from pptx import Presentation
from pptx.util import Inches, Pt, Emu
from pptx.dml.color import RGBColor
from pptx.enum.text import PP_ALIGN, MSO_ANCHOR
from pptx.util import Inches, Pt
import copy
from io import BytesIO

# ── Colour palette ──────────────────────────────────────────────────────────
C_DARK_BLUE   = RGBColor(0x1A, 0x37, 0x6C)   # deep navy
C_MED_BLUE    = RGBColor(0x27, 0x5D, 0xA6)   # accent blue
C_LIGHT_BLUE  = RGBColor(0xD6, 0xE4, 0xF7)   # pale blue fill
C_TEAL        = RGBColor(0x00, 0x86, 0x8A)   # teal accent
C_ORANGE      = RGBColor(0xE8, 0x7D, 0x1E)   # warm orange
C_RED         = RGBColor(0xC0, 0x39, 0x2B)   # alert red
C_GREEN       = RGBColor(0x1E, 0x8A, 0x44)   # green
C_WHITE       = RGBColor(0xFF, 0xFF, 0xFF)
C_DARK_GREY   = RGBColor(0x2C, 0x2C, 0x2C)
C_MID_GREY    = RGBColor(0x60, 0x60, 0x60)
C_LIGHT_GREY  = RGBColor(0xF4, 0xF6, 0xF9)
C_GOLD        = RGBColor(0xF0, 0xC0, 0x27)
C_PURPLE      = RGBColor(0x6C, 0x3D, 0x9E)

prs = Presentation()
prs.slide_width  = Inches(13.333)
prs.slide_height = Inches(7.5)
blank = prs.slide_layouts[6]

# ── Helper functions ─────────────────────────────────────────────────────────
def add_rect(slide, x, y, w, h, fill_rgb=None, line_rgb=None, line_width=None):
    shape = slide.shapes.add_shape(1, Inches(x), Inches(y), Inches(w), Inches(h))
    if fill_rgb:
        shape.fill.solid()
        shape.fill.fore_color.rgb = fill_rgb
    else:
        shape.fill.background()
    if line_rgb:
        shape.line.color.rgb = line_rgb
        if line_width:
            shape.line.width = Pt(line_width)
    else:
        shape.line.fill.background()
    return shape

def add_text(slide, text, x, y, w, h, size=14, bold=False, color=C_DARK_GREY,
             align=PP_ALIGN.LEFT, italic=False, wrap=True, anchor=MSO_ANCHOR.TOP):
    tb = slide.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h))
    tf = tb.text_frame
    tf.word_wrap = wrap
    tf.vertical_anchor = anchor
    tf.margin_left = tf.margin_right = tf.margin_top = tf.margin_bottom = 0
    p = tf.paragraphs[0]
    p.alignment = align
    run = p.add_run()
    run.text = text
    run.font.size = Pt(size)
    run.font.bold = bold
    run.font.italic = italic
    run.font.color.rgb = color
    run.font.name = "Calibri"
    return tf

def add_multiline_text(slide, lines, x, y, w, h, size=11, color=C_DARK_GREY,
                        bold_first=False, wrap=True, line_spacing=None):
    """lines = list of (text, bold, color_override)"""
    tb = slide.shapes.add_textbox(Inches(x), Inches(y), Inches(w), Inches(h))
    tf = tb.text_frame
    tf.word_wrap = wrap
    tf.margin_left = tf.margin_right = tf.margin_top = tf.margin_bottom = 0
    for i, item in enumerate(lines):
        if isinstance(item, str):
            text, bold, col = item, False, color
        else:
            text = item[0]
            bold = item[1] if len(item) > 1 else False
            col  = item[2] if len(item) > 2 else color
        if i == 0:
            p = tf.paragraphs[0]
        else:
            p = tf.add_paragraph()
        if line_spacing:
            p.space_before = Pt(line_spacing)
        run = p.add_run()
        run.text = text
        run.font.size = Pt(size)
        run.font.bold = bold
        run.font.color.rgb = col
        run.font.name = "Calibri"
    return tf

def slide_header(slide, title, subtitle=None,
                  bar_color=C_DARK_BLUE, title_color=C_WHITE):
    """Top header bar with title"""
    add_rect(slide, 0, 0, 13.333, 1.0, fill_rgb=bar_color)
    add_text(slide, title, 0.35, 0.08, 12.5, 0.85,
             size=26, bold=True, color=title_color, align=PP_ALIGN.LEFT,
             anchor=MSO_ANCHOR.MIDDLE)
    if subtitle:
        add_text(slide, subtitle, 0.35, 0.78, 12, 0.3,
                 size=11, bold=False, color=C_LIGHT_BLUE, align=PP_ALIGN.LEFT)

def footer(slide, text="MDS/MPN Overlap Disorders  |  Board Prep Study Guide"):
    add_rect(slide, 0, 7.15, 13.333, 0.35, fill_rgb=C_DARK_BLUE)
    add_text(slide, text, 0.3, 7.17, 12.5, 0.3,
             size=9, color=C_LIGHT_BLUE, align=PP_ALIGN.LEFT)

def section_pill(slide, text, x, y, w=2.5, h=0.32, color=C_MED_BLUE):
    add_rect(slide, x, y, w, h, fill_rgb=color)
    add_text(slide, text, x+0.05, y, w-0.1, h,
             size=9, bold=True, color=C_WHITE, align=PP_ALIGN.CENTER,
             anchor=MSO_ANCHOR.MIDDLE)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 1 – Title Slide
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
# Full background gradient-like via two rects
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_DARK_BLUE)
add_rect(s, 0, 0, 13.333, 3.5, fill_rgb=C_MED_BLUE)
# Accent stripe
add_rect(s, 0, 3.4, 13.333, 0.12, fill_rgb=C_GOLD)

add_text(s, "MDS / MPN Overlap Disorders", 0.6, 0.5, 12, 2.2,
         size=44, bold=True, color=C_WHITE, align=PP_ALIGN.CENTER,
         anchor=MSO_ANCHOR.MIDDLE)
add_text(s, "Myelodysplastic / Myeloproliferative Neoplasms", 0.6, 2.6, 12, 0.7,
         size=20, bold=False, color=C_GOLD, align=PP_ALIGN.CENTER)
add_text(s, "Board Prep Study Guide  |  Pathology  |  2026", 0.6, 3.7, 12, 0.5,
         size=16, color=RGBColor(0xAA, 0xCC, 0xEE), align=PP_ALIGN.CENTER)

# Entity pills
entities = ["CMML", "aCML", "JMML", "MDS/MPN-U", "CNL (ref)"]
cols = [C_TEAL, C_ORANGE, C_GREEN, C_PURPLE, C_MID_GREY]
for i, (ent, col) in enumerate(zip(entities, cols)):
    xx = 1.2 + i * 2.2
    add_rect(s, xx, 4.5, 2.0, 0.55, fill_rgb=col)
    add_text(s, ent, xx, 4.5, 2.0, 0.55,
             size=13, bold=True, color=C_WHITE, align=PP_ALIGN.CENTER,
             anchor=MSO_ANCHOR.MIDDLE)

add_text(s, "Sources: Quick Compendium Clinical Pathology 5e | Harrison's 22E | Goldman-Cecil | Henry's Lab Medicine",
         0.6, 7.1, 12, 0.35, size=9, color=RGBColor(0x88, 0xAA, 0xCC),
         align=PP_ALIGN.CENTER)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 2 – Overview & Classification
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "Overview: What Are MDS/MPN Overlap Disorders?")
footer(s)

# Left panel – concept
add_rect(s, 0.25, 1.1, 5.8, 5.9, fill_rgb=C_WHITE, line_rgb=C_MED_BLUE, line_width=1)
add_text(s, "Core Concept", 0.4, 1.15, 5.5, 0.4,
         size=13, bold=True, color=C_DARK_BLUE)
concept_lines = [
    ("Features of BOTH myelodysplasia AND myeloproliferation simultaneously", False),
    ("", False),
    ("MDS features:", True, C_MED_BLUE),
    ("  • Cytopenias (dysplastic blood cells)", False),
    ("  • Bone marrow dysplasia", False),
    ("  • Ineffective haematopoiesis", False),
    ("", False),
    ("MPN features:", True, C_TEAL),
    ("  • Hypercellular marrow", False),
    ("  • Peripheral blood leukocytosis / monocytosis", False),
    ("  • Splenomegaly", False),
    ("", False),
    ("Key rule: BCR-ABL1 MUST be absent in all entities", True, C_RED),
    ("Philadelphia chromosome MUST be absent", False, C_RED),
]
add_multiline_text(s, concept_lines, 0.4, 1.6, 5.5, 5.2, size=11, line_spacing=1)

# Right panel – WHO entities table
add_rect(s, 6.4, 1.1, 6.7, 5.9, fill_rgb=C_WHITE, line_rgb=C_MED_BLUE, line_width=1)
add_text(s, "WHO 2022 Classification – MDS/MPN Entities", 6.55, 1.15, 6.4, 0.4,
         size=13, bold=True, color=C_DARK_BLUE)

# Table header
add_rect(s, 6.4, 1.6, 6.7, 0.38, fill_rgb=C_DARK_BLUE)
add_text(s, "Entity", 6.45, 1.62, 2.2, 0.34, size=10, bold=True, color=C_WHITE)
add_text(s, "Key Defining Feature", 8.7, 1.62, 4.2, 0.34, size=10, bold=True, color=C_WHITE)

rows = [
    ("CMML", "Monocytosis >1×10⁹/L + dysplasia", C_WHITE, C_DARK_GREY),
    ("aCML", "Neutrophilia + dysgranulopoiesis, no BCR-ABL", C_LIGHT_BLUE, C_DARK_GREY),
    ("JMML", "Children; RAS/MAPK mutations; monocytosis", C_WHITE, C_DARK_GREY),
    ("MDS/MPN-RS-T", "Ring sideroblasts + thrombocytosis, SF3B1", C_LIGHT_BLUE, C_DARK_GREY),
    ("MDS/MPN-U", "MDS/MPN features, not fitting above", C_WHITE, C_DARK_GREY),
]
for i, (name, feat, bg, fg) in enumerate(rows):
    yy = 2.02 + i * 0.88
    add_rect(s, 6.4, yy, 6.7, 0.86, fill_rgb=bg, line_rgb=RGBColor(0xCC, 0xDD, 0xEE), line_width=0.5)
    add_text(s, name, 6.45, yy+0.05, 2.2, 0.76, size=11, bold=True, color=C_DARK_BLUE)
    add_text(s, feat, 8.7, yy+0.05, 4.2, 0.76, size=10, color=fg, wrap=True)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 3 – CMML Part 1: Criteria & Morphology
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "CMML – Chronic Myelomonocytic Leukemia (1/2)", bar_color=C_TEAL)
footer(s)

# Diagnostic criteria box
add_rect(s, 0.25, 1.1, 8.2, 4.1, fill_rgb=C_WHITE, line_rgb=C_TEAL, line_width=1.5)
section_pill(s, "WHO Diagnostic Criteria (ALL required)", 0.35, 1.1, 3.5, color=C_TEAL)
crit_lines = [
    ("1.  Sustained PB monocytosis ≥0.5×10⁹/L AND monocytes ≥10% of WBC differential", False),
    ("     (must persist >3 months; exclude reactive causes first)", False, C_MID_GREY),
    ("2.  Not meeting criteria for BCR-ABL1+ CML, PV, ET, or PMF", False),
    ("3.  No PDGFRA, PDGFRB, FGFR1, PCM1-JAK2 rearrangements", False),
    ("4.  <20% blasts + promonocytes in PB and BM", False),
    ("     (≥20% → reclassify as AML)", False, C_RED),
    ("5.  Dysplasia in ≥1 myeloid lineage OR cytogenetic/molecular clonality evidence", False),
]
add_multiline_text(s, crit_lines, 0.4, 1.55, 7.9, 3.4, size=11, line_spacing=2)

# Subtype box
add_rect(s, 0.25, 5.3, 8.2, 1.9, fill_rgb=C_WHITE, line_rgb=C_TEAL, line_width=1)
section_pill(s, "Subtypes (WBC-based)", 0.35, 5.3, 2.5, color=C_TEAL)
subtype_lines = [
    ("MDS-CMML (WBC <13×10⁹/L): cytopenia-predominant, dyplastic features", False),
    ("MPN-CMML (WBC ≥13×10⁹/L): proliferative, splenomegaly, constitutional symptoms", False),
    ("Blast count: CMML-1 = <5% PB blasts, <10% BM blasts  |  CMML-2 = 5–19% PB or 10–19% BM", True, C_MED_BLUE),
]
add_multiline_text(s, subtype_lines, 0.4, 5.7, 7.9, 1.4, size=11, line_spacing=3)

# Right info panel
add_rect(s, 8.65, 1.1, 4.45, 6.1, fill_rgb=C_WHITE, line_rgb=C_TEAL, line_width=1)
section_pill(s, "Key Facts", 8.75, 1.1, 1.8, color=C_DARK_BLUE)
facts = [
    ("Epidemiology", True, C_DARK_BLUE),
    ("• Median age 73–75 years", False),
    ("• Male predominance (1.5–3:1)", False),
    ("• Incidence ~4/100,000/year", False),
    ("", False),
    ("Genetics", True, C_DARK_BLUE),
    ("• TET2 ~60%  (epigenetic)", False),
    ("• SRSF2 ~50%  (splicing)", False),
    ("• ASXL1 ~40%  (chromatin)", False),
    ("• RAS pathway ~30%", False),
    ("• TET2 + SRSF2 co-mutation → CMML phenotype", False),
    ("• Cytogenetics abnormal in ~30%", False),
    ("  (trisomy 8, -7/del7q most common)", False),
    ("", False),
    ("Immunophenotype", True, C_DARK_BLUE),
    ("• CD13+, CD33+ (myelomonocytic)", False),
    ("• CD14+, CD64+, CD68+, CD163+ (variable)", False),
    ("• Classical MO1: CD14+/CD16−", False),
    ("• Dual esterase staining characteristic", False),
]
add_multiline_text(s, facts, 8.75, 1.5, 4.1, 5.5, size=10, line_spacing=1)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 4 – CMML Part 2: Differential, Treatment, Prognosis
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "CMML – Differential Diagnosis, Treatment & Prognosis (2/2)", bar_color=C_TEAL)
footer(s)

# Differential
add_rect(s, 0.25, 1.1, 6.1, 5.9, fill_rgb=C_WHITE, line_rgb=C_TEAL, line_width=1)
section_pill(s, "Reactive Monocytosis – Must Exclude First", 0.35, 1.1, 4.0, color=C_RED)
diff_lines = [
    ("Infections:", True, C_DARK_BLUE),
    ("  TB, fungal infections, subacute bacterial endocarditis", False),
    ("  Viral infections, protozoal infections", False),
    ("", False),
    ("Autoimmune / Inflammatory:", True, C_DARK_BLUE),
    ("  Connective tissue diseases, sarcoidosis", False),
    ("  Lipid storage disorders", False),
    ("", False),
    ("Other:", True, C_DARK_BLUE),
    ("  Post-splenectomy state", False),
    ("  BM regeneration after chemotherapy", False),
    ("  Recovery phase of acute infection", False),
    ("", False),
    ("Haematologic mimics:", True, C_DARK_BLUE),
    ("  BCR-ABL1+ CML (exclude by FISH/PCR)", False),
    ("  PDGFRA/PDGFRB rearrangements → exclude", False),
    ("  Primary myelofibrosis with monocytosis", False),
    ("  PV with monocytosis", False),
]
add_multiline_text(s, diff_lines, 0.4, 1.55, 5.7, 5.3, size=10.5, line_spacing=1)

# Treatment & Prognosis
add_rect(s, 6.6, 1.1, 6.5, 2.8, fill_rgb=C_WHITE, line_rgb=C_ORANGE, line_width=1)
section_pill(s, "Treatment", 6.7, 1.1, 1.8, color=C_ORANGE)
tx_lines = [
    ("• Hypomethylating agents (azacitidine/decitabine)", False),
    ("   Response rate ~30–40%", False, C_MID_GREY),
    ("• Hydroxyurea: proliferative disease control", False),
    ("• Allogeneic HSCT: only curative option", True, C_RED),
    ("• Clinical trials: JAK inhibitors, SRC inhibitors", False),
    ("• TKIs NOT effective (no BCR-ABL)", True, C_RED),
]
add_multiline_text(s, tx_lines, 6.75, 1.55, 6.1, 2.2, size=10.5, line_spacing=1)

add_rect(s, 6.6, 4.05, 6.5, 3.05, fill_rgb=C_WHITE, line_rgb=C_RED, line_width=1)
section_pill(s, "Prognosis", 6.7, 4.05, 1.8, color=C_RED)
prog_lines = [
    ("• Median survival: <3 years", True, C_RED),
    ("• ~20% risk of AML transformation", True, C_RED),
    ("• Adverse prognostic factors:", False),
    ("   ASXL1 frameshift/nonsense mutations", False),
    ("   Higher blast count (CMML-2)", False),
    ("   MPN-CMML phenotype (higher WBC)", False),
    ("   Thrombocytopenia, anemia", False),
    ("• CMML-specific scoring systems:", False),
    ("   CPSS, GFM, MDAPS", False),
]
add_multiline_text(s, prog_lines, 6.75, 4.5, 6.1, 2.4, size=10.5, line_spacing=1)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 5 – Atypical CML
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "Atypical CML (aCML), BCR-ABL1-Negative", bar_color=C_ORANGE)
footer(s)

# Left column – criteria
add_rect(s, 0.25, 1.1, 6.2, 3.8, fill_rgb=C_WHITE, line_rgb=C_ORANGE, line_width=1.5)
section_pill(s, "Diagnostic Criteria", 0.35, 1.1, 2.2, color=C_ORANGE)
crit = [
    ("• WBC >13×10⁹/L with immature granulocytes", False),
    ("  (neutrophils, metamyelocytes, myelocytes, promyelocytes)", False, C_MID_GREY),
    ("• Dysgranulopoiesis (MANDATORY – key feature)", True, C_RED),
    ("• Bone marrow: myeloid hyperplasia + dysplasia", False),
    ("• Blasts <20%  (≥20% → AML)", False),
    ("• Monocytes NOT prominent (<10% of WBC differential)", False),
    ("• Basophilia absent or minimal", False),
    ("• Philadelphia chromosome ABSENT", True, C_RED),
    ("• BCR-ABL1 ABSENT (mandatory exclusion by PCR/FISH)", True, C_RED),
]
add_multiline_text(s, crit, 0.4, 1.55, 5.8, 3.2, size=11, line_spacing=1)

# Left column – genetics
add_rect(s, 0.25, 5.05, 6.2, 2.2, fill_rgb=C_WHITE, line_rgb=C_ORANGE, line_width=1)
section_pill(s, "Molecular Genetics", 0.35, 5.05, 2.2, color=C_ORANGE)
gen = [
    ("SETBP1 mutations: ~25% of cases", False),
    ("ETNK1 mutations: recurrent, recently identified", False),
    ("CSF3R mutations: 5–10% (vs 80% in CNL)", False),
    ("JAK2 mutations: some cases", False),
    ("No single defining mutation (contrast with CNL)", False, C_MID_GREY),
]
add_multiline_text(s, gen, 0.4, 5.5, 5.8, 1.6, size=11, line_spacing=2)

# Right – vs Classic CML comparison table
add_rect(s, 6.65, 1.1, 6.45, 6.15, fill_rgb=C_WHITE, line_rgb=C_ORANGE, line_width=1)
section_pill(s, "aCML vs Classic BCR-ABL+ CML", 6.75, 1.1, 3.2, color=C_DARK_BLUE)

# Table headers
add_rect(s, 6.65, 1.48, 6.45, 0.4, fill_rgb=C_DARK_BLUE)
for col_x, col_w, text in [(6.7, 2.2, "Feature"), (8.95, 2.0, "Classic CML"), (11.0, 2.0, "Atypical CML")]:
    add_text(s, text, col_x, 1.49, col_w, 0.38, size=10, bold=True, color=C_WHITE)

table_rows = [
    ("BCR-ABL1 / Ph", "Present", "Absent"),
    ("Dysplasia", "Absent", "Present (hallmark)"),
    ("Basophilia", "Prominent", "Absent/minimal"),
    ("WHO category", "MPN", "MDS/MPN"),
    ("TKI response", "Excellent", "None"),
    ("Monocytosis", "Absent", "Absent"),
    ("Median survival", "Long with TKI", "~2–3 years"),
    ("Key mutation", "BCR-ABL1", "SETBP1, ETNK1"),
]
alt_bg = [C_WHITE, C_LIGHT_BLUE]
for i, (feat, classic, atypical) in enumerate(table_rows):
    yy = 1.92 + i * 0.62
    bg = alt_bg[i % 2]
    add_rect(s, 6.65, yy, 6.45, 0.60, fill_rgb=bg,
             line_rgb=RGBColor(0xCC, 0xDD, 0xEE), line_width=0.5)
    add_text(s, feat, 6.7, yy+0.03, 2.2, 0.54, size=10, bold=True, color=C_DARK_GREY)
    txt_col = C_RED if atypical in ("Absent", "None", "~2–3 years") else C_DARK_GREY
    add_text(s, classic, 8.95, yy+0.03, 2.0, 0.54, size=10, color=C_GREEN)
    add_text(s, atypical, 11.0, yy+0.03, 2.0, 0.54, size=10, color=txt_col)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 6 – JMML
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "JMML – Juvenile Myelomonocytic Leukemia", bar_color=C_GREEN)
footer(s)

# Key facts
add_rect(s, 0.25, 1.1, 3.8, 6.1, fill_rgb=C_WHITE, line_rgb=C_GREEN, line_width=1.5)
section_pill(s, "Epidemiology & Clinical", 0.35, 1.1, 2.8, color=C_GREEN)
epi = [
    ("• EXCLUSIVELY a childhood disease", True, C_RED),
    ("• Incidence: 1.3/million children <14 yrs", False),
    ("• Most common age: <3 years", False),
    ("• Male predominance (2:1)", False),
    ("", False),
    ("Clinical features:", True, C_DARK_BLUE),
    ("• Monocytosis >1×10⁹/L", False),
    ("• Splenomegaly (often massive)", False),
    ("• Leukocytosis (WBC 25–30×10⁹/L)", False),
    ("• Thrombocytopenia + anemia", False),
    ("• Circulating NRBCs frequent", False),
    ("• Cutaneous leukemic infiltrates", False),
    ("• Hypergammaglobulinemia, autoantibodies", False),
    ("", False),
    ("Special association:", True, C_DARK_BLUE),
    ("• Neurofibromatosis type 1 (NF1) – frequent", True, C_ORANGE),
    ("• Noonan syndrome (PTPN11 – some spontaneous recovery)", False),
    ("• Elevated HbF in normal karyotype cases", False),
]
add_multiline_text(s, epi, 0.4, 1.55, 3.5, 5.5, size=10.5, line_spacing=1)

# Diagnostic criteria
add_rect(s, 4.3, 1.1, 4.5, 6.1, fill_rgb=C_WHITE, line_rgb=C_GREEN, line_width=1)
section_pill(s, "WHO Diagnostic Criteria", 4.4, 1.1, 2.6, color=C_GREEN)
diag = [
    ("Clinical & Haematologic (ALL required):", True, C_DARK_BLUE),
    ("1. PB monocytosis >1×10⁹/L", False),
    ("2. BCR-ABL1 absent (Ph chromosome absent)", False),
    ("3. Blasts + promonocytes <20% (PB + BM)", False),
    ("4. Splenomegaly", False),
    ("", False),
    ("PLUS one genetic criterion:", True, C_RED),
    ("A. Somatic mutation in KRAS, NRAS, or PTPN11", False),
    ("B. Clinical NF1 diagnosis OR NF1 mutation", False),
    ("C. CBL mutation + LOH of CBL", False),
    ("D. Monosomy 7 or other cytogenetic abnormality", False),
    ("   OR ≥2 of the following if no mutation found:", False, C_MID_GREY),
    ("   • Elevated HbF for age", False, C_MID_GREY),
    ("   • Myeloid precursors on PB smear", False, C_MID_GREY),
    ("   • WBC >10×10⁹/L", False, C_MID_GREY),
    ("   • Clonal chromosomal abnormality", False, C_MID_GREY),
    ("   • GM-CSF hypersensitivity in colony assay", False, C_MID_GREY),
]
add_multiline_text(s, diag, 4.45, 1.55, 4.2, 5.5, size=10.5, line_spacing=1)

# Genetics + treatment
add_rect(s, 9.05, 1.1, 4.05, 3.5, fill_rgb=C_WHITE, line_rgb=C_GREEN, line_width=1)
section_pill(s, "RAS/MAPK Pathway Mutations", 9.15, 1.1, 2.8, color=C_GREEN)
gen2 = [
    ("Mutation          Frequency", True, C_DARK_BLUE),
    ("PTPN11            ~35% (most common)", False),
    ("NRAS               ~20%", False),
    ("KRAS               ~20%", False),
    ("NF1                 ~15%", False),
    ("CBL                 ~10%", False),
    ("", False),
    ("Karyotype:", True, C_DARK_BLUE),
    ("• Monosomy 7 in ~25% of cases", False),
    ("• Normal karyotype → often high HbF", False),
    ("", False),
    ("Mutations are mutually exclusive", False, C_MID_GREY),
]
add_multiline_text(s, gen2, 9.15, 1.55, 3.8, 2.9, size=10.5, line_spacing=1)

add_rect(s, 9.05, 4.75, 4.05, 2.5, fill_rgb=C_WHITE, line_rgb=C_RED, line_width=1)
section_pill(s, "Prognosis & Treatment", 9.15, 4.75, 2.5, color=C_RED)
prog2 = [
    ("• Poor prognosis overall", True, C_RED),
    ("• Death from organ failure (leukemic infiltrates)", False),
    ("• Allogeneic BMT: only curative option", True, C_RED),
    ("• Noonan+PTPN11 cases: may spontaneously recover", False, C_GREEN),
    ("• ~35% 5-yr survival without BMT", False),
    ("• Research: MEK inhibitors (RAS pathway)", False),
]
add_multiline_text(s, prog2, 9.15, 5.15, 3.8, 2.0, size=10.5, line_spacing=1)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 7 – MDS/MPN-RS-T and MDS/MPN-U
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "MDS/MPN-RS-T  &  MDS/MPN Unclassifiable (MDS/MPN-U)", bar_color=C_PURPLE)
footer(s)

# RS-T
add_rect(s, 0.25, 1.1, 6.2, 6.1, fill_rgb=C_WHITE, line_rgb=C_PURPLE, line_width=1.5)
section_pill(s, "MDS/MPN with Ring Sideroblasts & Thrombocytosis (MDS/MPN-RS-T)", 0.35, 1.1, 5.8, color=C_PURPLE)
rst_lines = [
    ("Definition:", True, C_DARK_BLUE),
    ("• Anaemia with dysplastic erythropoiesis", False),
    ("• Ring sideroblasts ≥15% of erythroid precursors (or ≥5% if SF3B1 mutated)", False),
    ("• Thrombocytosis (platelets ≥450×10⁹/L)", False),
    ("• No BCR-ABL1, no PDGFRA/B/FGFR1 rearrangements", False),
    ("• Blasts <20%", False),
    ("", False),
    ("Key Molecular Feature:", True, C_DARK_BLUE),
    ("• SF3B1 mutation: hallmark (RNA splicing gene)", True, C_PURPLE),
    ("  → leads to ring sideroblast formation", False, C_MID_GREY),
    ("• JAK2 V617F may be present (thrombocytosis component)", False),
    ("• Concurrent SF3B1 + JAK2: strongly suggestive", True, C_PURPLE),
    ("", False),
    ("Clinical:", True, C_DARK_BLUE),
    ("• Elderly patients, similar to MDS-RS + MPN overlap", False),
    ("• Anaemia + elevated platelet count", False),
    ("• Relatively better prognosis than other MDS/MPN entities", False),
    ("", False),
    ("Treatment:", True, C_DARK_BLUE),
    ("• EPO ± lenalidomide for anaemia", False),
    ("• Hydroxyurea/anagrelide for thrombocytosis", False),
    ("• Allogeneic HSCT for high-risk cases", False),
]
add_multiline_text(s, rst_lines, 0.4, 1.55, 5.8, 5.5, size=10.5, line_spacing=1)

# MDS/MPN-U
add_rect(s, 6.65, 1.1, 6.45, 6.1, fill_rgb=C_WHITE, line_rgb=C_MID_GREY, line_width=1.5)
section_pill(s, "MDS/MPN Unclassifiable (MDS/MPN-U)", 6.75, 1.1, 3.5, color=C_MID_GREY)
u_lines = [
    ("Definition (diagnosis of exclusion):", True, C_DARK_BLUE),
    ("• Has features of BOTH MDS and MPN", False),
    ("• Does NOT meet criteria for CMML, aCML, JMML,", False),
    ("  MDS/MPN-RS-T, or classic MPN", False),
    ("• Blasts <20%", False),
    ("• BCR-ABL1 and Ph chromosome absent", False),
    ("", False),
    ("Two Main Scenarios:", True, C_DARK_BLUE),
    ("1. Provisional MDS/MPN-U with prominent thrombocytosis:", False),
    ("   – MDS features + platelets ≥450×10⁹/L", False),
    ("   – No SF3B1 mutation", False),
    ("   – No ring sideroblasts (or <15%)", False),
    ("", False),
    ("2. MDS with JAK2 mutation:", False),
    ("   – MDS features but JAK2 V617F present", False),
    ("", False),
    ("Genetics:", True, C_DARK_BLUE),
    ("• Heterogeneous – no defining mutation", False),
    ("• ASXL1, TET2, EZH2, SETBP1 may be found", False),
    ("• NGS/cytogenetics for clonality evidence", False),
    ("", False),
    ("Prognosis:", True, C_DARK_BLUE),
    ("• Variable, generally poor", False),
    ("• Median survival ~18–30 months", False),
    ("• ~15–20% risk of AML transformation", False),
    ("• HSCT for eligible patients with high-risk disease", False),
]
add_multiline_text(s, u_lines, 6.8, 1.55, 6.1, 5.5, size=10.5, line_spacing=1)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 8 – Master Comparison Table
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "Master Comparison Table – All MDS/MPN Entities")
footer(s)

# Table
cols_x     = [0.2,  2.55, 4.65, 6.75, 8.85, 11.0]
cols_w     = [2.3,  2.1,  2.1,  2.1,  2.1,  2.1]
col_heads  = ["Feature", "CMML", "aCML", "JMML", "MDS/MPN-RS-T", "MDS/MPN-U"]
col_colors = [C_DARK_BLUE, C_TEAL, C_ORANGE, C_GREEN, C_PURPLE, C_MID_GREY]

# Header row
add_rect(s, 0.2, 1.05, 13.0, 0.5, fill_rgb=C_DARK_BLUE)
for cx, cw, ch, cc in zip(cols_x, cols_w, col_heads, col_colors):
    bg = cc if ch != "Feature" else C_DARK_BLUE
    if ch != "Feature":
        add_rect(s, cx, 1.05, cw, 0.5, fill_rgb=bg)
    add_text(s, ch, cx+0.05, 1.06, cw-0.1, 0.48,
             size=10, bold=True, color=C_WHITE, align=PP_ALIGN.CENTER,
             anchor=MSO_ANCHOR.MIDDLE)

table_data = [
    # (row label, cmml, acml, jmml, rs-t, u)
    ("Age",            "65–75 yrs",  "65–75 yrs",  "<3 yrs",     "Elderly",       "Variable"),
    ("Defining PB finding", "Monocytosis\n≥0.5×10⁹/L", "Neutrophilia\n>13×10⁹/L", "Monocytosis\n>1×10⁹/L", "Thrombocytosis\n≥450×10⁹/L", "Mixed"),
    ("Dysplasia",      "YES",        "YES (key!)",  "YES",        "Erythroid",     "YES"),
    ("BCR-ABL1 / Ph",  "ABSENT",     "ABSENT",      "ABSENT",     "ABSENT",        "ABSENT"),
    ("Key mutation(s)","TET2, SRSF2\nASXL1, RAS", "SETBP1\nETNK1, CSF3R", "PTPN11\nKRAS, NRAS\nNF1, CBL", "SF3B1\n(± JAK2)", "Heterogeneous\nASXL1, TET2"),
    ("Monosomy 7",     "Occasional", "Occasional",  "~25%",       "Rare",          "Occasional"),
    ("Blasts",         "<20%",       "<20%",        "<20%",       "<20%",          "<20%"),
    ("Prognosis",      "<3 yrs",     "~2–3 yrs",    "Poor",       "Better",        "18–30 mo"),
    ("Curative Rx",    "Allo-HSCT",  "Allo-HSCT",   "Allo-BMT",   "Allo-HSCT",     "Allo-HSCT"),
    ("TKI response",   "NO",         "NO",          "NO",         "NO",            "NO"),
]

alt_bg = [C_WHITE, C_LIGHT_BLUE]
row_h = 0.535
for i, row in enumerate(table_data):
    yy = 1.58 + i * row_h
    bg = alt_bg[i % 2]
    add_rect(s, 0.2, yy, 13.0, row_h, fill_rgb=bg,
             line_rgb=RGBColor(0xCC, 0xDD, 0xEE), line_width=0.3)
    for j, (cx, cw, val) in enumerate(zip(cols_x, cols_w, row)):
        is_bold = (j == 0)
        txt_col = C_DARK_BLUE if j == 0 else (C_RED if val in ("ABSENT", "NO") else C_DARK_GREY)
        add_text(s, val, cx+0.05, yy+0.02, cw-0.1, row_h-0.04,
                 size=9 if "\n" in val else 10,
                 bold=is_bold, color=txt_col,
                 align=PP_ALIGN.CENTER if j > 0 else PP_ALIGN.LEFT,
                 anchor=MSO_ANCHOR.MIDDLE, wrap=True)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 9 – High-Yield Board Points
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "High-Yield Board Points & Mnemonics")
footer(s)

# Left column – mnemonics
add_rect(s, 0.25, 1.1, 6.2, 6.1, fill_rgb=C_WHITE, line_rgb=C_GOLD, line_width=2)
section_pill(s, "Mnemonics & Key Rules", 0.35, 1.1, 2.5, color=C_GOLD)
mn_lines = [
    ("The UNIVERSAL Rule:", True, C_RED),
    ("All MDS/MPN entities: BCR-ABL1 ABSENT, Ph ABSENT", True, C_RED),
    ("All MDS/MPN entities: Blasts <20%  (≥20% = AML)", True, C_RED),
    ("All MDS/MPN entities: TKIs do NOT work", True, C_RED),
    ("", False),
    ("CMML Memory Aid:", True, C_TEAL),
    ('"C = Chronic Monocytosis (>1000/μL, >10% of WBC)"', False, C_TEAL),
    ("  TET2 + SRSF2 co-mutation → think CMML phenotype", False),
    ("", False),
    ("aCML Memory Aid:", True, C_ORANGE),
    ('"aCML = Absent BCR-ABL + Abnormal dysplasia + Awful prognosis"', False, C_ORANGE),
    ("  Dysgranulopoiesis is the KEY differentiator from CNL", False),
    ("  SETBP1 is aCML; CSF3R T618I is CNL", False),
    ("", False),
    ("JMML Memory Aid:", True, C_GREEN),
    ('"JMML = Just kids, Mutations in RAS pathway, Marrow transplant needed"', False, C_GREEN),
    ("  NF1 association is a classic exam question", False),
    ("  GM-CSF hypersensitivity in colony assay is confirmatory", False),
    ("", False),
    ("RS-T Memory Aid:", True, C_PURPLE),
    ('"Ring Sideroblasts (SF3B1) + Thrombocytosis = RS-T"', False, C_PURPLE),
    ("  SF3B1 mutation = ring sideroblasts; JAK2 = thrombocytosis", False),
),
]
add_multiline_text(s, mn_lines, 0.4, 1.55, 5.8, 5.5, size=10.5, line_spacing=1)

# Right column – classic exam traps
add_rect(s, 6.65, 1.1, 6.45, 6.1, fill_rgb=C_WHITE, line_rgb=C_RED, line_width=2)
section_pill(s, "Classic Exam Traps", 6.75, 1.1, 2.2, color=C_RED)
traps = [
    ("Trap 1: BCR-ABL negative CML", True, C_RED),
    ("  → There is NO such thing. aCML is a distinct entity.", False),
    ("  Eliminate any option suggesting BCR-ABL-negative CML exists", False, C_MID_GREY),
    ("", False),
    ("Trap 2: TKIs in aCML/CMML", True, C_RED),
    ("  → TKIs do NOT work. No BCR-ABL = no TKI benefit.", False),
    ("", False),
    ("Trap 3: CMML vs Reactive Monocytosis", True, C_RED),
    ("  → Must persist >3 months; must exclude infections,", False),
    ("    connective tissue disease, etc.", False),
    ("", False),
    ("Trap 4: aCML vs CNL", True, C_RED),
    ("  → aCML has DYSPLASIA + immature forms", False),
    ("  → CNL has mature neutrophils WITHOUT dysplasia", False),
    ("  → CSF3R T618I strongly favours CNL", False),
    ("", False),
    ("Trap 5: JMML age", True, C_RED),
    ("  → Exclusively a CHILDHOOD disease (<14 yrs)", False),
    ("  → Adult with similar picture = CMML", False),
    ("", False),
    ("Trap 6: Blasts ≥20%", True, C_RED),
    ("  → Always reclassify as AML regardless of prior MDS/MPN dx", False),
    ("", False),
    ("Trap 7: JMML genetic test", True, C_RED),
    ("  → In vitro GM-CSF hypersensitivity = CONFIRMATORY test", False),
]
add_multiline_text(s, traps, 6.8, 1.55, 6.1, 5.5, size=10.5, line_spacing=1)

# ════════════════════════════════════════════════════════════════════════════
# SLIDE 10 – Diagnostic Algorithm
# ════════════════════════════════════════════════════════════════════════════
s = prs.slides.add_slide(blank)
add_rect(s, 0, 0, 13.333, 7.5, fill_rgb=C_LIGHT_GREY)
slide_header(s, "Diagnostic Algorithm – Approach to MDS/MPN")
footer(s)

# Step boxes
steps = [
    (0.3, 1.15, 12.5, 0.72, C_DARK_BLUE, C_WHITE,
     "STEP 1 – Exclude BCR-ABL1 / Ph chromosome by FISH + PCR. If positive → Classic CML (treat with TKI). Stop here."),
    (0.3, 2.05, 12.5, 0.72, C_MED_BLUE, C_WHITE,
     "STEP 2 – Exclude PDGFRA, PDGFRB, FGFR1, PCM1-JAK2 rearrangements. If positive → specific MPN with eosinophilia."),
    (0.3, 2.95, 12.5, 0.72, C_TEAL, C_WHITE,
     "STEP 3 – Check age. Patient <14 years? → Consider JMML. Check monocytosis, test PTPN11/KRAS/NRAS/NF1/CBL, GM-CSF sensitivity."),
    (0.3, 3.85, 12.5, 0.72, C_GREEN, C_WHITE,
     "STEP 4 – Persistent monocytosis ≥0.5×10⁹/L AND ≥10% of WBC (>3 months)? Dysplasia present? Blasts <20%? → CMML"),
    (0.3, 4.75, 12.5, 0.72, C_ORANGE, C_WHITE,
     "STEP 5 – Neutrophilia >13×10⁹/L with dysgranulopoiesis? No monocytosis, no basophilia? Blasts <20%? → aCML"),
    (0.3, 5.65, 12.5, 0.72, C_PURPLE, C_WHITE,
     "STEP 6 – Anaemia + ring sideroblasts ≥15% (or ≥5% + SF3B1) + thrombocytosis ≥450×10⁹/L? Blasts <20%? → MDS/MPN-RS-T"),
    (0.3, 6.55, 12.5, 0.62, C_MID_GREY, C_WHITE,
     "STEP 7 – Has both MDS and MPN features but doesn't fit above? Blasts <20%, BCR-ABL absent? → MDS/MPN-Unclassifiable"),
]
for x, y, w, h, bg, fg, text in steps:
    add_rect(s, x, y, w, h, fill_rgb=bg)
    add_text(s, text, x+0.15, y+0.02, w-0.3, h-0.04,
             size=11, bold=False, color=fg, anchor=MSO_ANCHOR.MIDDLE, wrap=True)

# Save
out_path = "/tmp/workspace/mds-mpn-guide/MDS_MPN_Overlap_Board_Prep.pptx"
buf = BytesIO()
prs.save(buf)
with open(out_path, "wb") as f:
    f.write(buf.getvalue())
print(f"Saved: {out_path}")

Successfully replaced 1 instance(s) of the string in '/tmp/workspace/mds-mpn-guide/build_deck.py'