慢性粒单核细胞白血病诊治进展
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grnulocytic proliferation an increase in erythroid precursors mild to moderate increase in the amount of reticulin fibres (30%)
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Immunohistochemistry on tissue sections
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Morphology (BM)
hypercellular in over 75% of wenku.baidu.comases
normalcellular and hypocellular also occur
dysgranulopoiesis, dyderythropoiesis, micromegakaryocytes and megakaryocytes with abnormally lobated nuclei (in up to 80% of patients)
1 CMML
2 Atipical CML, BCR-ABL1 negative
3 JMML
4 MDS/MPN, U (RARS-T, refractory
anemia with ringed sideroblasts associated with thrombocytosis)
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Definition
relatively insensitive as compared with cytochemistry or flow cytometry
CMML诊治进展
江苏省人民医院 血液科 洪鸣
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Contents
1 Definition 2 Diagnosis 3 Risk stratification 4 Therapeutic options
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Definition
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WHO Classification of MDS/MPN
monocytic proliferation can be difficult to appreciate (cytochemistry and immunohistochemistry)
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Abnormal monocytes have denser Monocytosis with morphologically chromatin, nuclear normal monocytes (PB) convolutions and folds and
(WHO classification of myeloid neoplasms)
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Diagnosis
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Clinical manifestation
• MDS-type
– Fatigue and dyspnea due to anemia – susceptibility to infections – rarely bleeding
The monocytes generally are mature, but can exhibit abnormal granulation or unusual nuclear lobation or chromatin patten. (abnormal monocytes)
Dysgranulopoiesis is present in most cases.
• MPN-type
– significant weight loss – drenching nigh sweats – left upper quadrant pain from significant
splenomegaly
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Morphology (PB)
PB monocytes usually range from 2 to 5 × 109/L, but may exceed 80 × 109/L.
granules and a stippled
nuclear chromatin.
CMML-1 (BM)
CMML-2(BM)
Representative peripheral blood and BM smears distinction between promonocytes 精a品n课d件abnormal monocytes may be
Immunophenotype
The PB and BM cells usually express CD33 and CD13, with variable expression of CD14, CD68, CD64.
An increased percentage of CD34+ cells has been associated with early transformation to acute leukemia.
a more grMoenoycyitseshwitchyntucolepalr aansdm. Cytoplasmic abnormalities (PB)
Promonocytes typically have
a light-gray cytoplasm with
a few lilac-colored
A clonal hematopoietic stem cell disorder that is characterized by the presence of an absolute monocytosis (>1×109/L) in the peripheral blood and the presence of myelodysplastic and myeloproliferative features in the bone marrow.
Occasionally, overexpression of CD56, aberrant expression of CD2, and decreased expression of HLA-DR, CD13, CD15, and CD36 may be observed.
精品课件
Histopathology
精品课件
Immunohistochemistry on tissue sections
精品课件
Morphology (BM)
hypercellular in over 75% of wenku.baidu.comases
normalcellular and hypocellular also occur
dysgranulopoiesis, dyderythropoiesis, micromegakaryocytes and megakaryocytes with abnormally lobated nuclei (in up to 80% of patients)
1 CMML
2 Atipical CML, BCR-ABL1 negative
3 JMML
4 MDS/MPN, U (RARS-T, refractory
anemia with ringed sideroblasts associated with thrombocytosis)
精品课件
Definition
relatively insensitive as compared with cytochemistry or flow cytometry
CMML诊治进展
江苏省人民医院 血液科 洪鸣
精品课件
精品课件
精品课件
Contents
1 Definition 2 Diagnosis 3 Risk stratification 4 Therapeutic options
精品课件
Definition
精品课件
WHO Classification of MDS/MPN
monocytic proliferation can be difficult to appreciate (cytochemistry and immunohistochemistry)
精品课件
Abnormal monocytes have denser Monocytosis with morphologically chromatin, nuclear normal monocytes (PB) convolutions and folds and
(WHO classification of myeloid neoplasms)
精品课件
Diagnosis
精品课件
Clinical manifestation
• MDS-type
– Fatigue and dyspnea due to anemia – susceptibility to infections – rarely bleeding
The monocytes generally are mature, but can exhibit abnormal granulation or unusual nuclear lobation or chromatin patten. (abnormal monocytes)
Dysgranulopoiesis is present in most cases.
• MPN-type
– significant weight loss – drenching nigh sweats – left upper quadrant pain from significant
splenomegaly
精品课件
Morphology (PB)
PB monocytes usually range from 2 to 5 × 109/L, but may exceed 80 × 109/L.
granules and a stippled
nuclear chromatin.
CMML-1 (BM)
CMML-2(BM)
Representative peripheral blood and BM smears distinction between promonocytes 精a品n课d件abnormal monocytes may be
Immunophenotype
The PB and BM cells usually express CD33 and CD13, with variable expression of CD14, CD68, CD64.
An increased percentage of CD34+ cells has been associated with early transformation to acute leukemia.
a more grMoenoycyitseshwitchyntucolepalr aansdm. Cytoplasmic abnormalities (PB)
Promonocytes typically have
a light-gray cytoplasm with
a few lilac-colored
A clonal hematopoietic stem cell disorder that is characterized by the presence of an absolute monocytosis (>1×109/L) in the peripheral blood and the presence of myelodysplastic and myeloproliferative features in the bone marrow.
Occasionally, overexpression of CD56, aberrant expression of CD2, and decreased expression of HLA-DR, CD13, CD15, and CD36 may be observed.
精品课件
Histopathology