Clinical laboratory Clinical laboratory diagnostics of diagnostics of hemoblastosishemoblastosis

Leukemia definitionLeukemia definition

LeukemiaLeukemia – – it is tumor it is tumor arisingarising from from bloodforming cells and bloodforming cells and primary lesionprimary lesion bone bone marrowmarrow

Classification of leukemiasClassification of leukemias

Acute leukemiasAcute leukemias myeloblasticmyeloblastic lymphoblasticlymphoblastic

ChronicalChronical leukemiasleukemias myeloidmyeloid lynphoidlynphoid

AcuteAcute myeloblasticmyeloblastic leukemiasleukemias

UndifferentiatedUndifferentiatedMyeloblasticMyeloblastic withoutwithout maturingmaturingMyeloblasticMyeloblastic withwith maturingmaturing PromyelocyticPromyelocyticMyelomonoblasticMyelomonoblasticMonoblasticMonoblasticErythroblasticErythroblasticMegacaryoblasticMegacaryoblastic

HistochemicalHistochemical signssigns of of differentiation ofdifferentiation of acute acute

leukemiasleukemias1. 1. Reaction for peroxidaseReaction for peroxidase 2. 2. Reaction for acidity phosphataseReaction for acidity phosphatase3. 3. Reaction for uncpecificReaction for uncpecific esterasesesterases4. 4. Reaction for lipidesReaction for lipides5. 5. Reaction for Reaction for compoudcompoud

carbohydratescarbohydrates

Causes of development of Causes of development of iron-deficiency states:iron-deficiency states:

Blood lossBlood loss VegetariansVegetarians Prolonged achlorhydriaProlonged achlorhydria Extensive surgical removal of the proximal Extensive surgical removal of the proximal

small bowel or chronic diseases, such as small bowel or chronic diseases, such as pancreatitis, enteritis. pancreatitis, enteritis.

Increased iron requirement:Increased iron requirement:

From birth to age 2 and during From birth to age 2 and during adolescence adolescence

During pregnancyDuring pregnancy and lactationand lactation

ReactionReaction of myeloblastesof myeloblastes andand other of neutrophil cellsother of neutrophil cells for for

peroxidase peroxidase

Reaction of monoblastesReaction of monoblastes forfor αα--naphtylacetateestherasenaphtylacetateestherase

Reaction of myeloblastes and Reaction of myeloblastes and monoblastesmonoblastes forfor acidityacidity

phosphatasephosphatase

Acute lymphoblasticAcute lymphoblastic leukemialeukemia - - bloodblood

AcuteAcute В- В-lymphoblastosislymphoblastosis – – bone bone marrowmarrow

BigBig vacuolizedvacuolized lymphoblasteslymphoblastes

Laboratory methodsLaboratory methods

The World Health Organization's The World Health Organization's criterion for anemia in adults is criterion for anemia in adults is Hb values less than 12.5 g/dL. Hb values less than 12.5 g/dL.

Usually, US values are slightly Usually, US values are slightly higher. Anemia is suggested in higher. Anemia is suggested in males with Hb levels less than males with Hb levels less than 13.5 g/dL and in females with Hb 13.5 g/dL and in females with Hb levels less than 12.5 g/dL.levels less than 12.5 g/dL.

Acute lymphoblasticAcute lymphoblastic leukemialeukemia – – bone marrrowbone marrrow

Acute lymphoblasticAcute lymphoblastic leukemialeukemia – – bone marrrow. Initial stagebone marrrow. Initial stage. .

Acute lymphoblastosisAcute lymphoblastosis – – bone bone marrow.marrow. TotalTotal lymphoblasticlymphoblastic

metaplasiametaplasia

Chronic myelogenous (or myeloid) Chronic myelogenous (or myeloid) leukemia (CML), also known as leukemia (CML), also known as chronic granulocytic leukemia (CGL), chronic granulocytic leukemia (CGL), is a cancer of the white blood cells. It is a cancer of the white blood cells. It is a form of leukemia characterized by is a form of leukemia characterized by the increased and unregulated growth the increased and unregulated growth of predominantly myeloid cells in the of predominantly myeloid cells in the bone marrow and the accumulation of bone marrow and the accumulation of these cells in the blood. these cells in the blood.

ChronicalChronical myeloidmyeloid leukemiasleukemias

MyelocyticMyelocytic MonocyticMonocytic EosinophilicEosinophilic ErythroblasticErythroblastic MegacaryocyticMegacaryocytic

ChronicalChronical myelocytic leukemiamyelocytic leukemia – – bloodblood. . ChronicalChronical phasephase

ChronicalChronical myelocytic leukemiamyelocytic leukemia – – bloodblood..

ChronicalChronical myelocytic leukemiamyelocytic leukemia – – bloodblood

Stage of blastic crisisStage of blastic crisis

Chronical lymphoidChronical lymphoid leukemiasleukemias

В-В-lymphocyticlymphocytic Т- Т- lymphocyticlymphocytic (1,5 %) (1,5 %) HaircellHaircell

ChronicalChronical В- В-cellcell lymphocyticlymphocytic leukemialeukemia - - bloodblood

ChronicalChronical lymphocyticlymphocytic leukemialeukemia – – blood. Gumprecht’s bodies.blood. Gumprecht’s bodies.

ChronicalChronical lymphocyticlymphocytic leukemialeukemia – – bone marrowbone marrow. . TotalTotal lymphoidlymphoid

metaplasia.metaplasia.

ChronicalChronical lymphocyticlymphocytic leukemialeukemia – – bone marrowbone marrow. . TotalTotal lymphoidlymphoid

metaplasia.metaplasia.

Chronical haircell leukemiaChronical haircell leukemia - - bloodblood

Chronical haircell leukemiaChronical haircell leukemia - - bloodblood

Haircell leukemiaHaircell leukemia - - bloodblood. . Reaction forReaction for acidityacidity phosphatasephosphatase

Chronical monocytic leukemiaChronical monocytic leukemia - - bloodblood

Mechanisms of cellular Mechanisms of cellular oncogenes activatingoncogenes activating

Point mutationsPoint mutationsChromosomal abnormalitiesChromosomal abnormalitiesVirualVirual transductiontransductionInsertionInsertion mutagenesismutagenesisGenesGenes amplificationamplification

ClinicalClinical manifestation ofmanifestation of leukemialeukemia

Metaplastic anemiaMetaplastic anemiaThrombocytopeniaThrombocytopeniaHemorrhagicHemorrhagic syndromesyndromeSecondarySecondary

immunedeficiencyimmunedeficiencyDecreaseDecrease of resistanceof resistance

Thank for your Thank for your attention!attention!