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poor

adjective Referring to a status wherein a person or persons lack enough money to live at a standard of comfort considered normal in a society. In 2009, 14.3% of Americans were poor; by race, 25% of Hispanics and Blacks are poor, 9% of Whites are poor.

leukemia

Hematology An uncommon–incidence, US 3.5/105/yr—malignant clonal expansion of myeloid or lymphoid cells characterized by an ↑ in circulating WBCs; leukemias may be an incidental finding when evaluating an unrelated clinical problem, or when the expansion compromises BM production of one or more cell lines causing anemia, thrombocytopenia, granulocytopenia; leukemias are divided by chronology–acute or chronic, by cell lineage–lymphoid, myeloid/myelocytic, monocytic or megakaryocytic and divided by stage of maturation or cell size Clinical BM infiltration by leukemia, resulting in anemia, thrombocytopenia, granulocytopenia, immune paralysis, ↓ B cells and CD4–helper T cells, ↑ CD8–suppressor T cells, infiltration and leukostasis, cranial nerve palsies, meningitis, lymphadenopathy, hepatosplenomegaly, testicular and cutaneous involvement, metabolic derangements–eg, ↑ Ca2+, K+, LD, ammonia, weight loss, less commonly, autoimmune hemolytic anemia, pallor and arthralgia Diagnosis Hx, physical exam, peripheral smear Management Chemotherapy, RT, BMT. See Accelerated leukemia, Acute leukemia, Acute lymphocytic leukemia, Acute myelocytic leukemia, Acute promyelocytic leukemia, Adult T-cell leukemia-lymphoma, Aleukemic leukemia, Biphenotypic leukemia, Central nervous system leukemia, Chemotherapy-induced leukemia, Chronic leukemia, Chronic lymphocytic leukemia, Chronic myelocytic leukemia, Chronic myelomonocytic leukemia, Congenital leukemia, Erythroleukemia, FAB classification, Hairy cell leukemia, Hand mirror cell leukemia, Herald state of leukemia, Mast cell leukemia, Megakaryoblastic leukemia, Multilineage leukemia, Plasma cell leukemia, Preleukemia, Prolymphocytic leukemia, Promyelocytic leukemia, Smoldering myeloid leukemia.
Leukemia Acute v. Chronic
Acute leukemia More common in children, 80% are ALL, often before age 10, peak at ages 3–7 in whites, ♂:♀ ratio, 1.3:1 Cell types Early pre-B cell 67%; pre-B cell 18%; B cell 1%; T cell 14%; 50-85% are cALLA positive–common acute lymphocytic leukemia antigen, CD10; 5% have Philadelphia chromosome Clinical ALL is more abrupt than AML, with petechial hemorrhage, bone and abdominal pain, headache and vomiting due to ↑ intracranial pressure, lymphadenopathy, splenomegaly, hepatomegaly Lab 70% have low-grade lymphocytosis–< 20 x 109 when diagnosed Evaluation Acute leukemia immunophenotypic profile Specimen EDTA–lavender top tube and sodium heparin–green top tube, peripheral blood smears Method of analysis Flow cytometry, immunofluorecesence Markers measured CD1, -2, -3, -4, -5, -7, -8, -10, -19. -20, -21, -33, -34, -56, megakaryocytic markers, HLA D/DR, kappa, lambda, TdT Management Protocols vary according to standard- or high-risk clinical features, and may include BMT
Chronic leukemia More common in adults/older children, often myelocytic; CML is Philadelphia chromosome positive; may occur < age 5 with myelomonocytosis, anemia, thrombocytopenia, lymphadenopathy; WBC count < 50 x 109, ≠ HbF, ≠ muraminidase; adult CML comprises 20% of all leukemias Clinical Gradual onset of fatigability, anorexia, splenomegaly; lymphadenopathy is uncommon Lab > 25 x 109/L leukemic cells in blood–often an absolute lymphocytosis of > 15 x 1010/L, < 10% blasts in BM, myeloid:erythroid ratio is 10-30:1, 90% of cases have low-to-absent leukocyte alkaline phosphatase and rarely also, ≠ vitamin B12 and B12-binding capacity Evaluation Chronic leukemia immunophenotype profile Specimen EDTA–lavender top tube and sodium heparin–green top tube, peripheral blood smears Method of analysis Flow cytometry, immunofluorescence Markers measured CD3, -5, -19, -20, -21, kappa, lambda Management see Chemotherapy, Induction Prognosis see Remission.
Leukemia–prognostic features
Acute lymphocytic leukemia
Good Age 2-10, CD10 positivity, hyperdiploid karyotype
Poor Age < 2; >10, B-cell phenotype, especially L2 phenotype by FAB classification, presence of chromosome translocations, CNS involvement, mediastinal masses, high initial WBC count
Acute myelocytic leukemia
Good Younger, presence of Auer rods, rapid therapeutic response
Poor Older, prior malignancy or therapy, multiple chromosome defects  
References in periodicals archive ?
That means that the increase in disposable income for the richest 20 per cent of households has been more than four times greater than the increase in disposable income for the poorest 20 per cent.
PS8,669 PS13,629 The richest 20% The second richest 20% The third richest/poorest 20% The second poorest 20% The poorest 20%
Eliminating the tax could drive penetration further and enable the poorest consumers to benefit from mobile connectivity and value-added services such as mobile money.
The Equality Trust found the poorest 10% of the population pay more of their gross income in VAT (12.
In India -- which has long stuck to the principle of "common but differentiated responsibility" in dealing with climate change -- the emissions of someone in the poorest half of the population are, on average, just one-twentieth those of someone in the poorest half of the American population.
In contrast, the number of drivers from the most affluent areas of the two local authorities is 215 or 32 per 10,000 - some 30% less than the rate of crashes among the poorest people.
The report found that the richest fifth of the population pay three percentage points less of their income in tax than the poorest fifth.
The TaxPayers' Alliance research found that direct and indirect taxes accounted for an average 47% of the gross income of the poorest 10% of households, with VAT accounting for the biggest share of the bill.
But we are the poorest country and it is high time both Russians and Americans, and everydoby understand they cannot constantly demand things from the poorest country and the poorest people," Borisov made clear.
75 million of the poorest families in the UK have been made poorer by a "perfect storm" of welfare reform in the last three years, a new Oxfam report claims.
Despite tough economic times, a global coalition of developed and developing countries today pledged to accelerate the fight to end extreme poverty by committing a record $52 billion in financing over the next three years for the World Bank s fund for the poorest, the International Development Association (IDA).
Sadly with more than 18,000 murders a year (some estimates put the rate much higher - including the murder of many Zimbabweans not reported) there is in effect a civil war taking place and the poorest have seen little or no improvement in their lives since the end of apartheid with corruption and exploitation rampant.