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ANEMIAS
LEUKEMIAS
Professor Yu.I. Bondarenko
ANEMIA
SCHEME OF BLOOD FORMATION
DEFINITION OF ANEMIA

Anemia is decrease of
erythrocytes amount and
hemoglobin contents in unite of
blood volume which is
accompanied also with
qualitative changes of
erythrocytes
Pathogenic classification of anemias
 1.
Posthemorrhagic anemia
 2.
Hemolytic anemia
 3.
Anemia as a result insufficiency
of blood formation
Acute posthemorrhagic anemia





1.
2.
3.
4.
5.
Reasons:
Wounding of vessels
Gastro-intestinal bleeding
Dysmenorrhea
Bleeding stomach ulcer
Lung tuberculosis
Chronical posthemorrhagic
anemia
Causes:
 1.
 2.
 3.
 4.
 5.
 6.
Stomach ulcer
Stomach tumor
Hemorrhoid
Uterine bleeding
Renal bleeding
Nose bleeding
By colour index - hypochromic
Equired hemolytic anemia
1.
 2.
 3.
 4.

Toxic
Immune
Mechanical
Equired membranopathy
Toxic hemolytic anemia
Poisoning by hemolytic poisons:








Arsine
Acetic lead
Phosphorus
Nitrobenzene
Phenylhydrazine
Biliary acids
Mushroom poison
Snake venom
Immune hemolytic anemia

1. Autoimmune anemia

2. Posttrasfusion anemia
а) transfusion of АВ0-uncompatible blood
б) transfusion of Rh- uncompatible blood

3. Hemolytic anemia of new-born
Equired hemolytic anemia
Reticulocytosis
Equired hemolytic anemia
Reticulocytosis
Hereditary hemolytic anemia

1. Enzymopathy

2. Hemohlobinopathy

3. Membranopathy
Enzymopathies
1.
Deficit of glucoso-6dehydrogenase
2.
Deficit of pyruvate kinase
Medicine drug cause hemolyse
in the G-6-PhDG insuficiency






Sulfanilamides
Antimalaric drugs
Aminosalycilic acid
Phenacetin
Vitamines C and K
Aspirin in large doses
Hemolytic anemia due to pyruvate
kinase insefficiency. Reticulocytosis
Hemohlobinopathies

Sickle-cell anemia

Thalassemia:
 α-thalassemia
 ß-thalassemia
Sickle-cell anemia - blood
Sickle-cell anemia – blood:
at the left – sickle erythrocytes
at the right – test to hypoxia
Minor (heterozygotic)
thalassemia – blood
Minor (Heterozygotic)
thalassemia – blood
Major (Homozygotic)
thalassemia – blood
Major (homozygotic)
Cooley’s anemia – blood
Membranopathies






Hereditary
Hereditary
Hereditary
Hereditary
Hereditary
Hereditary
microspherocytosis
eliptocytosis
pyropoikilocytosis
stomatocytosis
acanthocytosis
echinocytosis
Membranopathy
Hereditary microspherocytosis - blood
Membranopathy
Hereditary eliptocytosis – blood
Megaloblastes. Megalocytes.Jolly’s
bodies. Cabot’s rings.
LEUKEMIA
Leukemia definition
Leukemia
– it is tumor
arising from bloodforming
cells and primary lesion
bone marrow
Classification of leukemias
Acute leukemias
 myeloblastic
 lymphoblastic
 Chronical leukemias
 myeloid
 lynphoid

Acute myeloblastic leukemias
Undifferentiated
 Myeloblastic without maturing
 Myeloblastic with maturing
 Promyelocytic
 Myelomonoblastic
 Monoblastic
 Erythroblastic
 Megacaryoblastic

Histochemical signs of differentiation
of acute leukemias
 1.
 2.
 3.
 4.
 5.
Reaction for peroxidase
Reaction for acidity phosphatase
Reaction for uncpecific esterases
Reaction for lipides
Reaction for compoud
carbohydrates
Reaction of myeloblastes and other
of neutrophil cells for peroxidase
Reaction of monoblastes for
α-naphtylacetateestherase
Reaction of myeloblastes and
monoblastes for acidity phosphatase
Acute lymphoblastic leukemia - blood
Acute В-lymphoblastosis – bone marrow
Big vacuolized lymphoblastes
Acute lymphoblastic leukemia – bone
marrrow
Acute lymphoblastic leukemia – bone
marrrow. Initial stage.
Acute lymphoblastosis – bone marrow.
Total lymphoblastic metaplasia
Chronical myeloid leukemias




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Myelocytic
Monocytic
Eosinophilic
Erythroblastic
Megacaryocytic
Chronical myelocytic leukemia –
blood. Chronical phase
Chronical myelocytic leukemia –
blood.
Chronical myelocytic leukemia – blood
Stage of blastic crisis
Chronical lymphoid leukemias



В-lymphocytic
Т- lymphocytic (1,5 %)
Haircell
Chronical В-cell lymphocytic
leukemia - blood
Chronical lymphocytic leukemia –
blood. Gumprecht’s bodies.
Chronical lymphocytic leukemia –
bone marrow. Total lymphoid
metaplasia.
Chronical lymphocytic leukemia –
bone marrow. Total lymphoid
metaplasia.
Chronical haircell leukemia - blood
Chronical haircell leukemia - blood
Haircell leukemia - blood. Reaction
for acidity phosphatase
Chronical monocytic leukemia - blood
Mechanisms of cellular oncogenes
activating
Point
mutations
Chromosomal abnormalities
Virual transduction
Insertion mutagenesis
Genes amplification
Clinical manifestation of leukemia
Metaplastic
anemia
Thrombocytopenia
Hemorrhagic syndrome
Secondary immunedeficiency
Decrease of resistance