User talk:Sai Ashray

Acute lymphoblastic leukemia. (Breaking down word by word)

Acute- Storming sudden onset with rapidly deterioration and a survival upto 6-12 months. Lymphoblastic- Immature precursor cells of lymphocyte. Leukemia- Neoplastic proliferation of PHSC that are uncontrolled and unregulated in the bone marrow and released into the circulation irrespective of the lineage.

On a cell- 1.Apoptotic area~ down regulates the unecessary cells. 2.Anti-apoptotic area~ inhibits apoptosis. 3. Tumor suppressor gene~ inhibits proliferation. 4. Proto-oncogene~ activates proliferation.

A). Molecular pathogenesis- =Chromosomal abnormalities~ a) numerical-.Haploid. Diploid. Triploid. Tetraploid. Aneuploidy.(Not a multiple of 23) [Hyperploidy >51 good prognosis, <46 bad prognosis]. b)Structural-. Balanced Translocation.

Chromosome-9 ABL gene is present which tells the body to proliferate cells by activating tyrosine kinase enzyme. Here, ABL gene goes,fuses with chromosome-22 BCR gene and forms a chimeric gene(BCR-ABL) 190KD(importance is lighter the weight, more aggressive).

B.) Immunophenotyping- B-cells they have the cell lines CD-10aka(CALLA),19. (if 20,21 are there then mature) T- cells they cell lines CD-1,2,5,7,8(if 3,4,8 are there then highly functional)

C.) Morphology- Bone marrow- Hyper cellular and where macrophages eat some cells and give rise to gaps (Starry sky appearance). Blood picture- Anemia, Thrombocytopenia, either Aleukemic Leukemia or Leukemia.

Clinical features- -Bone pain. -Anemia-Normocytic/megalocytic, normochromic.(fatigue, palpitations, headache, dyspnea). -Leucopenia- (fever, infections). -Thrombocytopenia- (Petechiae <3mm, Purpurae 3-10mm size, Echymosis >10mm, bleeding gums, epistaxsis. -Leukostasis (due to high count) Pulmonary(dyspnea), cerebral(Headache,TIA, blurring vision). - Tumor lysis syndrome- increased Potassium (arrhythmias), Phosphate (Uremia, hypocalcuria).

Prognosis- Good- 2-10 years, hyperploidy, t(12:22), NOTCH-1 HOX-11. Bad- <2 >10 years, hypoploidy, t(9;22),t(4;11),t(1:19).

Investigations- bone marrow and peripheral smear examination

Treatment- Induction drugs~ (Vincristine, Daunorubicin, Methotrexate, Imatinib, L-asparginase).

Consolidation drugs~ (Daunorubicin Methotrexate,Imatinib).

Maintenance drugs~ (Prednisolone, Vincristine, Methotrexate and Imatinib).

Acute lymphoblastic leukemia
Want others to get benefitted Sai Ashray (talk) 11:36, 27 February 2021 (UTC)