关键区别 - MDS vs白血病
MDS和白血病是由于骨髓中的异常。白血病可以定义为异常的积累malignant单克隆白血细胞在里面骨髓。Myelodysplastic syndromesor MDS refer to a set of acquired bone marrow disorders that are due to the defects in the stem cells.白血病是一种恶性肿瘤,但骨髓增生性是一种前体病变,可以发生恶性转化。这是MDS和白血病之间的关键区别。
内容
1。概述和关键差异
2。What is MDS (Myelodysplastic Syndromes)
3。什么是白血病
4。Similarities Between MDS and Leukemia
5。并排比较 - 表格形式的MDS与白血病
6.概括
什么是MD?
Myelodysplastic syndromes(MDS)描述一组由于干细胞中缺陷引起的一组获得的骨髓疾病。这些疾病的特征是骨髓衰竭的增加,并且在所有方面都有定量和定性异常髓样细胞谱系(即红细胞,白细胞和血小板)。躯体点突变在诸如TP53和E2H2之类的基因中,据信是这种情况的根本原因。
Clinical Features
MDS is usually seen among elderly people. The most frequently observed manifestations are,
- Anemia
- Bleeding due to pancytopenia
- 中性粒细胞减少
- 单核细胞增多
- Thrombocytopenia
These features can be seen either individually or in conjunction with each other.
尽管存在全年症,但骨髓表现出增加的细胞性。突变性颗粒是常见的并发症。粒细胞precursors and巨核细胞具有异常形态。
谁的MDS分类
Disease |
Marrow Blasts (%) |
Clinical Presentation |
细胞遗传异常(%) |
Refractory anemia | <5 | Anemia | 25 |
Refractory anemia with ring sideroblasts | <5 | Anemia, > 15 % ringed sideroblasts in the red cell precursors | 5-20 |
MDS with isolated del | <5 | Anemia, normal platelets | 100 |
耐难治性细胞质伴有多发育不全 | <5 | Bicytopnenia or pancytopenia | 50 |
过量BLASTS-1的难治性贫血 | 5-9 | 细胞质含有外周血爆炸(<5%) | 30-50 |
过量BLASTS-1的难治性贫血 | 10-19 | 胞质的周围血液爆炸 | 50-70 |
骨髓增生综合征,未分类 | <5 | 中性粒细胞减少and thrombocytopenia | 50 |
Investigations
- Examination of blood and bone marrow cells obtained from a blood sample and a bone marrow biopsy.
管理
骨髓中爆炸率<5%的患者接受了保守管理,其中包括
- 红细胞和血小板输血
- Antibiotics for infection
如果骨髓中爆炸的百分比> 5%,则管理层通过以下程序,
- 支持护理以最大程度地减少获得其他并发症的风险
- Chemotherapy
- 列纳奈度胺的给药
- 骨髓移植
什么是白血病?
白血病可以定义为异常的积累malignant monoclonal white blood cells in the bone marrow. This results in bone marrow failure causing anemia, neutropenia, and thrombocytopenia. Normally, the proportion of blast cells in the adult bone marrow is less than 5%. But in the leukemic bone marrow, this proportion is over 20%.
Types of Leukemia
There are 4 basic subtypes of leukemia as,
- Acute myeloid leukemia(AML)
- 急性淋巴细胞白血病(ALL)
- Chronic myeloid leukemia(AML)
- 慢性淋巴细胞性白血病(CLL)
这些疾病相对罕见,它们的年发病率为10/1000000。通常,白血病可以在任何年龄发生。但是所有这些主要在童年时期都出现,而CLL经常出现在老年人中。引起白血病的病原体包括放射线,病毒,细胞毒性剂,免疫抑制和遗传因素。可以通过检查外周血和骨髓的染色幻灯片来诊断该疾病。对于亚分类和预后,免疫表型,细胞遗传学和分子遗传学是必不可少的。
急性白血病
急性白血病的发生率随着年龄的增长而增加。急性粒细胞白血病的表现中位年龄为65岁。急性白血病可能是从头出现的,或者是由于先前的细胞毒性化学疗法或骨髓增生性的。急性淋巴细胞白血病的表现中位年龄较低。这是童年最常见的恶性肿瘤。
所有人的临床特征
- 呼吸困难和疲劳
- 流血和瘀伤
- Infections
- 头痛/confusion
- Bone pain
- 肝肾上腺肿/lymphadenopathy
AML的临床特征
- 牙龈肥大
- 紫外的皮肤沉积
- Fatigue and breathlessness
- Infections
- 流血和瘀伤
- 肝肾上腺肿
- Lymphadenopathy
- Testicular enlargement
Investigations
For Confirmation of Diagnosis
- 血数 - 血小板和血红蛋白通常很低;白细胞计数通常会增加。
- Blood Film – Lineage of the disease can be identified by observing the blast cells. Auer rods can be seen in AML.
- 骨髓抽吸 - 减少erythropoiesis,,,,reduced巨核细胞,细胞的增加是要寻找的指标。
- Chest X-ray
- Cerebrospinal fluid examination
- 凝血轮廓
用于计划治疗
- Serum urate and liver biochemistry
- Electrocardiography/echocardiogram
- HLA type
- Check HBV status
管理
未治疗的急性白血病通常致命。但是,通过姑息治疗,可以延长寿命。治疗治疗有时可能会成功。失败可能是由于疾病复发或疗法并发症或由于疾病的无反应性。总的来说,可以通过长春新碱的联合化疗来诱导缓解。对于高危患者,可以进行同种异体干细胞移植。
慢性髓细胞性白血病
CML is a member of the family of myeloproliferative neoplasms which exclusively occur in adults. It is defined by the presence of the Philadelphia chromosome and has a more slowly progressive course than acute leukemia.
Clinical Features
- 有症状的贫血
- 腹部不适
- 减肥
- 头痛
- 瘀伤和流血
- Lymphadenopathy
Investigations
- 血液计数 - 血红蛋白低或正常。血小板低,正常或升高。WBC被提高。
- 血膜中成熟的髓样前体的存在
- 细胞的增加,随着骨髓抽吸物中的髓样前体增加。
管理
CML治疗的第一线药物是伊马替尼(Glivec),它是酪氨酸激酶抑制剂。二线治疗包括羟基脲,α干扰素和同种异体干细胞移植的化学疗法。
Chronic Lymphocytic Leukemia
CLL is the most common leukemia that mostly occurs in old age. It is caused due to clonal expansion of smallB lymphocytes。
Clinical Features
- 无症状淋巴细胞增多
- Lymphadenopathy
- 骨髓衰竭
- 肝肾上腺肿
- B-symptoms
Investigations
- 在血数中可以看到非常高的白血细胞水平
- Smudge cells can be seen in blood film
管理
Treatment is given to troublesome organomegaly, hemolytic episodes, and bone marrow suppression. Rituximab in combination with Fludarabine and cyclophosphamide show a dramatic response rate.
What are the Similarities Between MDS and Leukemia?
两者都是由于骨髓异常引起的血液学疾病。
The examination of a blood film and bone marrow biopsy are carried out for the diagnosis of both conditions
What is the Difference Between MDS and Leukemia?
MDS vs Leukemia |
|
Myelodysplastic syndromes describe a set of acquired bone marrow disorders that are due to the defects in the stem cells. | 白血病可以定义为异常的积累malignant monoclonal white blood cells in the bone marrow. |
Type | |
This is a precursor lesion that has the potential of a malignant transformation. | 这是一个恶性。 |
Incidence | |
This is usually seen among elderly people. | 这在任何年龄段中都可以看到,但是成年人比儿童更受这种状况的影响。 |
Clinical Features | |
常见的临床特征是 · Anemia · Bleeding due to pancytopenia ·中性粒细胞减少 · Monocytosis · Thrombocytopenia |
Frequently seen clinical features of leukemia are, ·牙龈肥大 · Violaceous skin deposits ·疲劳和呼吸困难 · Headache/confusion · Infections ·骨痛 ·流血和瘀伤 ·肝肾上腺肿 · Testicular enlargement ·淋巴结肿大 |
管理 | |
骨髓中爆炸率<5%的患者接受了保守管理,其中包括 ·红细胞和血小板输血 ·感染抗生素 如果骨髓中爆炸的百分比> 5%,则管理层通过以下程序, ·支持性护理,以最大程度地减少获得其他并发症的风险 ·化学疗法 · Administration of lenalidomide 骨髓移植 |
管理根据患者患有白血病的类型而变化。化学疗法在白血病的治疗中起主要作用。 |
摘要 - MDS vs白血病
Myelodysplastic syndromes (MDS) describe a set of acquired bone marrow disorders that are due to the defects in thestem cells白血病是骨髓中异常恶性单克隆血细胞的积累。骨髓增生性是一种前体病变,可以经历恶性转化,但白血病是恶性肿瘤。这是MDS和白血病之间的主要区别。
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您可以下载本文的PDF版本,并根据引文说明将其用于离线目的。请在此处下载PDF版本MD和白血病之间的差异
References:
1. Kumar,Parveen J.和Michael L. Clark。Kumar&Clark临床医学。爱丁堡:W.B。桑德斯,2009年。
图片提供:
1。“Granulocytic Dysplasia” By Emily Patonay – Own work(CC BY-SA 4.0)通过下议院维基梅迪亚
2。“Symptoms of leukemia” By Mikael Häggström – (Public Domain) via下议院维基梅迪亚
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