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Pathophysiology behind the leukemias

Pathophysiology-Behind-the-Leukemias

Pathophysiology Behind the Leukemias Authors: Yan Yu, Katie Lin Reviewers: Jennifer Au Merna Adly Crystal Liu Lynn Savoie* * MD at time of publication Point Mutation (in DNA) Chromosomal Abnormality (duplication, loss, recombination error) Combinations of these genetic defects causes reduced tumor suppressor gene expression and/or increased oncogene expression Initiating Mutational Event ALL Any combination of mutations, chromosomal alterations, or other genetic abnormalities that creates a neoplastic cell (incapable of regulating cell growth/division). AML CLL CML Translocation between Chr 9 and Chr 22à Philadelphia chromosome ( abnormal Chr 22) àBCR-ABL1 oncogene (along with other genetic abnormalities) • In White Blood Cells and their precursors: Lack of cell growth inhibition and / or apoptosis. • Over stimulation of cell division/growth Neoplastic blood cell incapable of regulated cell division Neoplastic cells uncontrollably divide in a monoclonal way: one neoplastic cell originates all successive cells Genes regulating differentiation/maturation disrupted, affected neoplastic cells are incapable of further differentiation/maturation Genes regulating maturation remain intact (affected neoplastic cell is capable of further differentiation/maturation) Some neoplastic cells take time to mature furtheràless rapid disease progression (more indolent disease); cells don’t die CLL: Chronic Lymphoid Leukemia Note: Although it is tempting to group the leukemias together for study purposes, it is best to learn the 4 main types of leukemias independently of one another, as they have a uniquely different pathophysiology and clinical presentation Specific mutations cause slower disease progression CML: Chronic Myeloid Leukemia Degeneration during CML’s ”blast crisis” Specific mutations cause rapid division and buildup of existing neoplastic cells àAcute/rapid disease progression. ALL: Acute Lymphoblastic Leukemia AML: Acute Myeloid Leukemia Legend: Pathophysiology Mechanism Sign/Symptom/Lab Finding Complications Re-Published January 19, 2020 on www.thecalgaryguide.com

Patofisiologi di Balik Leukemia secara Umum

Patofisiologi di Balik Leukemia secara Umum