Hematopoiesis is the production of cellular blood constituents which are derived from hematopoietic root cells ( HSC ) .HSC are normally found in the myelin of the bone, otherwise known as the bone marrow and can give rise to all different mature blood cell types. The HSC has the ability to halt their cells from going depleted as are self renewing because when they proliferate, some of their girl cells stays as HSC ‘s.
The symptoms of acute leukemia tend to develop really all of a sudden as opposed to the patterned advance of symptoms over clip in chronic leukemia. The symptoms include anaemia which is normally from a consequence of a decrease in the ruddy blood cell ( RBC ) count. Anemia cause farther jobs such as lividness, weariness, and shortness of breath. Thrombocytopenia besides develops as there are decreased Numberss in thrombocytes in the circulating system. This can do extra hemorrhage at the site of hurt even if its from a minor injury as the coagulating thrombocytes in the blood are non plenty. In many instances sick persons may see febrilities, nosebleed, petechiae, bone and joint hurting and frequent infections due to the decrease of infection-fighting WBC in the blood. There may besides be expansion of the liver and lien ( hepatosplenomegaly ) and expansion of lymph nodes ( lymphadenopathy ) .
The blood movie would demo cell with large karyons that fill about all of the cell, go forthing really small cytol. The cells are swollen and tend to clop up with each other. There is a presence of auer rods. There is more than 20 % of myeloblasts, high degrees of leukocytes ( 135.3 x 109/L. low RBC counts and cells contains no granules. ( 199 words )
State the typical manifestation of person showing with chronic leukemia including the blood movie morphology. ( word bound: 200 words ) ( 5 Markss )
Chronic leukemia tends to develop decelerating over a long period of clip runing from many months to old ages without being noticed. Symptoms include swelling of the lien, liver and lymph nodes. There is besides an addition in the sum of WBC. Anemia besides occurs because of the decreased figure of RBC. They have febrilities, weight loss, and inclination to contuse and shed blood easy.
The blood movie morphology normally shows that in CML leukocytosis is over 100,000/mm3 in the WBC. There are leucocytes that have eosinophils and basophils and neutrophil precursors.
In CLL it shows decreased Numberss of RBC and thrombocytes. Lymphocytosis is 5000 mm3. Lymphocytes are little and normal with around 50 % of them n the blood movie demoing abnormalcies such as condensed chromosomes in a unit of ammunition karyon.
Explain the following techniques and give one illustration for each, of application and diagnosing or monitoring of leukemia: ( word bound: 230 ) ( 15 Markss )
Cytochemistry: this uses Myeloperoxidase ( MPO ) staining which discolorations and identifies cells and their composing. It helps to acknowledge ALL from AML.
Immunophenotyping: this uses flow cytometric Immunophenotyping to screen out T-lymphocytes by their Cadmium antigens with the assistance of fluorescence/ optical maser visible radiations to set up where there is overpopulation in immunophenotypic marker types. It ‘s besides used to analyse heterozygous populations of cells in regard to their province of distinction and biological line of descent ( presence and absence of some membrane constructions ) .
Cytogeneticss: this is done by fluorescent in situ hybridisation ( FISH ) technique. It assesses chromosomal abnormalcies that are related to leukemia. It diagnoses and tells what specific type of leukemia it is. It recognizes translocations for chronic myelocytic leukemia ( 9 ; 22 ) , acute myelocytic leukemia ( 8 ; 21 ) . Omissions associated with myelodysplastic syndromes or AML ( 5q ; 7q ) and eventually trisomies ( trisomy 12 ) for CML. FISH diagnose leukemias that look similar but does non portion familial abnormalcies and necessitate different interventions. ( 154 Wordss )
What is the Philadelphia chromosome? Give an illustration of where it is normally found. ( word bound: 120 words ) ( 5 Markss )
Philadelphia chromosome is where chromosome 22 has an abnormalcy due to portion of chromosome 9 being translocated onto it. This occurs in individual bone marrow cells that causes chronic myeloid leukemia ( CML ) and is besides found in acute lymphoblastic leukemia. The translocation is causes by a procedure known as clonal enlargement where many cells are being produced from the one mutation cell. The Philadelphia chromosome carries the merger cistron BCR-ABL which is derived from proto-oncogene ABL from chromosome 9 and BCR proto-oncogene from chromosome 22.
Fig 1: the formation of the Philadelphia chromosome.
( hypertext transfer protocol: //www.cancer.gov/dictionary/ ? CdrID=44179 )
( 85 words )
State the difference between root cell and bone marrow grafts. ( word bound: 100 words ) ( 4marks )
Stem cells graft is when root cells are acquired by aphaeresis from the peripheral blood and can be done handily at the outpatient section. The aphaeresis procedure filters any unwanted blood elements so that lone root cells are collected. However, bone marrow graft is when root cells are harvested straight from the bone marrow utilizing all right acerate leaf. This is normally taken from around the hip articulation, under general anaesthesia and requires hospitalization. The aggregation of root cells from the bone marrow is much richer in root cells that that collected by aphaeresis in the circulating blood. ( 96 words )
State the difference between autologous and allogenic grafts. ( word bound: 50 words ) ( 4 Markss )
Autologous grafts is when root cells are collected from the patient ‘s ain organic structure ( weather from blood or bone marrow ) and the 1s collected should non be contaminated with malignant neoplastic disease meanwhile allogenic graft is when root cells are recovered from a giver that matches the receiver at histocompatibility antigens. ( 48 words )