2.Chronic Leukemia¶

Proliferation of RBC,Platlets,Basophils,Neutrophils,Platelets,Lymphocytes

graph TD
    BB[Neoplastic Proliferation of Blood  Cells]

    subgraph Myloproliferaative Dyplasia
    Y[Myeloid Cell Neoplasia];    
    Y ==> yy1z[All Are elevated RBC.Platelets,Granulocytes]

    yy1z ==> Z1[Predominatly Elevated Basophils]
    Z1 ==>Y1[Chronic Myeloid Leukemia]
    Y1 ==> Y11["`t(9:22) Tyrosine Kinase`"]
    Y11 ==> Y1a[No Leukocyte Alkaline Phosphatease
    if + spleenomegaly ➡️ ALL.AML,
    ]

    yy1z ==> Yza[Predominantly RBC elevated]
    Yza ==>Y2[Polycythemai Vera]
    Y2 ==>|from| Z2[JAK~2~ Kinase mutation] 
    Z2 ==> Y2a[⬆️⬆️ RBC,and others ]

    yy1z ==> Z3[Premdominantly Platelets]
    Z3==>Y3[Essential Thrombocythemia]
    Y3 ==> Y3a[⬆️⬆️ Elevated Platelets ➡️if Paltelets function normally Thrombosis if not the Bleeding Disorder
    NO marrow Fibrosis,No ALL,AML risk];
    end 

    subgraph Chronic Lymphoid Leukemia
    X[Chronic Leukemia] ==> X1[CLL-Lymphocyte Proliferation]
    X1 ==> X1a[Naive Bcell] & X1b[Mature Bcell] & X1c["`CD4~+~`"]
    X1a ==> X1aa["`CD5+,CD20+,
    smudge cell,
    A-globulenemia (or ) Hemolytic anemia,
    Lympadenopathy ➡️ Lymphoma`"];
    X1b ==> X1ca77[Red pulp spleenomeagaly
    TRAP enzyme +
    Dry marrow]
    X1c ==> X1ca[HTLV-1 virus] & X1cab[Mycosis Fungoides];
    X1ca ==> X1cacb[Stimulate Plasma cell ➡️ Lytic lesion,Hypercalcemia];
    end

    BB===>Y
    BB===>X

Smudge cell of Naive B-cell¶

Hairy Cells of Mature B-cells¶

Symptoms of Chronic Lymphoid LEukemia¶

Naive B-cell Leukemia¶

A-globulenemia(abnormal Ig ,so no function)
Hemolysis(Auto-immunity)
Lymphoma(As b-cell goes to lymph)

Mature B-cell¶

Rash (Cd4+ cell to skin)
Lymphadenopathy, Hepatic spleenomegaly

Symptoms of Myeloproliferative Disorder¶

Hyper-uraemia ,risk of GOUT
MArrow Fibrosis(burnout)
AML /ALL risk