Title: in the name of god
1in the name of god
2(No Transcript)
3?????
- ?????? ????? ????? ?????? ?? ?? ??? ????? ? ?????
- ???? ????? ??? ???? ????? ?????? ?????? ?? ???
????? ??? ?????? ???? ?? ????? - ????? ?????
- ??? ??? ????? ????? ????? ????? ???? ??????????
????? ?? ???? ????? - ???? ??? ?????? ????? ??? ???? ????????????
?????? ?? ???? ????? - ????????myelogenous
- ???????? lymphocytic
?? ?? ??? ?????? ? ????? ????? ???? ????? ??
????? ?????? ???
4classifications of Leukemia
- Acute Lymphocytic Leukemia (ALL)
- Chronic Lymphocytic Leukemia (CLL)
- Acute Mylogenous Leukemia (AML)
- Chronic Mylogenous Leukemia (CML)
5ALL
- ??????? ?? ?????
- ??? ????? 4 ?????
- ?????? ?????????
- ???????? ?????? ??????
- ???? ?? ??????? ???? ?? ??? ??????????? ?????
????? ?????? - ????? ?? ????? ???? ???????RBC?Plt
6CLL
- ??????? ?? ?????????
- ??????? ?? ?????60 ?????
- ?????? ?? ?????
- ?????? ?????? ???? ?????
- ???? ?? ?? ???? ??????? ???? ???????? B
- ???? ?????? ?? ???????
- ????? ????
- ????? ??????
7AML
- ?????? ??????? ????????( ?????????????RBC?????????
?) - ???? ????? ???????? ????60 ?????
- ????? ???? ?????? ????? ?? ????? ???? ??AML
- ?????????????????????????????????????????????????
???????? ?????????? - ????? ????? ALL???
- ??????? ? ???? ???? ?? ????? ?? ??? ????? ?????
??? - ???????????? ?? DIC?? ??? ????????????
8CML
- ??? ??????? ?? ???????? 22??? ????? ????????
- ???? ??? ????? ?? ??????? ?????? ?? ???? ??????
?????? - ???? ?? ??? ??? ???? ?? ???
- ?? ????? ???? ?????? 40-50 ?????
- ?? ???? ???? ???? ?????
- ?? ???? ????? ?? ?????
9Acute Lymphocytic Leukemia(ALL)
- ???????? ??? ??? ???????? ????? ?? ????? 2-6 ???
- ???? ?????????? ???? ?? ??? ??????? ? ??? ?????
- ?????? ????? ??? ???? ???? ????? ?? ????? ???????
???? ????????? ???? ? ??????? ???? ???? ???
10?????
- ??? ????? ?????? ?? ?????? ?? ????? ??? ???
- 1) ???? ??????? ???? ?????
- 2)???? ???????? ???? ??????
- 3) ???? ??????? ???????
- 4) ???? ??????? ?????? ?? ????? ???
11?????
?????? ??? ?????? ?????? ????? ? ??? ??
??????? ????? ? ???? ??? ????? ?? ??????
??? ??? ??? ???? ????? ??? ??? ??????? ????
???? ???? ? ??????? ???
??? ??????? ?????? ???????? ???? ? ??? ???? ??
? ???? ???? ?????? ????? ? ???? ??? ?????????? ?
???? ????? ??????? ??? ???? ?? ????? ???
?????? ????? ????
12Development of Leukemia in the Bloodstream
Legend
White Cell
Red Cell
Platelet
Blast
Germ
13 14?????? ??????
- 1. Blood examination CBC differentiate
PBS - - anemia,
- - thrombocytopenia,
- - variable leukocyte count, usually increased,
- - blood morphology presence of blast cells
- 2. Bone marrow biopsy
- - presence of blast cells,
- - suppression of normal haematopoiesis
15(No Transcript)
16???? ???? ????? ALL
- L1?? ????????????? ??? ???? ?? ????????? ?????
???? ??????? ? ?????????????? ??? ???? ???? ????
?????? ?? ???????????????? ?? ????? - L2?????? ??????? ?????? ????????? ?? ??????
- L3 ?? ?????? ALL????????? ????? ????????? ???
????? ????? ?????????????? ????????
17?????? ??????
- 3. LP
- 4. Chest xray
- 5. CTscan
- 6 .MRI
- 7.Physical examinations Hepatomegaly?
Lymphadenopathy ?Splenomegaly -
18Pictures Of Blood
19(No Transcript)
20??? ????
- ?? ???? ?? ?? ? ????? WBC ?? ????? ?? ???
- ?????? ??? ???? WBC???? ?? 10000 ? ?? ???? ?? 10
??? - ??? ???? ????? WBC ??? 10000 -50000
- ??? ???? ????? ????? 10 ??? ?WBC????? ?? 50000
- ?????????? ???? ?? ??? ???? ????? ????? ?? ?????
??????????? ??? ?????? ????? ?? ????????? ????
????? ???
21Treatment strategy in ALL
- ??????????????????????????????????????????????????
?????????????????????????????????????
22?????
- ????? ?????? ????? ?????????? ???? ??????? ??
??????? ???? - ????? ??? ???? ????? ?????? ? ??? ????????? ??
??? 10 ?? 12 ????? ?????? ???? ????? ? ??????? ??
????? - ????? ????? ???? ??????? ?? ???????
- ?????????? ?? ???? ???????????
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30???? ????? ???? ??????
- ??? ????????? ???IT
- ?? ?? ???? ???? ??? ????? ????? 0.9 ???? 1 ????
??? ?????????? - ????????? ?? ?? ???? ???? ?? ??? ? ?? D.W ?? N.S
??????? ????? - ?? ?? ???????? ????? ???? ??? 20 ???????
????????? - ????? ?????????????? ?? ???? ???? ?????
- ?? ?? ???????? ????? ???? ??? 20 ???? ??? ?????
??????? - ??? ???????????? ????? 1 ?????? ?? ?? N.S ?
D.W??????? ??? - ?-??????????? ?? ???? 10000 ????? ?? 5 ???? ????
???? ??? - ?? ???IM ???? ?? ?? 2 ???? ???? ?? ???? ????
?????? - ????????????? ?? ?? ???? ???? ???
- ?? ?? ???? ???? ????? ???? ??? 5 ???? ???
????????????? - ?????? ??????? ?? 10-40 ????? ??????? ???
31???? ??????
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???????? 28 ???(???? ????) - ?-?????????????????? ?3 ??? ?? ????
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?? ????
32???? ??????
- 2) ????? ???? ??????? ?? 6 ??? ??? ???? ???? ????
???? ??? ????? ????? ????? - ?????? ???? ?-???????????(IV) ????
???????(PO.IV)??????????? (PO) - 3) ??????? ?? ?????? ????? ???? ???? ??????
?????? ????? ???? ????? ???????????????????????? - 4)????????? 2 ?? 3 ??? ??? ?? ???
- ?? ??????? ??????????(??????? ??????)?
- ??? ???????(????????????)
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??? ???
35?????? ???????
- ??????? ?? ??????? ????? ?? 95 ?? ?????? ??? ???
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39?????
- 1)??????? ?????? ??????????? ????? ??????????????
?????? ?????1379 - 2)?????? ??????? ?????- ???????????? ????????????
2008 - 3) ????? ?? ?????? ?????????????????? ????
?????????? ???? ???? ???????????? ?????
?????????? ??? ??? ??????2006 - 4)???????? ??????? ???????? ???? ????????? ????
???????? ???????1381 - 5)??????? ???? ??????? ????? ??????????? ????
????? ???????? ????? 1386 - 6)??????? ???? ??????? ??????????? ????
???????????? ????? ??? ?? - ???????? ????????1374
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??????? ?? ????????? ?? ?????????? ???? ???????
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???? ?????????? ??????? ?????????? ???? ?????
??????? ???? 1 ????? 1 ??????? 1385? 41-46 - 8) ????? ???? ?? ???? ????? ????? ?? ????? ???
???????????? ?????? ????? ?? ????????? ?????????
???? ???? ???? ??????? ????? ? ???? ???????
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1387
40Leukemia
Ahmad darvishi Nursing 86 Hormozgan university of
medical sciences Bandarabbas faculty of
nursing?midwifery and paramedical sciences 1388
41(No Transcript)