Muhammed’s Spleen is Palpable

Muhammed’s Spleen is Palpable

1. Epidemiology

   • BY RACE & ETHNICITY
     • White people
   • BY AGE GROUP
     • 65-74
   • % surviving 5 years
     • 61.4%

2. Leukocytosis Vs Leukemia

   • both have High WBC count
     • Leukemia
       • Caused by genetic mutations
       • More severe
         • WBCs don’t function properly
       • Always pathological
     • Leukocytosis
       • Caused by infections
       • pathological or physiological effects
       • Less severe
         • WBCs function normally

3. pharmacology

   • Imatinib
     • Action
       • inihibiting tyrosine kinase enzyme
     • Side effects
       • nausea/vomiting/diarrhea
         • edema/skin rash
     • Administration
       • given orally and metabolized by CYP3A4
   • Dasatinib & Nilotinib
     • Administration
       • orally
     • Action
       • inihibiting tyrosine kinase enzyme
     • Used in
       • ALL
       • CML

4. high WBC count over 11,000 cells/mm3

   • Only one type of WBC is affected
     • Basophils
       • may occur in people with a history of underactive thyroid disease, known as hypothyroidism.
     • Monocytes
       • indicate the presence of chronic infection, an autoimmune or blood disorder, cancer.
     • Lymphocytes
       • lymphocytic leukocytosis. It may also be linked to specific lymphomas and leukemias.
     • Neutrophils
       • neutrophilic leukocytosis: This condition is a normal immune response, such as infection, injury,, some
     • Eosinophils
       • If a person registers high levels of eosinophils, the body might be reacting to a parasitic infection, allergen, or asthma
   • Causes
     • Allergy
     • Drugs
     • Polycythemia vera
     • Leukemia
     • Stress

5. Leukemoid Reaction

   • Normal response & subsides after eliminating the stressor
     • WBC count 15,000-100,00 cells/mm3.
     • Dohle bodies
     • High NAP/LAP scores
     • Toxic granulations

6. Genetic tests

   • PCR
     • using a blood sample or bone marrow cells To find the BCR-ABL fusion gene
   • (FISH)
     • FISH can be used to look for specific pieces of the BCRABL gene on chromosomes.

7. Types of leukemia

   • ACUTE leukemia
     • > 20% blasts in bone marrow
       • MYELOID
         • AML
           • gum infiltrates
           • Auer rods
           • 15-60yrs
       • LYMPHOID
         • ALL
           • newborns-14yrs
           • B-ALL is more common
           • Dense chromatin is found in mature cells
   • CHRONIC leukemia
     • < 20% blasts in bone marrow
       • MYELOID
         • CML
           • 25-60 yrs
           • Philadelphia chromosome
           • Splenomegaly
             • Causes
               • Cirrhosis
               • Cystic fibrosis
               • Cytomegalovirus
               • Lymphoma
             • Symptoms
               • Anemiaؤ
               • Fatigue
               • Frequent infections
           • Basophilia
       • LYMPHOID
         • CLL
           • common in adults
           • Asymptomatic
           • smudge cells

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