Chapter 11- Hodgkin Lymphoma & Myeloid Neoplasms Flashcards
Hodgkin lymphoma (HL) Pathologic Cells
B cells
Hodgkin lymphoma (HL) Patients
Bimodal age distribution: young adults (15-34 years) and older adults (>55 years)
Hodgkin lymphoma (HL) Unique Features
More predicable than NHLs,
Reed-Sternberg cells, arises from a single node, spreads to nearby nodes in a predicable manner, painless lymphadenopathy, fever,
cachexia, pruritus, anemia.
Radiation is a risk for other cancers, previous EBV infection is associated with 70% of cases
Hodgkin lymphoma (HL) Prognosis
Chemotherapy is very effective at managing HL, nearly all live to see
another 5 years after diagnosis and approximately 50% are cured.
Acute myeloid leukemia
(AML)
Pathologic Cells
Immature myeloblasts that lose the ability to differentiate
Acute myeloid leukemia
(AML)
Patients
Adults, average age
of Dx. is 50 years
Acute myeloid leukemia
(AML)
Unique Features
Aggressive, various mutations stops myeloblast differentiation, myeloblasts replace marrow and suppress hematopoiesis, resembles ALL and AML (pancytopenia),
Auer rods
Acute myeloid leukemia
(AML)
Prognosis
Poor prognosis even with Tx. (chemotherapy, stem cell transplant, transfusion), average long-term survival is 15-30%
Myelodysplastic syndromes
Pathologic Cells
Myeloid stem cells that retain ability to differentiate
Myelodysplastic syndromes
Patients
Older adults,
average age of Dx. is
age 50-70
Myelodysplastic syndromes
Unique Features
Marrow is replaced by
myeloblasts that retain
capacity to differentiate,
hematopoiesis is disordered and at least one cytopenia is
found in peripheral blood, up to 40% eventually transform
into AML
Myelodysplastic syndromes
Prognosis
Median survival is 9 years after diagnosis, very poor prognosis once transitioned to AML
Chronic myeloproliferative
disorders (i-iv)
Patients
Adults & older adults
Chronic myeloproliferative
disorders (i-iv)
Unique Features
RBC/granulocyte/platelet
proportions are abnormal with an increase of at least one whole blood cell in circulation, may progress into a spent phase, pancytopenia,
splenomegaly
Chronic myeloproliferative
disorders
i. Chronic myelogenous
leukemia (CML)
Pathologic Cells
Myeloid stem cells that retain ability to differentiate
Chronic myeloproliferative
disorders
i. Chronic myelogenous
leukemia (CML)
Patients
Adults, most commonly age 30-50
Chronic myeloproliferative
disorders
i. Chronic myelogenous
leukemia (CML)
Unique Features
Philadelphia chromosome t(9,22), severe granulocytosis, severe extramedullary hematopoiesis causes pulp of spleen to resemble marrow with severe splenomegaly, anemia, 50% enter into accelerated phase (blast crisis) resembles ALL
Chronic myeloproliferative
disorders
i. Chronic myelogenous
leukemia (CML)
Prognosis
Remission is common with tyrosine
kinase inhibitor medications, 70%
cured with stem cell
transplantation, 3-year survival if transitions into aggressive leukemia (blast crisis)
Chronic myeloproliferative
disorders
ii. Polycythemia vera
Pathologic Cells
RBCs, increased
production
Chronic myeloproliferative
disorders
ii. Polycythemia vera
Patients
Patients with JAK2
mutations develop
PCV
Chronic myeloproliferative
disorders
ii. Polycythemia vera
Unique Features
Itching skin or risk for 30% have thrombotic
complications: stroke, M.I., organ infarction (spleen, kidneys)
Chronic myeloproliferative
disorders
ii. Polycythemia vera
Prognosis
PCV: low levels of EPO, patients live 1.5-3 years without medical management, but are expected to live 10-20 years after diagnosis with management
Chronic myeloproliferative
disorders
iii. Primary myelofibrosis
Pathologic Cells
Myeloid stem cells that retain ability to differentiate
Chronic myeloproliferative
disorders
iii. Primary myelofibrosis
Patients
Adults, > 50 years
