chronic and other bs

Question 1

Myelodysplastic syndromes

Answer 1

Myelodysplastic syndromes
 Clonal diseases of stem cell origin
 characterized by low peripheral cell counts, but usually
hypercellular bone marrow, with abnormal morphology.
 They are resistant to chemotherapy, and may turn into acute
leukemia (AML).

Question 2

Myeloproliferative neoplasms

Answer 2

Myeloproliferative neoplasms
 Malignant, clonal diseases of stem cell origin.
 Characterized by high peripheral cell counts of certain
cell lines and splenomegaly.
 The bone marrow is hypercellular, with
differentiation, without dysplasia

Question 3

non-Hodgkin’s lymphomas- immature

Answer 3

B-cell
● B-lymphoblastic lymphoma /
leukemia
T-cell and NK cell
● T-lymphoblastic lymphoma /
leukemia

Question 4

non-Hodgkin’s lymphomas- peripheral mature- b cell

Answer 4

● B-cell CLL / SLL (small lymphocytic
lymphoma)
● hairy cell leukemia
● plasma cell myeloma / plasmacytoma
● mantle cell lymphoma
● Burkit’s lymphoma
● follicular lymphoma
● diffuse large B-cell lymphoma

Question 5

non-hodgking lymphoma -t cell and nk

Answer 5

T cell granular lymphocytic leuk.
● adult T cell lymphoma / leukemia
● mycosis fungoides / Sézary’s sy.
● anaplastic large T cell lymphoma

Question 6

Chronic Myeloid Leukemia (CML

Answer 6

A neoplasm of the hemopoietic stem cells
 It is an MPN ‒ granulocytic overproduction is
dominant, but other myeloid cell lines are also
affected (thrombocytosis is common).
 The disease accounts for cca 10‒15% of all
leukemias.
 Most common between 20 and 40 years of age.
 In the absence of treatment it is a three-phase
disease
 Treatment is quite successful

Question 7

cml natural course

Answer 7

Natural course without treatment
 Chronic Phase
 Accumulation of myeloid cells
 bone marrow
 peripheral blood
 spleen and liver
 elsewhere

 Accelerated Phase
 Further genetic changes in the stem cell leading eventually to
acute transformation (ie acute leukemia)

 Blast crisis
 Acute leukemia (2/3 myeloblastic, 1/3 lymphoblastic)

Question 8

CML - clinical features of chronic phase

Answer 8

CML - clinical features of chronic phase
Peak age 20 to 40 years
 Weight loss, night sweats
Splenomegaly
Gout
Often found by chance

Question 9

cml- peripheral and bonemarrow

Answer 9

Peripheral blood film
 Anaemia
 Leukocytosis (> 25 G/L, sometimes > 100 G/L
 WBC differential shows granulocytes in all stages of
maturation
 Basophilia, thrombocytosis.
Bone marrow
 Hypercellular (reduced fat spaces)
 Myeloid:erythroid ratio – 10:1 to 30:1 (N : 2:1)
 Myelocyte predominant cell, blasts less 10%
 Megakaryocytes increased & dysplastic
 Increase reticulin fibrosis in 30-40%