Chapter 11 Study Guide

Question 1

ALL = acute lymphoblastic leukemia/lymphoma

Answer 1

• most common in children (3-7 years old)
• children refuse to walk bc of hemarthrosis = bleeding into a joint
• very abrupt symptom onset
• pathogenesis = immatrue lymphocytes (lymphoblasts) continue to proliferate → accumulates in blood and bone marrow → bone marrow is at least 20% of blasts
• this accumulation of lymphoblasts in the bone marrow leads to
  1. anemia = low RBCs
  2. leukopenia = low WBCs
  3. thrombocytopenia = low platelets
  4. splenomegaly and hepatomegaly = enlarged spleen and liver bc they filter out -blast cells

Question 2

CML = chronic myeloid leukemia

Answer 2

• pathogenesis = malignant granulocytes have Philadelphia chromosome (Ph+) → translocation of chromosomes 9 and 22 → creates new bcr/abl fusion gene
• 40-50 year old adults

Question 3

CLL = chronic lymphoid leukemia

Answer 3

• most common leukemia in U.S. → 30% of leukemia cases
• usually found by accident in routine blood exams
• follows an indolent course = disease progresses slowly, mostly asymptomatic
• pathogenesis = 95% are malignant B-cell precursors → malignant lymphocytes invade lymphoid tissues and bone marrow

Question 4

multiple myeloma (plasma cell myeloma)

Answer 4

• Bence Jones protein
• hypercalcemia = bc bone destruction is releasing calcium
• kidney damage → renal failure
• honeycomb bone = demineralized bone
• pathogenesis = malignant plasma cells invade bone and form multiple tumor sites → light chain (monoclonal) antibodies

Question 5

Hodgkin lymphoma

Answer 5

• presence of Reed-Sternberg cells
• Reed-Sternberg cells → spread in predictable way → metastasis along contiguous lymphatic pathway
• cervical nodes are the most common site of lymph node enlargement

Question 6

Non-Hodgkin lymphoma

Answer 6

• does not have reed-sternberg cells
• spreads early and unpredictable
• two major complications → emergencies of non-Hodgkin lymphoma
  1. superior vena cava obstruction
  2. spinal cord compression

Question 7

is prognosis worse for AML or ALL?

Answer 7

prognosis is worse from AML than ALL

Question 8

what is the most common leukemia in the U.S.?

Answer 8

chronic lymphoid leukemia = CLL is the most common leukemia in the U.S. → accounts for 30% leukemia cases

Question 9

what leukemia is found by accident in routine blood exams?

Answer 9

chronic lymphoid leukemia = CLL is usually found by accident in routine blood exams

Question 10

what are the general symptoms of leukemia?

Answer 10

• this accumulation of -blasts in the bone marrow leads to
  1. anemia = low RBCs
  2. leukopenia = low WBCs
  3. thrombocytopenia = low platelets
  4. splenomegaly and hepatomegaly = enlarged spleen and liver bc they filter out -blast cells

Question 11

what is the difference acute leukemia and chronic leukemia?

Answer 11

acute = affects the -blast level cells → blast cells are large, immature (non-functional) cells in bone marrow
chronic = bone marrow has normal functional cells and mutated cells

Question 12

what is the difference between myeloid and lymphatic lineage?

Answer 12

myeloid = blood cells (RBCs, WBCs, platelets)
lymphatic = lymphocytes (B and T cells)