Ghiduri practice hematologice - Spitalul Clinic Municipal de Urgenta ...
Ghiduri practice hematologice - Spitalul Clinic Municipal de Urgenta ...
Ghiduri practice hematologice - Spitalul Clinic Municipal de Urgenta ...
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In cadrul LAL-T se consi<strong>de</strong>ra 4 subtipuri: pro-T, pre-T, timica centrala si timica medulara.<br />
La 25% din LAL la copii si 35% la adult apar markeri imunofenotipici ai seriei mieloi<strong>de</strong>.<br />
2. Modificari citogenetice si <strong>de</strong> genetica moleculara mai frecvente<br />
translocatia/ Modificarea Frecventa % Caracteristicile clinice<br />
rearanjarea moleculara copil adult<br />
Prognostic prost (mai ales la<br />
Fuziune<br />
adult), hiperleucocitoza la copii,<br />
T(1;19) E2A/PBX1 5-6 3 afectarea SNC, <strong>de</strong> obicei<br />
imunofenotip <strong>de</strong> pre-B cu<br />
markeri <strong>de</strong> mielo.<br />
Prognostic foarte prost (mai ales<br />
T(9;22) Fuziune 3-5 20-40 la adult), hiperleucocitoza,<br />
BCR/ABL<br />
majoritatea imunofenotip pre-B<br />
Prognostic foarte prost,<br />
T(4;11) / Fuziune 2-3 3-6 hiperleucocitoza, predomina la<br />
r 11q23 MLL/AF4<br />
copilul mic, fenotip pro-B<br />
Prognostic mai bun cu tratament<br />
T(8;14) sau<br />
intensiv, predomina la sexul<br />
t(2;8) sau Fuziune 1-2 2-4 masculin, <strong>de</strong>terminari<br />
t(8;22) MYC/IgH<br />
extramedulare, morfologic<br />
LAL3, imunofenotip B<br />
Prognostic intermediar (mai<br />
r14q11 HOX11,<br />
putina experienta la adult),<br />
HOX11L2/TC 3-4 6 predomina sexul masculin,<br />
R 7q34<br />
T(12;21)<br />
Rδ<br />
TAL1/<br />
TCRβ<br />
Fuziune<br />
TEL/AML1<br />
3 2<br />
20-25 1-2<br />
12<br />
hiperleucocitoza, <strong>de</strong>terminari<br />
extramedulare, fenotip T<br />
Prognostic favorabil (experienta<br />
limitata la adult)