急性白血病Acute leukemia
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作者：中山醫 鍾念庭
簡介
早期造血細胞不正常增生且無法正常分化
定義
blast cell > 20%
病因
大多數是未知的，但遺傳和環境因素都有影響，如down syndrome, chemicals, radiation, tobacco, chemotherapy, retroviruses infection
分類
抽Bone marrow和周邊血鏡檢，除了細胞學型態外，也利用MPO、nonspecific esterase、chloroacetate esterase、PAS等、或CD染色去區分AML(acute myeloid leukemia)和ALL(acute lymphoblastic leukemia)
臨床表現
造成症狀的三個主因
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前驅細胞不正常增生但無法成熟分化，造成正常造血細胞數目減少
fatigue (RBC↓)、bleeding (platelets↓)、infection (neutrophil↓) -
器官、組織被白血病細胞浸潤
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白血病細胞增生，細胞代謝物增加
LDH↑, uretic acid↑, K+↑, PO42-↑, Ca2+↓
(化療治療後更容易發生，稱作Tumor lysis syndrome)
References
- 奇美血液腫瘤科見習筆記
- Uptodate
- Overview of acute myeloid leukemia in adults
- Overview of the outcome of acute lymphoblastic leukemia in children and adolescents
- Clinical manifestations, pathologic features, and diagnosis of precursor B cell acute lymphoblastic leukemia/lymphoma
- Clinical manifestations, pathologic features, and diagnosis of precursor T cell acute lymphoblastic -leukemia/lymphoma
- The Massachusetts general hospital handbook of internal medicine, pocket medicine six edition
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