Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Test 2 🏁🏁 > Blood Cancer > Flashcards

Blood Cancer Flashcards

1
Q

WHAT IS BLOOD CANCER?

A
  • Cancer arising from cells responsible for blood formation or immune function
  • Commonly occurs in your bone marrow where stem cells are located and mature
  • In the bone marrow, normal cell production is interrupted and abnormal cells begin to grow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

WHAT IS BONE MARROW?

A
  • Bones are made up of 3 main parts:
    — Compact bone
    — Spongy bone
    — Bone marrow
  • Red marrow
  • Yellow marrow
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

UNDERSTANDING BLOOD CELL FORMATION

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

UNDERSTANDING BLOOD CELL FORMATION 2

A
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

LEUKEMIA BASICS

A
  • Four main types
    — Acute Lymphoblastic (Lymphocytic) Leukemia (ALL)
    — Acute Myeloid (Myelogenous) Leukemia (AML)
    — Chronic Lymphocytic Leukemia (CLL)
    — Chronic Myeloid Leukemia (CML)
  • All begin in the bone marrow
    — Myeloid stem cell line
    — Lymphoid stem cell line
  • ALL and AML are made of immature blasts
  • CLL and CML have few to no blasts
  • Each major type has its own subtypes
  • acute leukemias are more aggressive and need timely treatment
  • chronic leukemias are slower growing and might not need treatment
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

MYELODYSPLASTIC SYNDROMES (MDS)

A
  • Sometimes called “pre-leukemia”; affects myeloid cell line, where 5-19% blasts are present
  • Bone marrow doesn’t make enough healthy blood cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

MYELODYSPLASTIC SYNDROMES (MDS)
Risk factors

A
  • Male gender, white
  • Older age (60+, typically)
  • No risks known for de novo (Latin for “from the beginning”) MDS
  • Secondary MDS may be due to previous cancer treatment
  • can progress to AML
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

MYELODYSPLASTIC SYNDROMES (MDS)
Symptoms

A
  • Possible to have none
  • Cytopenias (anemia, neutropenia, thrombocytopenia)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

LYMPHOMA BASICS
Hodgkin Lymphoma (HL)

A

Abnormal lymphocytes accumulate and form masses (tumors) in the lymphatic system
- Classical Hodgkin Lymphoma (95%)
- Nodular Lymphocyte Predominant Hodgkin Lymphoma (5%)
-
- was initially named Hodgkins disease, this was later changed to Hodgkin lymphoma
- Is a B cell lymphoma
- Distinguished from other lymphoma by the presence of the Reed-Sternberg cell
- Hodgkin lymphoma is most likely to be diagnosed in young adults, but then becomes more common again after age 65
- most forms are curable

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

LYMPHOMA BASICS
Non-Hodgkin Lymphoma (NHL)

A
  • B-cell lymphomas ~85% of all NHLs
  • T-cell and NK-cell lymphomas ~15% of all NHLs
  • 70–90 subtypes
  • graded on behavior: Aggressive or indolent, sometimes intermediate
  • Stage I –IV
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

LYMPHOMA STAGING

A

Often time a letter follows the stage number
- ex. Stage 3b, stage 2a
- A: no symptoms present
- B: unexplained fevers, Drenching night sweats, unexplained weight loss of 10% or more in last 6 months,
- E: involvement of organs or tissues beyond the lymph system

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

MYELOMA BASICS

A
  • Cancer of the plasma cells (product of B lymphocytes)
  • Can be a single tumor – “plasmacytoma,” asymptomatic and slow growing – “smoldering,” or
  • diffuse throughout the body – “multiple myeloma”
  • CRAB criteria are important to the diagnosis:
    — Calcium is increased
    — Renal (kidney) failure or insufficiency
    — Anemia
    — Bone lesions
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MYELOPROLIFERATIVE NEOPLASMS (MPNS)

A
  • Myelo – of the bone marrow
  • Proliferative – to grow or reproduce quickly
  • Neoplasm – abnormal growth of cells
  • Many subtypes, but three are considered “classic”:
    — Polycythemia vera (PV) – too many red blood cells are made
    — Essential Thrombocythemia (ET) – too many platelets are made
    — Myelofibrosis (MF) – scarring of the bone marrow after it has “exhausted” itself or as a primary disease
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

CANCER MOLECULAR PROFILING

A
  • ## Identifies DNA, RNA, or protein molecules associated with certain diseases
  • Examples of types of tests:
    — Immunohistochemistry/Flow cytometry - antibodies/antigens
    — FISH - Fluorescence in situ Hybridization
    — NGS - Next-Generation Sequencing
    — qPCR - Quantitative Polymerase Chain Reaction
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

HOW IS BLOOD CANCER TREATED?

A
  • Cellular Therapy
  • Clinical Trial
  • Palliative Care
  • Chemotherapy
  • Radiation Therapy
  • Targeted Therapy
  • Immunotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

HOW IS BLOOD CANCER TREATED? 2

A
  • Treatment varies greatly based on key factors:
    — What type of blood cancer
    — Leukemia vs. Lymphoma
    — Acute vs. Chronic
    — Myeloid vs. Lymphoid
  • Molecular/genetic changes?
    — BCR/ABL mutation (Philadelphia chromosome) CML, ALL
    — FLT3, IDH1/2
  • Comorbidities of patient
    — Heart, kidney, liver function OK to withstand chemotherapy
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

CHEMOTHERAPY

A
  • Stops the growth of dividing cells
  • Used in combinations to make other treatments more effective
  • Can be used with surgery or radiation
  • Can be given by many different routes
    — PO, IV, IM, IT, IP
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

CHEMOTHERAPY SIDE EFFECTS

A
  • Fatigue
  • Alopecia
  • Neuropathy/Confusion
  • Mouth sores
  • Nausea/Diarrhea
  • Cytopenias - Neutropenia, Anemia, Thrombocytopenia
    — Infection
    — Bleeding
  • Skin and nail changes
  • Mood changes
  • Infertility and changes in libido
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

RADIATION THERAPY

A
  • Works by damaging DNA of cancer cells so that they cannot replicate
  • Types
    — Internal: put inside the target, ie: brachytherapy
    — External: comes from a machine, targets certain area of your body
  • Used in combination with chemotherapy and surgery
20
Q

RADIATION THERAPY SIDE EFFECTS

A
  • Fatigue
  • Localized skin changes
  • Specific side effects related to the area being treated:
    — Lung: fatigue, SOB, cough
    — Brain: fatigue, hair loss, nausea/vomiting
    — GI: nausea/vomiting, diarrhea, abdominal pain, bladder, fertility
    — Head/neck: sore throat, dry mouth, taste alteration, hair loss
21
Q

TARGETED THERAPY

A
  • Specifically targets the changes found in cancer cells’ DNA which makes it become cancerous
  • Types:
    — Monoclonal antibodies

— Cancer growth inhibitors:
—- Tyrosine kinase inhibitors: dasatinib, imatinib, nilotinib
—- Proteasome inhibitors: bortezomib
—- PI3K inhibitors: idelalisib
—- HDAC inhibitors: panobinostat, vorinostat
—- mTOR inhibitors: sirolimus, everolimus
—- Hedgehog pathway inhibitors: glasdegib

22
Q

TARGETED THERAPY SIDE EFFECTS

A
  • Diarrhea
  • Liver abnormalities- increased LFTs, hepatitis
  • Skin and nail changes
  • High blood pressure
  • Alterations in blood clotting
23
Q

IMMUNOTHERAPY

A
  • Harnesses your immune system to fight the cancer
  • Types:
    — Monoclonal or Bispecific antibodies
    —- Rituximab, Obinutuzumab
    —- Blinatumomab
  • Checkpoint inhibitors
    — Nivolumab, pembrolizumab
  • Vaccines
    — Antigen, whole cell, dendritic cell
  • Cytokines
    — Interferon and interleukin
24
Q

IMMUNOTHERAPY SIDE EFFECTS

A
  • Fever/chills
  • Weakness/fatigue
  • Blood pressure abnormalities
  • Shortness of breath
  • Nausea/vomiting
  • Swelling/fluid retention
  • Organ inflammation
    — Colitis
    — Hepatitis
    — Pneumonitis
25
Q

CELLULAR THERAPY

A
  • Hematopoietic Stem Cell Transplant
  • Adoptive Cell Therapy
26
Q

HEMATOPOIETIC STEM CELL TRANSPLANT

A
  • Allows patient to receive high doses of chemotherapy to eradicate disease but then recover normal hematopoietic cell function
  • Types :
    — Autologous
    — Allogeneic
    — Umbilical Cord Blood
27
Q

ADOPTIVE CELL THERAPY

A
  • Therapies that use body’s own defense system to fight cancer
  • Tumor-infiltrating lymphocytes (TILs)
    — Penetrate the environment around the tumor
    — Mostly used in solid tumor
  • T-cell receptors (TCRs)
    — T cells engineered to express a specific T-cell receptor which can recognize cancer antigens
    — Mostly used in solid tumor
  • Chimeric Antigen Receptor T cells (CAR T)
    — T cells taken from patient, engineered to produce chimeric antigen receptors and then injected back into the patient which then recognizes specific antigen on tumor cells
28
Q

CHIMERIC ANTIGEN RECEPTOR T-CELL THERAPY

A
29
Q

CAR T-CELL THERAPY SIDE EFFECTS

A
  • Cytokine release syndrome (CRS)
    — T cells naturally release cytokines, however in CRS there is a massive amount released which cause fever, hypotension
    — Anti-IL6 antibody: tocilizumab
  • Neurotoxicity
    — Confusion, headache, seizure, cerebral edema
  • B cell aplasia
    — Normal B cells often killed by infused CAR T cells since they express same targets
    — Patients will go on to receive immunoglobulin therapy
30
Q

ADOPTIVE CELL THERAPY

A
  • Since 2017, there have been three approved CAR T-cell products
  • Yescarta (axicabtagene ciloleucel)
  • Kymriah (tisagenlecleucel)
  • Tecartus (brexucabtagene autoleucel)
  • Adoptive-cell therapy continues to be highly studied with many new and exciting therapies coming down the pipeline
31
Q

CLINICAL TRIALS

A
  • Carefully controlled research studies conducted by doctors to improve the care and treatment of people with cancer or other illnesses
  • Key step in advancing all cancer treatments
  • Cancer clinical trials are 40–50% of all trials conducted in the US
  • Trials available for all stages of cancer journey - newly diagnosed, relapsed/refractory
  • Can be very difficult to navigate available trials
32
Q

BENEFITS OF CLINICAL TRIALS

A
  • Contribution to present and the future
  • Financial access to new treatments
  • Early access to new therapies
  • Access to physicians with extensive experience in the type of cancer
  • Followed closely
33
Q

RISKS OF CLINICAL TRIALS

A
  • Possibility the treatment may not work
  • Unknown/fear of side effects
  • Randomized trials - risk of being in the standard of care arm
  • Increase time away from home, work and family
34
Q

ONCOLOGY NURSES ROLE WITH BLOOD CANCER PATIENTS AND CAREGIVERS

A

What to discuss with the patient and caregiver before and throughout treatment
- Disease and Treatment Education
— Understand specifics of disease
— Learn patient wishes and goals of care
— Be the patient advocate
- Fertility – treatment implications, preservation
- Potential Side Effects
— Recognize adverse effects of treatment and stress the importance of communicating with the healthcare team
— What are “normal” side effects and what needs immediate attention
— What to do for fever and emergency management
24-hour access to providers - who to contact and best method of communication

35
Q

ONCOLOGY NURSES ROLE WITH BLOOD CANCER PATIENTS AND CAREGIVERS

A
  • What to discuss with the patient and caregiver before and throughout treatment
  • Nutrition
    — Food safety guidelines are key
    — Small, frequent mini-meals and smart snacks
    — Real Food > Supplements
    — Eat a variety of foods
    — Be open to new foods, flavors and tastes
    — Keep a stable body weight
    — Stick to what you know
    — Ask about any dietary restrictions
    — Discuss side effects and changes in appetite/intake
    — Use trusted sources of oncology nutrition information
    — Ask for a referral to an oncology registered dietitian
36
Q

ONCOLOGY SOCIAL WORKER’S ROLE WITH BLOOD CANCER PATIENTS AND CAREGIVERS

A

Phases of Cancer Care:
- Prevention and Screening
- Diagnosis
- Palliative Care
- Treatment
- Survivorship
- End of Life
- Bereavement

37
Q

PSYCHOSOCIAL CONSIDERATIONS WHEN WORKING WITH ONCOLOGY PATIENTS AND THEIR CAREGIVERS

A
  • Physical concerns
    — Diagnosis, physical symptoms or side effects, fertility planning, intimacy, and treatment planning
  • Emotional concerns
    — Stress, fear, worry, anxiety, anger, frustration
  • Financial concerns
    — Insurance, medical and prescription costs, employment, daily living expenses
  • Practical concerns
    — Transportation, housing, childcare, school, daily tasks
38
Q

WHAT TO CONSIDER: PSYCHOSOCIAL NEEDS:
For the pt

A
  • Awareness of ethnic, cultural, and spiritual beliefs
  • May live alone, be unable to care for self or others
  • Concerns about how their cancer affects family members
  • Financial and employment concerns
  • Physical and cognitive side effects of treatment
  • May be predisposed to or develop mental health concerns
  • Emotional concerns
  • Self-care practices and positive coping strategies
39
Q

WHAT TO CONSIDER: PSYCHOSOCIAL NEEDS: For the caregiver:

A
  • Awareness of ethnic, cultural, and spiritual beliefs
  • Balancing employment and caregiver roles
  • Balancing family responsibilities
  • Traveling for treatment
  • May be predisposed to or develop mental health concerns
  • Emotional concerns
  • Self-care practices and positive coping strategies
40
Q

RELIABLE RESOURCES

A
  • The Leukemia & Lymphoma Society – LLS.org
  • National Cancer Institute – cancer.gov
  • American Cancer Society – cancer.org
  • CancerCare – cancercare.org
  • Cancer Support Community – cancersupportcommunity.org
  • Triage Cancer – Triagecancer.org
  • PubMed.gov
  • OncLive.com
41
Q

WHAT TO CONSIDER: CANCER & COVID-19

A
  • The Pandemic has brought on many concerns for all; even more for cancer patients. Fears are multiplied for immunocompromised patients and those undergoing treatments. Encourage patients to ask their doctor specific concerns; many factors need to be considered and the doctor would have information to determine next steps.
  • LLS offers support and guidance for blood cancer patients and caregivers to navigate both cancer & COVID-19. COVID-19 and blood cancer related updates and support resources on the LLS website:
    — https://www.lls.org/public-health/coronavirus o
    — https://www.cdc.gov/coronavirus/2019-ncov/index.html o
    — https://www.cdc.gov/coronavirus/2019-ncov/vaccines/index.html
42
Q

Acute lymphoblastic leukemia (ALL)

A
  • Most common cancer seen in children
  • Risk peaks between one – four, then decreases until about age 55
  • May also see Philadelphia chromosome - more common in adults (25% of cases versus 3% four pediatric ALL)
43
Q

Acute Myeloid Leukemia (AML)

A
  • Most common acute leukemia in adults
  • Has many subtypes based on differences in biomarkers
44
Q

Chronic Lymphocytic Leukemia (CLL)

A
  • most common type of leukemia in adults in western countries
  • Can progress slowly or quickly, depending on the forms it takes
  • Some patients may have CLL for years and not need treatment, their doctor monitors them under “ watch & wait” some patients referred to as “watch & worry”
45
Q

Chronic Myeloid Leukemia (CML)

A
  • has three phases
    — chronic
    — accelerated
    — blast (often called “ blast crisis”)
  • Diagnosis of CML REQUIRES oral treatment upon diagnosis to prevent it from becoming aggressive
46
Q

DX for leukemia

A

Bone marrow aspiration

Test 2 🏁🏁 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions