Myeloid Leukemia Frequency at KAUH During 2008 - 2010
Myeloid Leukemia Frequency at KAUH During 2008 - 2010
DONE BY : LAYLA AL‐SHATTI
MONIA ZA`GAN SUPERVISED BY:
DR.TALAAT MIRZA DONE BY :
LAYLA AL‐SHATTI MONIA ZA`GAN SUPERVISED BY:
DR.TALAAT MIRZA
Contents
• Aim of study.
• Introduction.
• Materials and methods.
• Results.
• Conclusion.
Aim of Study
• To find out the frequency of myeloid
leukemia at KAUH during the years
2008 to 2010.
Introduction
• What is the leukemia?
leukemia is a type of cancer characterized by the accumulation of malignant blood cells in the bone
marrow and blood .
Continue
Lymphocytic Leukemia
•
Lymphocytic
leukemia develops from cells called
“lymphoblasts” in
the bone marrow.
Chronic Lymphocytic Leukemia
• CLL is neoplastic disease characterized by the accumulation of small, mature‐
appearing lymphocytes in the blood, marrow, and lymphoid tissue.
Lymphocytes.
Lymphocytes.
Acute Lymphocytic Leukemia
• ALL is neoplastic disease that result from
multistep somatic mutation in single lymphoid progenitor cell.
Myeloid Leukemia
Myeloid leukemia develops from cells called "myeloblasts"
in the bone marrow.
Chronic myeloid leukemia
• CML is a myeloproliferative disorder characterized by increased
proliferation of the granulocytic cell
line without the loss of their capacity
to differentiate.
Acute Myeloid Leukemia
• AML is a quickly
progressive malignant disease characterized by an increase in the number of immature cells in the bone
marrow accompanied
by an arrest in their
maturation.
Classification of AML
• According FAB subtypes the AML is classified to eight groups:
AML‐M0
AML‐M5 AML‐M6
AML‐M3 AML‐M2
AML‐M1
AML‐M4
AML‐M7
Worst treated Worst treated
Best treated Best treated
Pathophysiology
Incidence of Myeloid Leukemia
Signs and Symptoms
CML AML
•Appear gradually.
•Moderate symptoms.
•Appear gradually.
•Moderate symptoms.
•Occur s uddenly.
•Severe symptoms.
.
•Occur s uddenly.
•Severe symptoms.
.
Risk Factors
•The cause of myeloid leukemia is not known.
•There are some factors that may increase the risk of develop leukemia.
•Radiation
•Immunocompromise d individuals.
•Age and gender (older males).
•Antecedent
hematologic disorders.
•Congenital disorders.
•Environmental factors.
AMLAML CMLCML
Clinical Diagnosis
•CBC with differential.
• Bone marrow aspiration or biopsy.
•Cytogenetic studies such as FISH analysis and PCR test.
•Flowcytometry: expression of
leukemic markers. Specific to AML
Specific to CML
Treatment
The treatment of myeloid leukemia patients is based on the stage of leukemia and diagnostic test results.
There are several options for the treatment include:
Chemotherapy Drugs e.g.
anthracycline.
Leukapheresis.
Stem cells transplantation.
Materials and Methods
• This project is a retrospective analysis of the results of leukemia cases that were
diagnosed over 2 years in the university
hospital hematology lab by Phoenix program.
The results consisted of Complete blood count (CBC), bone marrow aspiration and
immunophenotyping by flow cytometry.
Materials and Methods
• Coulter Counter
The COULTER System is a quantitative, automated hematology analyzer for in vitro diagnostic use in
clinical laboratories. The
System provides automated CBC, leukocyte differential, and Reticulocyte analysis.
Materials and Methods
• Bone Marrow Aspiration and Bone Marrow Biopsy:
• The specimen is used to make several preparations on glass slides and is transferred to a fixative solution and stained with Wright‐Giemsa stain,
hematoxylin‐eosin, or Prussian blue stains, then examine by oncologist .
Materials and Methods
*Flow Cytometers:
It is multi‐parameter analysis of cells as they pass through
a beam of laser light.
Materials and Methods
Panel of Acute Leukemia:
The CD marker that used in this panel were
CD 34
& 117 CD 34
& 117
CD15CD15 CD13
&14 CD13
&14 CD38CD38
CD33CD33 CD64CD64
CD45
&71 CD45
&71
CD56
&11b CD56
&11b Myeloid progenitor
Myeloid progenitor
Neutrophils, Eosinophils, Monocytes
Neutrophils, Eosinophils, Monocytes
Hematopoietic progenitors Hematopoietic
progenitors
Early B and T cells Early B and T cells
NK cells NK cells
Monocytes and macrophages Monocytes and
macrophages
Myelomonocytic cells Myelomonocytic cells
Leukocytes.
Leukocytes.
Results
Patient # 1
A 12 Y/O female patient, she was diagnosed as AML-M5.
The following results shows WBCs count pre- post
chemotherapy, bone marrow aspiration, and CD marker in pre chemotherapy:
Results
Bone Marrow Aspiration:
•The marrow is a particulate but hypercellular trails are seen.
•The three hemopoietic cell lineages are
grossly suppressed and replaced by sheets of immature looking mononuclear's, which
on flow analysis were shown to be monocytic in nature.
Results
Flow Cytometry Result:
Incidence of Myeloid Leukemia
According to Gender
Incidence of Myeloid Leukemia
According to Gender
Frequency of Myeloid Leukemia According to Type
‐ Sub
Mortality
Incidence of CML According to Age
Age 0‐9 10‐19 20‐29 30‐39 40‐49 50‐90
Male 1 0 1 0 0 1
Female 0 0 0 0 0 0
Incidence of AML According to Age
Age 0‐9 10‐19 20‐29 30‐39 40‐49 50‐90
Male 2 1 1 3 1 4
Female 1 2 2 1 0 1
Conclusion
• AML incidence was more than CML.
1‐ CML affects elderly people while AML affects all age groups of population.
2‐ CML at early stages is mild disease with
gradual symptoms. Some patients attribute symptoms to “old age” and ignore it.
• The occurrence of CML in males was more than females.
Conclusion
• The sample studied at KAUH contained a
limited number of cases. Most of cancer and leukemia cases are referred to KAHCC.
• Due to the relatively small number of cases, results cannot be generalized.
Recommendation
• A larger scale of this study is needed.
• All hospitals treating leukemia should be included.
Acknowledgement
• First and most off all, we are so ever thankful to
Allah all his mighty for the blessings he bestowed on us.
• We would like to express our great appreciation to our parents, family and friends for the support they showed us over the years.
• We are very thankful to Hematology lad staff and especially Mr. Mohammad Farwan for his support and assistance.
• We are thankful for Dr. Talaat Mirza for his supervision and guidance.
