4.3.4: Leukaemia and lymphadenopathy Flashcards
Leukaemia
Neoplastic condition of the bone marrow in which neoplastic cells of the lymphoid or non-lymphoid stem cells or their progeny undergo clonal expansion with or without cellular differentiation.
Why do we see clinical signs of leukaemia?
- Failure of normal marrow function
- Infiltrated organ dysfunction (i.e. when leukaemic cells released into circulation infiltrate tissues e.g. liver, spleen, lymph nodes)
- Hyperviscosity
- Paraneoplastic syndromes (IMHA, hypercalcaemia)
How can we subdivide lymphoproliferative disorders?
- If neoplastic B, T, or NK cells = lymphoma or lymphoid leukaemia
- If specific B (plasma cell) neoplasia = myeloma
Lymphoma
neoplasia of B, T, or NK cells, in extramedullary tissues
Lymphoid leukaemia
neoplasia of B, T or NK cells, involving marrow and/or blood.
Myeloma
B plasma cell neoplasia in marrow
Describe the characteristics of acute leukaemia
- Neoplastic transformation during stem cell proliferation
- Large numbers of immature (undifferentiated) cells
- Aggressive rapid disease
- Cytopenia -> there is marrow disruption by neoplastic expansion e.g. neutropenia, thrombocytopenia, anaemia
Describe the characteristics of chronic leukaemia
- Neoplastic transformation following differentiation
- This gives rise to large numbers of mature (differentiated) cells
- This is slow, progressive, and less aggressive in comparison to acute disease
- There is cytopenia, but it is less severe than the acute form of this disease
When there is bone marrow disruption, which cells are first to disappear?
Neutrophils
What is the half life of a neutrophil?
6-12 hrs
What is the half life of platelets?
6-8 days
What is the half life of platelets?
6-8 days
What is the half life of RBCs?
110-120 days
What can we subdivide acute leukaemia into?
- ALL: acute lymphoid leukaemia
- AML: acute myeloid leukaemia
