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ACUTE

LYMPHOBLASTICLEUKIMIA

PEDIATRI

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PEDIATRI• Benny Herlianto

• Ni Made Ayu Agustini

• Ni Luh Gede Wahyuni

• Luh Putu Swandewi

• Ni Luh Su!a Pratiwi Murti

• Putu Anindia Searningru!• Ni Luh Sri A"sari

• A#A# Made Wi$aya %usu!a

•  Tristina Wardani• De&ora Pratita A''hedya

• Maria Prisila

• Putu Diah (edaswari

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LE)%IMIA PADA ANA%

• Leukemia limfoblastik akut

( LLA / ALL )   85%

• Leukemia non limfoblastik akut( Leukemia mielositik akut )

• Leukemia mieloblastik kronik

• Leukemia limfositik kronik

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%LASI*I%ASI ALL

BERDASARKAN

•  Morfologi & sitokimia

( menurut !AB ( fren"#$ Ameri"a$ Britis# ) iba&i

alam L'$ L$ L

•   Imunologik 

( B *ell ALL$ + *ell ALL )•   Sitogenetik 

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%LASI*I%ASI +M,R*,L,GI-

Su&ty"e Mor"hology ,''urren'e +.-

L/ S!all round &lasts 01

'lu!"ed 'hro!atinL2 Pleo!or"hi' larger &lasts 23

'le4ted nu'lei5 6ne 'hro!atin

L7 Large &lasts5 nu'leoli5 1

8a'uolated 'yto"las!

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%LASI*I%ASI +IM)N,L,GI-

B- lineage (80%) MarkersPr-B C!"#($)T&'($)C!"0(-)CIg(-)

Cn C!"#($)T&'($)C!"0($)CIg(-)Pre-B

C!"#($)T&'($)C!"0($)CIg($)SIg(-)

Ma'*re-B

C!"#($)T&'($)C!"0(+)CIg(+)SIg($)T-lineage (,0%)Pre-T C!($) C!,(-) T&'($)

Ma'*re-T C!($) C!,($) T&'($)

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He!ato"oieti' ste! 'ell

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Hea'.ie'i/ S'e Cells sLe*kii/ S'e Cell

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Signaling "athway in'hildhood ALL

/# B9R:ABL tyrosine inasetransloasi t+;<22- "d ALL !enye&a&an

B9R:ABL 'yto"las!i' tyrosine inase&eriatan dgn B9R gen "d ro!oso! 22  "rotein inase ati4  "roli4erasi sel dgn!engati4an "hos"oinositide 7:inase  

t$d "roses trans4or!asi#

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Signaling "athway in'hildhood ALL

2# *LT:7 Re'e"tor tyrosine inaseMutasi "ada *LT:7 tyrosine inase aan

!engati4an *LT:7 Tyrosine inase  !engati4an RAS=RA*=ER% dan sinyaltransdusi yg aan !engati4an $alurtransri"si +STAT 1- t$d "roli4erasi yg td

terontrol

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Signaling "athway in'hildhood ALL

@# Pre:B 'ell rese"tor

Pre B 'ell res"tor "d "ere!&angan

nor!al early B:'ell !e!ilii 4ungsi!e!i'u "ertahanan dan "roli4erasi B:'ell t$d di4erensiasi# B:'ell "reursor ALLdi'irian sel yg &erhenti "d saat stase awal"ere!&angan B:'ell#

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Signaling "athway in'hildhood ALL

1# N,T9H/ "athway

Setelah N,T9H / ati4 dan !e!&elah diri5

N,T9H !ele"asan intraseluler do!ainN,T9H / yg &ertransloasi e nuleus dan&eer$a s&g 4ator transri"si yg !engatur"ere!&angan T:'ell#

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 TERIMA%ASIH