• Leukemia dibagi menjadi Leukemia Limfoblastik Akut dan Kronis, Leukemia Mieloblastik
Setiati S, Alwi I, Sudoyo AW, Stiyohadi B, Syam AF. Buku ajar
ilmu penyakit dalam jilid I. VI. Jakarta: InternaPublishing; 2014.
Akut dan Kronis.
• Leukemia akut penyakit yang bersifat agresif dengan transformasi ganas yang
menyebabkan terjadinya akumulasi progenitor hemopoietik sumsum tulang dini (selblas).
Setiati S, Alwi I, Sudoyo AW, Stiyohadi B, Syam AF. Buku ajar ilmu penyakit dalam jilid I. VI.
Jakarta: InternaPublishing; 2014.
LEUKEMIA??
• Sel darah putih
• darah
Kementrian Kesehatan RI (2015). Buletin Jendela Data dan Informasi Kesehatan SITUASI PENYAKIT KANKER.
Harrison, T. and Fauci, A. (2008). Harrison's principles of internal medicine. 17th ed. New York: McGraw-Hill, pp.677 - 686.
Etiologi dan
Faktor
Predisposisi
CML
(Chronic Myeloid Leukemia)
Kronik
CLL
(Chronic Lymphocytic Leukemia)
Leukemia
AML
(Acute myeloid Leukemia)
Akut
ALL
(Acute lymphocytic Leukemia)
HEMATOPOIESIS
Is found in condition :
1. Excessive hematopoiesis
2. Bone marrow replacement
3. Dystrophic hematopoiesis
One or more hematopoietic cell lines may be
present
EMH occur in :
1. Myeloproliferative disorders (MPD)
2. Myelodysplastic syndrome (MDS)
3. Acute leukemia
A Erythrocytes
B Large lymphocyte with purplish-red
(azurophil) granules and deeply
indented by adjacent erythrocytes
C Neutrophilic segmented
D Eosinophilic segmented
E Neutrophilic segmented
F Monocyte with gray blue cytoplasm,
coarse linear chromatin, blunt
pseudopods
G Platelets (thrombocytes)
H Lymphocyte
I Neutrophilic band
J Basophil
Bell, A., Sallah, S. and Diggs, L. (2005). The morphology of human blood cells [ATLAS]. Abbott
Park, IL: Abbott Laboratories.
TANDA dan GEJALA 1. Functional
neutropenia – fever,
• Kelemahan tubuh
• BB turun chills (INFECTION)
• Demam dengan atau tanpa infeksi
• Mudah berdarah 2. Thrombocytopenia –
• Nyeri tulang bleeding, bruising
• Batuk tidak spesifik
• Nyeri kepala 3. Anemia – weakness,
• Diaphoresis
Harrison, T. and Fauci, A. (2008). Harrison's principles of internal fatigue
medicine. 17th ed. New York: McGraw-Hill, pp.677 - 686.
Setiati S, Alwi I, Sudoyo AW, Stiyohadi B, Syam AF. Buku ajar ilmu
penyakit dalam jilid I. VI. Jakarta: InternaPublishing; 2014.
Temuan Fisik
• KU: tampak sakit sedang
• GCS bervariasi
• Tanda vital • Mani, A, Lee, DA. Leukemic Gingival Infiltration. N Engl J Med
2008; 358(3): 274. Copyright ©2008 Massachusetts Medical
Society
• DEMAM, TAKIKARDI,
TAKIPNEU, HIPOTENSI
• Kepala dan leher
• Thorax
• Abdomen
• Genitalia
• Ekstremitas Alvarado Ibarra M. Frontline Treatment of Acute Myeloid
Leukemia
Harrison, T. and Fauci, A. (2008).inHarrison's
Adults Long-Term
principles ofResults
internal in a Mexican
medicine. 17th ed. NewMedical
York: Center. Cancer
McGraw-Hill, therapy
pp.677 - 686. & Oncology International
Journal.
Setiati S, Alwi I, Sudoyo 2018;10(5).
AW, Stiyohadi B, Syam AF. Buku ajar ilmu
penyakit dalam jilid I. VI. Jakarta: InternaPublishing; 2014.
Temuan hematologi
• Anemia (normositik normokrom)
• Leukositosis (dengan peningkatan sel blast)
• Granule primer – Auer rods
• Trombositopenia
• Hiperurisemia dan hipoglikemia
Percival M, Lai C, Estey E, Hourigan C. Bone marrow evaluation for diagnosis and
monitoring of acute myeloid leukemia. Blood Reviews. 2017;31(4):185-192.
Percival M, Lai C, Estey E, Hourigan C. Bone marrow
evaluation for diagnosis and monitoring of acute
myeloid leukemia. Blood Reviews. 2017;31(4):185-
192.
Tatalaksana
• SUPORTIF
• platelet transfusions
• PRBCs (leukodepleted, irradiated)
• Prophylactic antibiotics
• fluconazole (candidiasis)
• acyclovir (HSV, VZV)
• Terapeutik dikembangkan!
• Tujuan: untuk eradikasi sel-sel klonal leukemik dan untuk memulihkan hematopoiesis
normal di dalam sumsum tulang
• transplantation
• Supportive careThe “7+3” induction regiment
7 days continuous intravenous cytrabine infusion and 3 dailey doses of daunorobicin
Harrison, T. and Fauci, A. (2008). Harrison's principles of internal medicine. 17th ed. New York:
McGraw-Hill, pp.677 - 686.
Survival in AML
• Jabbour EJ, Estery E, Kantarjian HM. Adult Acute Myeloid Leukemia. Mayo Clin Proc. 2006;81:247-260.
DAFTAR PUSTAKA
• Setiati S, Alwi I, Sudoyo AW, Stiyohadi B, Syam AF. Buku ajar ilmu penyakit dalam jilid I. VI. Jakarta:
InternaPublishing; 2014.
• Definition of LEUKEMIA [Internet]. Merriam-webster.com. 2019 [cited 12 July 2019]. Available from:
https://www.merriam-webster.com/dictionary/leukemia
• Kementrian Kesehatan RI (2015). Buletin Jendela Data dan Informasi Kesehatan SITUASI PENYAKIT
KANKER.
• Alvarado Ibarra M. Frontline Treatment of Acute Myeloid Leukemia in Adults Long-Term Results in a
Mexican Medical Center. Cancer therapy & Oncology International Journal. 2018;10(5).
• Harrison, T. and Fauci, A. (2008). Harrison's principles of internal medicine. 17th ed. New York:
McGraw-Hill, pp.677 - 686.
• Kim C. Homeostatic and pathogenic extramedullary hematopoiesis. Journal of Blood Medicine.
2010;I(I):13-19.
• Bell, A., Sallah, S. and Diggs, L. (2005). The morphology of human blood cells [ATLAS]. Abbott Park,
IL: Abbott Laboratories.
• Percival M, Lai C, Estey E, Hourigan C. Bone marrow evaluation for diagnosis and monitoring of
acute myeloid leukemia. Blood Reviews. 2017;31(4):185-192.
• Jabbour EJ, Estery E, Kantarjian HM. Adult Acute Myeloid Leukemia. Mayo Clin Proc. 2006;81:247-
260.