Klasifikasi LLA berdasar FAB ( France, American, British) .... L-1 : sel limfoblas kecil serupa, kromatin homogen, anak inti umumnya tidak tampak, sitoplasma sempitL-2 : sel limfoblas lebih besar dg ukuran bervariasi, kromatin lebih kasar dg satu atau lebih anak intiL-3 : sel limfoblas besar, homogen dg kromatin berbercak, banyak anak inti, sitoplasma basofilik, vakuolisasi

FAB Classification of ALL

L1: Small homogeneous blasts; mostly in childrenL2: Large heterogeneous blasts; mostly in adultsL3: Burkitt large basophilic B-cell blasts with vacuoles

Klasifikasi Leukemia Mieloblastik Akut (LMA) FAB (1976) M0 -- Undifferentiated AMLM1 -- AML without maturationM2 -- AML with maturationM3 -- Acute Promyelocytic LeukemiaM4 -- Acute Meylomonocytic LeukemiaM5 -- Acute Monocytic LeukemiaM6 -- Erythroleukemia (DiGuglielmos)M7 -- Megakaryoblastic Leukemia

Klasifikasi LMA (FAB 1976)M-0 : LMA dengan diferensiasi minimalM-1 : LMA tanpa maturasiM-2 : LMA dengan maturasiM-3 : leukemia promielositik hipergranularM-4 : leukemia mielomonositik akutM-5 : leukemia monositik akutM-6 : leukemia eritroblastikM-7 : leukemia megakarisitik akut

LeukemiaThe Intimate EnemyBrought to you byThe White Blood CellsAaron AllisonWind HendersonStephanie MookasVicmar MedinaAcute Myeloid Leukemia cell

Leukemia..Is the cancer of the white blood cells (leukocytes)Was named by Rudolf Virchow in 1887.A healthy WBCHairy Cell Leukemia(a chronic leukemia)

Mechanisms of the 4 primary classifications of Leukemia

Acute Lymphocytic Leukemia: Results from an excess of lymphocytes, primarily in children.Chronic Lymphocytic Leukemia: Results from an excess of lymphocytes, primarily in adults.Acute Myelogenous Leukemia: Cancerous cells in the blood and bone marrow that reproduce and spread rapidly.Chronic Myelogenous Leukemia: A chromosomal defect produces an abnormal enzyme triggering an overabundance of white blood cells.

SymptomsFever, chills, and other flu-like symptomsWeakness and fatigueFrequent infectionsLoss of appetite and/or weightSwollen lymph nodes, liver, or spleen

SymptomsHeadaches, vomiting, seizuresConfusion, loss of motor controlSwollen testiclesBone or joint painEasy bleeding or briusing

TreatmentsChemotherapyRadiation therapyBone Marrow Transplant (BMT)Biological therapy

ChemotherapyChemotherapy is the use of drugs to kill cancer cells.Most often given through an IV.Drugs do not reach cells in the CNS due to the blood-brain barrier.To reach leukemia cells in the CNS, must use intrathecal chemotherapy.Chemotherapy is given in cycles.Side effects:Healthy cells can be damaged (hair, blood cells, cells in digestive tract).May lower resistance to infection.Loss of hair.Mouth soresNauseaMay also affect a patients fertility.

Radiation therapyRadiation therapy uses high-energy rays to damage cancer cells and stop them from growing.Used along with chemotherapy.May be given in two ways:To one specific area where there is a collection of leukemia cells.Radiation that is directed at the whole body.Side effects:May become very tired.Can cause skin to become itchy, tender, or dry.May cause nausea, vomiting, and loss of appetite.In treatment to the brain, side effects may be permanent.Children my develop learning and coordination problems.

Biological therapyInvolves treatment with substances that affect the immune systems response to cancerInterferon is a form of biological therapy that is used against some types of Leukemia.

BMT The patients leukemia-producing bone marrow is destroyed by high doses of drugs and radiation then replaced by healthy bone marrow.

Whos at risk of developing Leukemia?EveryoneMenWomenChildren

New cases (2002)Acute Lymphocytic Leukemia (ALL)3,800

Chronic Lymphocytic Leukemia (CLL)7,000Acute Myelogenous Leukemia (AML)10,600Chronic Myelogenous Leukemia (CML)4,400Other unclassified forms of Leukemia5,000

Present StatisticsRisk FactorsExposure to benzene in the workplace.Exposure to extraordinary doses of irradiation.

About 170,000 people within the U.S. living with LeukemiaAbout 21,700 deaths within the U.S. will be attributed to Leukemia.

Survival RatesMortality rates 200212,100 males9,600 femalesTotal 21,700672 children