features of infections: fever, sore throat,
Clinical feature
• Gum
bleeding
• Mouth ulcer
Clinical feature
• Bleeding
manifestation
bleeding from
nose ( epistaxis)
• Bleeding from
nose
Clinical feature
• Purpura
Clinical feature
• Hematoma
Clinical feature
Swollen lymph
nodes, especially
in the neck or
arm.
Clinical feature
• Hepato-splenomegaly
Investigations
• Blood count CBC :
WBC : very high level of immature white blood cells.
Below 1 lack/m3
Hb: Reduced
Platelets : Usually thrombocytopenia
• Bone marrow aspiration
• .
Investigations
• Biopsy—Removes some bone marrow
from the hipbone or another large sternal
angle bone.
• The removal of tissue to look for cancer
cells is called a biopsy
MANAGEMENT
• Chemotherapy
• Radiotherapy
• Stem cell transplantation
• Blood transfusion
• Bone marrow transplantation
• Antibiotics are used to control infection
• Alpha interferon is given I/M or S/C
daily.
• Splenectomy
Blood cells:
• These cells fight infection, help the blood
to clot, and carry oxygen to all parts of the
body.
• When blood cells are affected, patients are
more likely to get infections, may bruise or
bleed easily, and may feel very weak and
tired.
Contd..
• Cells in hair roots: Chemotherapy can
lead to hair loss. The hair grows back, but
the new hair may be somewhat different in
color and texture.
• Cells that line the digestive tract:
Chemotherapy can cause mouth and lip
sores, nausea and vomiting, diarrhea, and
poor appetite. Many of these side effects
can be controlled with drugs.
Stem cell transplantation
• Patients who have stem cell transplantation
face an increased risk of infection, bleeding,
• In addition, graft-versus-host disease
(GVHD) may occur in patients who receive
stem cells from a donor's bone marrow.
• In GVHD, the donated stem cells react
against the patient's tissues.
• Most often, the liver, skin, or digestive tract
is affected.
Radiation therapy
• Radiation therapy may cause patients to
become very tired as treatment continues.
• In addition, when patients receive radiation
therapy, it is common for their skin to become
red, dry, and tender in the treated area.
Prognosis
• Patients treated conventionally have a
15% risk of death in the first 12th months,
and thereafter an annual risk of 20-25%.
• Median survival is about 45 months with
chmotheraphy, but 65 months with
interferon.
Health education
• Ensure that patients and their families have
a clear understanding of disease and
prognosis.
• Teach family members about home care
while patient is still in hospital.
• Respect patient’s choice about treatment.
• Give patient and caregiver assistance to
cope with changes in their roles and
responsibilities.
Chemotherapy :
• Hydroxycarbamide is currently the most
widely used oral agent.
• Major form of treatment is Chemotherapy.
Combination of :
1. Vincristine(10-30mcg/kg of the body
weight a week as a single dose),
2. Prednisolone(10-15mg od)
3. L-Asparaginase for initial therapy
REFERENCES
• Jameson, J.,& Dennis L. K.,(2005).
Harrison's principles of internal medicine.
New York: McGraw-Hill Medical Publishing
Division. ISBN 0-07-140235-7.
• http://en.wikipedia.org/wiki/Leukemia
