6 Leukemia, Lymphoma, MM Flashcards by Paige Kingery

What are the three B symptoms?

Weight loss
Fever
Night sweats

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Leukemia is CA of what (2)?

Bone marrow

- Lymphatic system

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What are the four types of Leukemia?

Acute Myeloid Leukemia (AML)
Chronic Myeloid Leukemia (CML)
Acute Lymphoblastic Leukemia/Lymphoma (ALL)
Chronic Lymphocytic Leukemia (CLL)

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What is the most common type of Leukemia in ADULTS? What is the median age?

Acute Myeloid Leukemia (AML)

- Age 65 years

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What cancer is associated with chemical exposure/radiation or myelodysplastic syndrome (MDS) as risk factors?

Acute Myeloid Leukemia (AML)

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What do labs for Acute Myeloid Leukemia (AML) show?

Pancytopenia

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How do you calculate ANC and what is the normal range?

ANC = WBC x % neutrophils

- Normal ANC is 2500-7000

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What two findings will be seen on peripheral smear/bone marrow aspiration and biopsy for Acute Myeloid Leukemia (AML)?

Auer rods

- Leukemic blasts

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What two factors will improve prognosis for Acute Myeloid Leukemia (AML)?

Younger age

- No comorbidities

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What syndrome is at risk for progression to AML?

Myelodysplastic Syndrome (MDS)

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What two diseases are often asymptomatic and found routinely on CBC?

Myelodysplastic Syndrome (MDS)

- Chronic Myeloid Leukemia (CML)

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What is the only possible cure for Myelodysplastic Syndrome (MDS)?

Donor bone marrow transplant

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What condition is considered an oncologic emergency and associated with high mortality rate?

Tumor Lysis Syndrome

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What might cause Tumor Lysis Syndrome?

Chemotherapy initiation (within 1 day)

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What cancer is associated with BCR-ABL1/Philadelphia chromosome?

Chronic Myeloid Leukemia (CML)

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What are the three phases of Chronic Myeloid Leukemia (CML), and in which phase are patients most commonly diagnosed?

Which of the three has the best prognosis?

Chronic phase: most common (85% diagnosed here) AND best prognosis
Accelerated phase
Blast crisis phase

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What is the only possible cure for Chronic Myeloid Leukemia (CML)?

Donor stem cell transplant

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What three complications should be considered with Chronic Myeloid Leukemia (CML), and which two are considered an emergency?

Tumor lysis syndrome = emergency
Hyperviscosity syndrome
Hyperleukocytosis = emergency

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What is the most common type of Leukemia in CHILDREN? What is the median age?

Acute Lymphoblastic Leukemia/Lymphoma (ALL)

- Ages 2-5 years

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What are the three subtypes of Acute Lymphoblastic Leukemia/Lymphoma (ALL), and which is most common?

Precursor B-cell ALL: most cases of childhood ALL
T-cell ALL
Mature B-cell ALL aka Burkitt cell

Of the three subtypes of Acute Lymphoblastic Leukemia/Lymphoma (ALL), which two have the more favorable prognosis?

Which of the three typically presents at an older age?

The two B-cells:

Precursor B-cell ALL
Mature B-cell ALL aka Burkitt cell
T-cell ALL: older age

What five symptoms are most commonly associated with Acute Lymphoblastic Leukemia/Lymphoma (ALL)?

LAD
Hepatosplenomegaly
Pallor
Bone/MSK pain
Fever

What finding will be seen on peripheral smear/bone marrow aspiration and biopsy for Acute Lymphoblastic Leukemia/Lymphoma (ALL)?

Lymphoblasts

Of the four types of leukemia, which is seen ONLY in adults? What is the median age?

Chronic Lymphocytic Leukemia (CLL)

- Age 70 years

Which type of cancer involves B-cell lymphocytosis?

Chronic Lymphocytic Leukemia (CLL)

Which two symptoms are often seen with Chronic Lymphocytic Leukemia (CLL)?

- Organomegaly (lymph, spleen, liver) | - Skin involvement

What are the two stages of Chronic Lymphocytic Leukemia (CLL), and how do you differentiate between the two (think symptoms)?

- Indolent stage: often asymptomatic | - Advanced stage/Terminal phase: inclusion of B symptoms

Of the cancers we discussed in class, what is the only one where observation is considered appropriate treatment? When/with what stage is this considered?

Asymptomatic or early stage 1 of Chronic Lymphocytic Leukemia (CLL)

Lymphoma is CA of what? Provide five examples of organs which might be affected?

CA of lymphocytes - Lymph nodes - Spleen - Thymus - Bone marrow - Tonsils/adenoid

What are the two types of Lymphoma? Which is more common?

- Hodgkin Lymphoma (HL) | - Non-Hodgkin Lymphoma (NHL): more common

What cancer involves EBV as a possible risk factor?

Hodgkin Lymphoma (HL)

What finding will be seen on peripheral smear for Hodgkin Lymphoma (HL)?

Reed-Sternberg cells

What three symptoms may be seen with both Hodgkin Lymphoma (HL) and Non-Hodgkin Lymphoma (NHL)?

- Painless LAD - Mediastinal mass - B symptoms

What is the recommended treatment for Hodgkin Lymphoma (HL), and what two potential progressions/complications should be considered?

Combination chemotherapy + radiation | - Can lead to other cancer or heart disease

What cancer involves severe pain after alcohol?

Hodgkin Lymphoma (HL)

What is the age range affected by Hodgkin Lymphoma (HL)? What is the median age affected by Non-Hodgkin Lymphoma (NHL)?

- HL: 15-34 years | - NHL: 66 years

What are the two stages of Non-Hodgkin Lymphoma (NHL), and how does the tumor in each stage progress?

- Indolent stage = slow-growing mass | - Advanced stage = rapidly growing mass

What three diagnostic tools can be used for Non-Hodgkin Lymphoma (NHL)?

- Biopsy (prefer 2+ cm lymph nodes) - CT/PET scan - Bone marrow aspiration and biopsy

How does treatment differ for the the two stages of Non-Hodgkin Lymphoma (NHL)?

- Indolent = radiation alone | - Aggressive = chemotherapy

Which cancer involves the malignancy of plasma cells?

Multiple Myeloma (MM)

Which cancer is more commonly seen in African Americans?

Multiple Myeloma (MM)

What four symptoms are often associated with Multiple Myeloma (MM)?

- Back pain - Neurologic changes - Bone pain - Fatigue

What diagnostic tool can be an early indication of malignancy for Multiple Myeloma (MM), and what two findings are often seen?

Protein Electrophoresis shows: - Paraproteins (in blood = hyperviscosity; in urine = renal failure) - M spike

What cancer is associated with anemia and Rouleaux formation?

Multiple Myeloma (MM)

What could be found in the urine of a patient with Multiple Myeloma (MM)?

Bence-Jones proteins

What two findings could be seen on axial skeleton x-rays of a patient with Multiple Myeloma (MM)?

- Lytic lesions | - Generalized osteoporosis

What does CRAB stand for and what cancer is it associated with?

Multiple Myeloma (MM) - Calcium - Renal insufficiency - Anemia - Bone lesions

What condition involves bleeding from mucous membranes, visual issues from retinopathy, neuro sx? What cancer is it often associated with?

Hyperviscosity syndrome | - Associated with Multiple Myeloma (MM)

What treatment is recommended for a patient with Multiple Myeloma (MM), and why?

IV bisphosphonates to prevent bone mass loss