Blood Cancers 1 Flashcards
What types of blood cancers are most prevalent in the 7th, 8th and 9th decades of life?
CLL
AML
CML
0-5 WBCs
leukopenia
5-10 WBCs
normal
10-infinity WBCs
leukocytosis
10-18 WBCs
typical infection/inflammation
18-20 WBCs
some infections (hot abdomen)
20-50 WBCs
leukemoid reactions/leukemia
50+ WBCs
leukemia
define leukemia
unregulated accumulation of immature cells in the marrow and lymph tissue
what kind of shift does leukemia demonstrate?
left shift (increased immature cells)
generalized signs/symptoms of leukemia
weakness, fatigue, weight loss
bleeding from any orifice, splenomegaly, hepatomegaly, back pain, lymphadenopathy, symptoms similar to infection
what is the biggest difference between actue and chronic luekemia?
acute has blasts and pros
chronic does not
what specific types of cells are involved in actue leukemia?
stem cell
myeloblast
promyelocytes
what specific tyes of cells are involved in chronic leukemia?
myelocytes metamyelocytes bands neutrophils eosinophils basophils
AML demonstrates proliferation of?
myeloblasts
promyelocytes
ALL demonstrates proliferation of
lymphoblasts
prolymphocytes
S/S of acute leukemia
abnormal bleeding easy bruising multiple joint pain progressive pallow and weakness swollen lymph nodes low grade fever hepatosplenomegaly
why is there hepatosplenomegaly with acute leukemia?
immature cells are non functional and the body gets rid of them
S/S of chronic leukemia
similar to acute but they develop over months
CML demonstrates proliferation of?
myelocytes
metamyelocytes
neutrophils
bands
CLL demonstrates proliferation of?
small mature lymphocytes
acute leukemia without remission is usually fatal within?
3 minths
chronic leukemia without remission will survive?
for years
what do patients need if suspicious or diagnostic cells are found on CBC?
bone marrow biopsy
lymph node biopsy
leukemia should be cassified into?
lymphocytic
non-lymphocytic (myelocytiic)
non-lymphocytic leukemia can be further divided by?
cell type (neutorphils, eosinophils, basophils, monocytes
who is AML most common in?
middle and later years (slightly higher in males)
what is the most common acute leukemia in the first few months of life?
AML
what will you see in a CBC in AML?
increase in primitive cells (myeloblasts, promyelocytes, monoblasts, promonocytes)
predominantly neutrophilic involvement
what are the types of AML?
acute monocytic
acute eosinophilic
acute basophilic
acute stem cell
what cell should you assume is the culprit in AML unless proven otherwise?
neutrophils
WBC 80 segs (50-70) 10 bands (0-6) 10 lymphs 20-40) 2 pros myelo 40 myeloblasts 38
80 WBCs (leukemia)
pros and blasts (acute)
major cell type- myelocyte (myelocytic)
AML
WBC 80 segs (50-70) 10 bands (0-6) 10 lymphs 20-40) 2 EO-promyelocytes 40 EO-myeloblasts 38
80 WBC (leukemia)
pros and blasts (acute)
major cell type (eosinophils)
Acute eosinophilic leukemia (AEL)
WBC 80 segs (50-70) 10 bands (0-6) 10 lymphs 20-40) 2 B-promyelocytes 40 B-myeloblasts 38
80 WBC (leukemia)
blasts and pros (acute)
major cell type (basophils)
acute basophilic leukemia (ABL)
WBC 80 segs (50-70) 10 bands (0-6) 10 lymphs 20-40) 2 promonocytes 40 monoblasts 38
80 WBC (leukemia)
pros and blasts *acute)
major cell type (monocyte)
acute monocytic leukemia (AMoL)
ALL is characterised y a large number of?
lymphoblasts (L-blasts) and prolymphocytes (L-pros)
what age group is ALL usuallyin?
patietns less than 20
S/S of ALL
rapid onset fatigue fever bleeding infection lymphdenopathy hepatosplenomegaly
WBC 60
segs (50-70) 10
lymphs (20-40) 10
L blasts 80
60 WBC (leukemia)
blasts (acute)
major cell type (lymphocytes)
acute lymphocytic leukeima (ALL)
radiolucent submetaphyseal band
knee pain
3 years old
DDX?
leukemia
neuroblastoma
scurvy
syphilis
what xray findings indicate scurvy more?
Pelken’s spur
ring epiphysis
dense zone of provisional calcification (white line of frankel)
scorbutic zone (trummerfeld’s zone)
CML S/S
gradual onset with hepatosplenomegaly abdominal discomfort weight loss anemia weakness fatigue easy bruising bleeding lymphadenopathy anemia
describe the chromosomal part of CML
low alkaline phosphatase levels
philadelphia chromosome involved in 90% of CML patietns
whoch is worse, CML or CLL?
CML
WBC 60 segs (50-70) 20 bands (0-6) 30 lymphs 20-40) 10 meta 30 myelo 10
WBC 60 (leukemia)
segs decreased, bands high, lymph decreased
meta and myelo (chronic)
chronic myelocytic leukemia (CML)
types of CML
CEL (eo-myelo, eo meta)
CBL (b myelo, b meta)
CMoL (excessive mature monocytes)
a patient with CML went into remossion, but then a couple years later she gets sick with a 104 temp, and the CBC says 80 WBCs, 40% blasts, what does that mean?
her CML became acute and she is going into a BLAST crisis
what does CLL result from?
proliferation of long lived non functional lymphocytes
how are most people with CLL diagnosed?
from routine peripheral blood studies
S/S of CLL
insidious onset lymphadenopathy hepatosplenomegaly fatigure weight loss abdominal fullness may be anemic
lab results of CLL
high white count predominantely lymphocytosis, anemia
thrombocytopenia
granulocytopenia
describe other problems with CLL
lymphocytic infiltration of bone marrow, lymph nodes, liver, spleen and other organs
increased susceptiblility to infections
WBC 80
segs (50-70) 10
lymphs (20-40) 90
80 (leukemia)
no blasts or pros (chronic)
predominant cell type= lymphocytes
CLL
