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1888? Paul Ehrlich? ?? ??

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Title: 1 Author: lee won sik Last modified by: aaa Created Date: 4/18/2001 4:20:22 PM Document presentation format: – PowerPoint PPT presentation

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Title: 1888? Paul Ehrlich? ?? ??

1
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2
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4
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5
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1888? Paul Ehrlich? ?? ??
?? ? 2-6?/???, ??? ? ?? ??
15-25?? ?? ?? ??, 60? ?? ??
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??? ??

6
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7
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1. ???(95??)
???(75) ??? ??? ?? ??
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?? ? ????(??, ??????)
???? ??
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2. ???(5??)

8
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???? ?? ??
?? ????? ??
???? ??? lt30
??????? ?? ? 2?? ??
?????? lt500/mm3
???? lt20,000/mm3
?????? lt1

9
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1. ??????
??, ?????? ??
??? ? ??? ??
??? ??
2.????
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???????? ??
?????? ??
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10
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??? ?? ?? ?? -gt ??
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11
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???? ??
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12
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?????? ??
?? ????? ?? ??
HLA ?? ???? ??, ?? ????? ???? ??
??
????????
???????
???????
????? ?? ?? ?? ???? ??

13
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1) ???????
??????? 40mg/kg? 4?? ????
???????? 3.5mg/kg? 5?? ????
??? ???(serum sickness), ??????
?? ????????? ?? ??

14
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2) ???????
???? T?? ?? ??
???? ATG? ?? ??
??? ?? 15mg/kg? ?? ??
??? ???, ???, ??? ??

15
????? ?? ?? - ??????

????
????? 50?? ???? ???? ??
?????? ?? 70?? ???? ??
??? ??? ??? ??? 30-40?? ??

16
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???
???
17
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????? ??? ??
??? ??? ???? ????? ??
???? ???? ? ???? ??? ??
????? ??? ??
?????? ??? ?? ?? ????? 75-90
??? ?? ????? 35-55

18
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??? ???? ???? ?? ???? ?? ?? ???
????? ?? 50? ??? ?? ????? ??? ????
50? ?? ????? ??? ????? ??? ? ???.
????
????? ??, ??????? ???? ?????????
????? ?? ??? ???? ?? ?????.
?? ?????? ?? ???? ????,
?? ????? ? ??? ?? ??? ????? ???.

19
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??? AA
?? AA
????
?????
??lt40?, KPSgt70
??gt40?, KPSlt70
??? ??, ??????
????, ??? ??, ????
??????,??????,??? ??
????
????
20
????? ???

21
????? ??? ??

???? ???? ??? ????? ???
???????? ?? ??? ??? ???
?? ??? ? ???? ??
?? ???? ??? ?? ??,
????? ?? ??? ??? ?? ???
?????? ??? ??
???? ??????? ?? (10-40)

22
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23
????? ??? ??
Disease Frequency Blood Findings Bone Marrow Findings Prognosis
Refractory anemia (RA) 5-10 Anemia Erythroid dysplasia only Protracted course No or rare blasts lt5 blasts Leukemic ransformation lt15 ringed sideroblasts in 6 Refractory anemia with 10-12 Anemia Erythroid dysplasia only Protracted course ringed sideroblasts No blasts 15 ringed sideroblasts Leukemia in 12 (RARS) lt5 blasts Refractory cytopenia with 24 Cytopenias Dysplasia in 10 of cells Variable clinical course multilineage dysplasia (2 or 3 lineages) in 2 lineages Leukemia in 11 (RCMD) No or rare blasts lt5 blasts No Auer rods No Auer rods lt1 x 109/L monocytes lt15 ringed sideroblasts RCMD with ringed 15 Cytopenias Dysplasia in 10 of cells sideroblasts (RCMD-RS) (2 or 3 lineages) in 2 lineages No or rare blasts 15 ringed sideroblasts No Auer rods lt5 blasts lt1 x 109/L monocytes No Auer rods Refractory anemia with 40 Cytopenias Unilineage or multilineage Progressive BM failure excess blasts-1 (RAEB-1 2) lt5 blasts dysplasia Leukemia in 25 (RAEB-1) No Auer rods 5-9 blasts lt1 x 109/L monocytes No Auer rods Refractory anemia with Cytopenias Unilineage or multilineage Progressive BM failure excess blasts-2 (RAEB-2 5-19 blasts dysplasia Leukemia in 33 Auer rods 10-19 blasts lt1 x 109/L monocytes Auer rods Myelodysplastic syndrome, Unknown Cytopenias Dysplasia in myeloid or Unknown unclassified (MDS-U) No or rare blasts platelet lineage No Auer rods lt5 blasts No Auer rods MDS with isolated del(5q) Unknown Anemia Nl or increased Long survival lt5 blasts megakaryocytes with Platelets nl or hypolobated nuclei increased lt5 blasts No Auer rods Isolated del(5q)
24
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1)??? ??? ??? ?
2)?????? ??
3)??? ??
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1) ? ???
2) ?? ??? 1, 2
3) ? ???

25
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?? ??? ??? ??????? ??? ????(??, ??????, ??????)?
???? ???? ???????? ???

26
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???? ????
??????
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27
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????? ????? ???? ?? ?? ??? ????? ???, ?? ?? FDA??
5-Azacytidine? Amifostine? ? ??? ??????? ??? ?
?? ?? ???? ? 40?? ??? ??? ? ?? ??
??? ?? ?? ???? ???? ?? ???? ??? ??

28
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