Blood Cancers 1 Flashcards by Rachael Beverage

What types of blood cancers are most prevalent in the 7th, 8th and 9th decades of life?

CLL
AML
CML

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0-5 WBCs

leukopenia

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5-10 WBCs

normal

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10-infinity WBCs

leukocytosis

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10-18 WBCs

typical infection/inflammation

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18-20 WBCs

some infections (hot abdomen)

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20-50 WBCs

leukemoid reactions/leukemia

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50+ WBCs

leukemia

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define leukemia

unregulated accumulation of immature cells in the marrow and lymph tissue

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what kind of shift does leukemia demonstrate?

left shift (increased immature cells)

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generalized signs/symptoms of leukemia

weakness, fatigue, weight loss

bleeding from any orifice, splenomegaly, hepatomegaly, back pain, lymphadenopathy, symptoms similar to infection

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what is the biggest difference between actue and chronic luekemia?

acute has blasts and pros

chronic does not

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what specific types of cells are involved in actue leukemia?

stem cell
myeloblast
promyelocytes

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what specific tyes of cells are involved in chronic leukemia?

myelocytes
metamyelocytes
bands
neutrophils
eosinophils
basophils

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AML demonstrates proliferation of?

myeloblasts

promyelocytes

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ALL demonstrates proliferation of

lymphoblasts

prolymphocytes

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S/S of acute leukemia

abnormal bleeding
easy bruising
multiple joint pain
progressive pallow and weakness
swollen lymph nodes
low grade fever
hepatosplenomegaly

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why is there hepatosplenomegaly with acute leukemia?

immature cells are non functional and the body gets rid of them

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S/S of chronic leukemia

similar to acute but they develop over months

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CML demonstrates proliferation of?

myelocytes
metamyelocytes
neutrophils
bands

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CLL demonstrates proliferation of?

small mature lymphocytes

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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