6-3: Chronic Leukemia Flashcards
Chronic leukemia is referring to a … proliferation of
proliferation CD8 or CD4 t-cells
MATURE T-CELLS circulating around in large numbers
Chronic leukemia is seen in which age group?
Older adult (bc it has a rather slow onset)
Chronic Lymphocytic leukemia (CLL)
- proliferation of what cell type?
- what markers are expressed?
- prolieration of naive B-cells
- co-express CD5 and CD20
Chronic lymphocytic leukemia on blood smear…
increased lymphocytes
smudge cells
*Smudge cells characteristic of which proliferative disease?
*CLL - chronic lymphocytic leukemia
*CD5 and CD20 are co-expressed on what cell type in which disease?
*on naive B-cells
Chronic lymphocytic leukemia
If Chronic lymphocytic leukemia involves a lymph node (lymph node becomes swollen) disease is named…
small lymphocytic LYMPHOMA (bc there is now a mass - not just blood)
Complications of CLL…
- hypogammaglobinemia - B-cell NEVER MATURE INTO PLASMA CELLS == LOW immunoglobulin == infection risk
- autoimmune hemolytic anemia - the B-cells dont mature into plasma cells to produce Ig’s but if they do they usually screw it up and cause some autoimmune rxn
- transformation to diffuse large B-cell lymphoma - enlarging lymph node or enlarging spleen
CLL deaths are most commonly caused by…
infection
Hairy cell leukemia-
- proliferation of what cells?
- cells are positive for what enzyme?
- Proliferation of mature B-cell
- cells are positive for TRAP (tartrate resistant acid phosphatase)
Proliferation of mature B-cell diseases:
- CLL (leukemia or lymphoma)
- hairy cell leukemia
“Hairy cells” in red pulp of spleen is characteristic of…
Hairy cell leukemia – enlarges the spleen
“dry tap” in bone marrow is characteristic of what disease?
hairy cell leukemia
dry tap = marrow fibrosis
hairy cell leukemia clinical features:
- splenomegaly (red pulp)
- dry tap with bone marrow aspiration
- lymphadenopathy is ABSENT!
red pulp enlargement disease vs white pulp enlargement disease and associated cells?
- red pulp = hairy cell leukemia due to mature B-cells
- White pulp = mononucleosis (EBV)
TRAP menomic thingy for hairy cell
B-cells are TRAPPED in the spleen (red pulp, they are TRAPPED in the bone marrow (dry tap) and therefore they cant go to where you normally expect them - lymph nodes.
Hairy cell leukemia prognosis and Tx
- Drug = 2-CDA and there is an excellent response
- adenosine deaminase inhibitor = adenosine accumulates to toxic levels in neoplastic B-cells
Adult T-cell Leukemia Lymphoma (ATLL) -
- Proliferation of what cells?
- Associated with what virus?
- where in the world is this common?
- neoplastic proliferation of mature CD4 T-cells
- HTLV-I association (human tcell leukemia virus type I)
- Japan and Caribbean
Adult T-cell Leukemia Lymphoma (ATLL) -
Clinical features
- RASH
- generalized LAD (lymphadenopathy) and HSH (hepatosplenomegally)
- -lytic bone lesions with hypercalcemia
T-cell leukemias generally like to do what?
Go to skin and cause a rash
patient has lytic bone lesions vs patient with lytic bone lesions and rash?
just bone lesions = multiple myeloma
bone lesions with rash = ATLL
Mycosis fungoides -
- proliferation of what cell type?
- what happens/clinical presenation?
- neoplastic prolif of amture CD4 t-cells
- t-cells involved so the cells infiltrate skin producting rash, plaques, or nodules –> t-cells in epidermis are called Pautrier microabscesses
*Pautrier microabscesses are associated with?
*T-cell neoplasms that aggregate in the epidermis
If T-cell neoplasm spreads to the blood its called?
Sezary syndrome
