Bệnh bạch cầu không ác tính

BỆNH BẠCH CẦU
KHÔNG
 ÁC
 TÍNH
 


WHITE
 BLOOD
 CELLS
 


Monocytes
 (BC
 đơn
 nhân)
 

 

•  have
 a
 longer
 lifespan
 than
 many
 white
 blood
 
cells

 
•  help
 to
 break
 down
 bacteria.
 
•  Size:
 12-­‐15
 um
 
•  #
 5.3%
 blood
 

 

 


Neutrophils
 (BC
 trung
 Bnh)
 
• 
• 
• 
• 

• 

 

kill
 and
 digest
 bacteria
 and
 fungi.
 
 
the
 most
 numerous
 type
 of
 white
 blood
 cell
 
first
 line
 of
 defense
 when
 infecMon
 strikes.
 
Size:

 10-­‐12
 um
 
#
 62%
 blood
 


Lymphocytes
 
 
•  create
 anMbodies
 to
 defend
 against
 bacteria,
 
viruses,
 and
 other
 potenMally
 harmful
 
invaders
 
•  Size:
 7-­‐8
 um

 or
 12-­‐15um
 
•  #30%
 blood
 


Basophils
 (BC
 ưa
 kiềm)
 
•  small
 cells
 appear
 to
 sound
 an
 alarm
 when
 
infecMous
 agents
 invade
 your
 blood.
 
 
•  secrete

 chemicals
 such
 as
 histamine,
 a
 marker
 
of
 allergic
 disease,
 that
 help
 control
 the
 body's
 
immune
 response.
 
•  Size:
 12-­‐15um
 
•  #0.4%
 blood
 

 


Eosinophils

 (BC
 ưa
 acid)
 
• 
• 
• 
• 

AVack
 and
 kill
 parasites,
 destroy
 cancer
 cells,
 
Help
 with
 allergic
 responses.
 
Size:
 10-­‐12um
 
#
 2.3%
 blood
 

WBC
 count
 
•  people
 produce
 about
 100
 billion
 white
 blood
 
cells
 a
 day
 
•  The
 total
 white
 blood
 cell
 count
 normally
 
ranges
 between
 4,000
 and
 11,000
 cells

 /
 
microliter
 


WBC
 disorder
 
•  Too
 few
 or
 too
 many
 white
 blood
 cells
 
indicates
 a
 disorder
 
•  Leukopenia:
 
–  WBC<
 4,000
 cells
 /microliter
 of
 blood,

 
 
–  people
 more
 suscepMble
 to
 infecMons.
 
 

•  Leukocytosis:
 
 
–  WBC>11,000
 cells
 /
 microliter
 of
 blood
 
–  Disrupt
 cell
 development
 –
 release
 abnormal
 cell.
 
 

Leukocytosis (Ác tính)
•  Leukocytosis
 is
 a
 condiMon
 characterized
 by
 an
 
elevated
 number
 of
 white
 cells
 in
 the
 blood,
 
which
 is
 usually
 due
 to:
 
•  Bacterial
 infecMon
 such
 as
 appendiciMs,

 tonsilliMs,
 ulcers
 
and
 urinary
 tract
 infecMon
 
•  Leukemia.
 
•  Pregnancy.
 
•  HemolyMc
 disease
 of
 new
 born.
 
•  Following
 exercise.
 
•  EmoMonal
 stress.
 
•  Food
 intake.
 


Leukopenia (Không ác tính)

 

•  Leukopenia
 is
 a
 condiMon
 characterized
 by
 a
 
decreased
 number
 of
 white
 cells
 in
 the
 blood,
 
which
 is
 usually
 due
 to:
 

•  Viral
 disease
 such

 as
 measles
 and
 infecMous
 
hepaMMs.
 
•  Some
 bacterial
 infecMons
 such
 as
 typhoid
 fever,
 
brucellosis,
 and
 typhus
 fever.
 
•  Rheumatoid
 arthriMs.
 
•  Systemic
 Lupus
 Erythematosis.
 
•  Certain
 drugs
 such

 as
 radio
 therapy
 and
 
chemotherapy.
 


Leukopenia - ClassificaMon
 

•  Neutropenia
 

 
•  Lymphocytopenia
 


Lymphocytopenia
 
•  Acquired
 
 

–  AIDS
 
–  Other
 infecMous

 disorders,
 including
 hepaMMs,
 influenza,
 
TB,
 typhoid
 fever,
 and
 sepsis
 
–  drugs,
 or
 autoimmune
 disorders
 
 

•  Hereditary


 
 

–  Aplasia
 of
 lymphopoieMc
 stem
 cells
 

–  Idiopathic
 CD4+
 T
 lymphocytopenia
 
–  Immunodeficiency
 with
 thymoma
 
–  Severe
 combined
 immunodeficiency
 associated
 with
 a
 
defect
 in
 the
 IL-­‐2
 receptor
 γ-­‐chain,
 deficiency
 of
 ADA
 or
 
PNP,
 or
 an

 unknown
 defect
 


Lymphocytopenia-­‐
 Diagnosis
 
•  Clinical
 suspicion
 (repeated
 or
 unusual
 
infecMons)
 
•  CBC
 with
 differenMal
 
•  Measurement
 of
 lymphocyte
 subpopulaMons
 
and
 immunoglobulin
 levels
 

Lymphocytopenia-­‐
 Treatment
 
• 
• 
• 
• 

Treatment
 of
 associated
 infecMons
 
Treatment
 of
 underlying
 disorder
 
SomeMmes
 IV
 immune
 globulin
 
Possibly
 hematopoieMc
 stem
 cell
 
transplantaMon

 


Neutropenia
 
•  ReducMon
 in
 blood
 neutrophil
 count.
 May
 have
 
no
 symptom.
 
•  occur
 in
 viral
 infecMons
 such
 as
 influenza,
 
bacterial
 infecMons
 such
 as
 tuberculosis,
 

myelofibrosis,
 or
 deficiencies
 of
 vitamin
 B12
 or
 
folate
 (folic
 acid).
 
•  received
 radiaMon
 therapy.
 
•  drugs
 (phenytoin,
 chloramphenicol,
 sulfa
 drugs)
 
•  drugs
 used
 in
 cancer
 treatment
 
(chemotherapy),toxins
 (benzene

 and
 insecMcides)
 


Neutropenia- Diagnosis
 
•  Clinical
 suspicion
 (repeated
 or
 unusual
 
infecMons)
 
•  Confirmatory
 CBC
 with
 differenMal
 
•  EvaluaMon
 for
 infecMon
 with
 cultures
 and
 
imaging
 
•  IdenMficaMon

 of
 mechanism
 and
 cause
 of
 
neutropenia
 


Neutropenia- Treatment
 
•  Treatment
 of
 associated
 condiMons
 (eg,
 
infecMons)
 
•  SomeMmes
 anMbioMc
 
 
•  Myeloid
 growth
 factors
 
•  DisconMnuaMon
 of

 suspected
 eMologic
 agent
 
(eg,
 drug)
 
•  SomeMmes
 corMcosteroids