毛细胞白血病PPT课件
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6
7
? ACP and TRAP ? biopsy ? elctron microscope
8
Bone marrow biopsy in HCL reticulin stain
9
10
? predict clinic outcome
? splenectomy 67% remained HCR after 6 month 5 years OS 61%
3
4
5
history of HCL(1958-1974)
? named as hairy cell leukemia ? microscopic sign
median mature lyphocyte cytoplasm pseudopods protruding serrated border ? lymphoproliferative disorder
? Cladribine 0.1mg/Kg/day for 7days
ORR 97%
CR 85%
? not identical therapy
14
15
Cladribine: recurrence rate 26%, median time 29 months
Side effect: progressively worse response cumulative myelotoxic effect second tumor
? Origin of HC
CD19+CD20+CD22+SIg+ CD10PCA-1
? Scretion
TNF-alfa IL-6
13
in 90s
? purine nucleoside analogs
? Pentostatin 4mg/m2/2W total 8 times
ORR 79% CR 76%
2
history of HCL(1923-1953)
? Edward in 1923 described splenomegaly without lymphadenopathy pancytopenia with lymphocytosis and monocytopenia
? Gosselin in 1944-1953 3 distinctive subtype bone lesion cutaneous manifestation
16
In The New Era
? Multi-colored Flow Cytometry ? Gene mutation BRAF-MEK-ERK pathway ? Immunotherapy or targeted therapy
17
百度文库
18
Expert consensus on diagnosis of B cell chronic lymphoproligerative disorders in China 2014
Hairy cell leukemia
past,present,furture by Yehonghui
1
Introduce
? extremely rare form of leukemia ? middle aged men ? pancytopenia and splenomegaly ? long life span
19
20
? chlorambucil
11
? interferon-alfa
in 80s
300m u/m2 year
3time per week and lasted for one
side-effect
2-4-8
ORR 70% CR 8%
12
in 90s
? Aetiology
HTLV EBV HPV-B +5 del(5q13)
7
? ACP and TRAP ? biopsy ? elctron microscope
8
Bone marrow biopsy in HCL reticulin stain
9
10
? predict clinic outcome
? splenectomy 67% remained HCR after 6 month 5 years OS 61%
3
4
5
history of HCL(1958-1974)
? named as hairy cell leukemia ? microscopic sign
median mature lyphocyte cytoplasm pseudopods protruding serrated border ? lymphoproliferative disorder
? Cladribine 0.1mg/Kg/day for 7days
ORR 97%
CR 85%
? not identical therapy
14
15
Cladribine: recurrence rate 26%, median time 29 months
Side effect: progressively worse response cumulative myelotoxic effect second tumor
? Origin of HC
CD19+CD20+CD22+SIg+ CD10PCA-1
? Scretion
TNF-alfa IL-6
13
in 90s
? purine nucleoside analogs
? Pentostatin 4mg/m2/2W total 8 times
ORR 79% CR 76%
2
history of HCL(1923-1953)
? Edward in 1923 described splenomegaly without lymphadenopathy pancytopenia with lymphocytosis and monocytopenia
? Gosselin in 1944-1953 3 distinctive subtype bone lesion cutaneous manifestation
16
In The New Era
? Multi-colored Flow Cytometry ? Gene mutation BRAF-MEK-ERK pathway ? Immunotherapy or targeted therapy
17
百度文库
18
Expert consensus on diagnosis of B cell chronic lymphoproligerative disorders in China 2014
Hairy cell leukemia
past,present,furture by Yehonghui
1
Introduce
? extremely rare form of leukemia ? middle aged men ? pancytopenia and splenomegaly ? long life span
19
20
? chlorambucil
11
? interferon-alfa
in 80s
300m u/m2 year
3time per week and lasted for one
side-effect
2-4-8
ORR 70% CR 8%
12
in 90s
? Aetiology
HTLV EBV HPV-B +5 del(5q13)