BI231 Introduction to Hematologic Malignancies

Question 1

What is a clonal disorder?

Answer 1

a mutation that develops in a normal hematopoietic precursor resulting in a survival advantage and proliferation. There is no interruption in normal body function other than having increased numbers of this clonal cell population

Question 2

What are 2 examples of a clonal hematologic disorder?

Answer 2

1) Monocloncal B-cell lymphocytosis (MBL)

2) Monoclonal gammopathy of undetermined significance (MGUS)

Question 3

Explain the first and second hit process

Answer 3

• 1st hit is the formation of a mutation that increases the number of the clonal cell population but doesn’t disrupt body functioning.
• 2nd hit is when a second mutation develops that results in uncontrolled proliferation and interference with normal body function

Question 4

What is the time frame for acute diseases?

Answer 4

days/months

Question 5

what is the time frame for chronic diseases?

Answer 5

months/years

Question 6

what are B symptoms?

Answer 6

constitutional symptoms;

1) fever
2) night sweats
3) weight loss

Question 7

What kind of weight loss is alarming?

Answer 7

unintentional and >10% in 6 months

Question 8

what are symptoms that would suggest cytopenias? (3)

Answer 8

1) fatigue/pallor (anemia)
2) infections (leukopenia)
3) bleeding/brusing

Question 9

what is the goal of treatment for acute/aggressive presentation cancers?

Answer 9

cure

Question 10

what is the difference in symptom presentation between chronic and acute cancers?

Answer 10

they are similar in presentation in that they each have B symptoms, symptoms of cytopenias etc, but the symptoms in chronic presentation evolve slower and some patients present with no symptoms (ex. abnormal blood counts on CBC, or noticed lymph nodes on routine physical exam)

Question 11

What is the goal of treatment for chronic cancers?

Answer 11

disease control

Question 12

When is treatment initiated in chronic patients ?

Answer 12

when the patient has symptoms

Question 13

true or false: over time, chronic/indolent blood cancers cannot transform into acute, aggressive blood cancers

Answer 13

FALSE; over time, chronic/indolent blood cancers can transform into acute aggressive blood cancers

Question 14

TRUE OR FALSE: myeloid malignancies never present as a lymphoma (enlarged lymph nodes)

Answer 14

TRUE

Question 15

list the important myeloproliferative diseases

Answer 15

1) chronic myeloid leukemia
2) polycythemia vera (PV)
3) essential thrombocytosis (CML)
4) Primary myelofibrosis

Question 16

what do CML, PV and ET all do to the normal of blood cells in the blood? What type of cancer can each of these progress to ?

Answer 16

they all are characterized by increased numbers of normal blood cells and can all transform over time into acute myeloid leukemia

Question 17

what is a myelodysplastic syndrome?

Answer 17

a stem cell disorder that is characterized by low numbers of abnormal blood cells.

Question 18

between myelodysplastic syndrome and myeloproliferative diseases, which one do patients present with cytopenias?

Answer 18

myelodysplatic syndrome

Question 19

true or false: myelodysplastic syndrome can transform into acute myeloid leukemia

Answer 19

true

Question 20

What is structures are involved in Leukemia cancers

Answer 20

predominantly involve the peripheral blood or bone marrow

Question 21

lymphoma

Answer 21

predominantly involving peripheral lymph nodes, spleen

Question 22

what are 3 common symptoms to have at presentation from low blood counts in a leukaemia patient?

Answer 22

1) bleeding/bruising from thrombocytopenia
2) fatigue/pallor from anemia
3) infections from neutropenia/leukopenia

Question 23

TRUE OR FALSE: myeloid malignancies always involve the bone marrow/peripheral blood and never with lymphadenopathy

Answer 23

TRUE

Question 24

what is the mainstay of treatment for hematologic malignancies?

Answer 24

chemotherapy

Question 25

What does cytopenia mean?

Answer 25

reduction in the number of blood cells