Concepts in malignant haematology

Question 1

How can we identify normal more mature non-lymphoid/lymphoid cells? How about normal progenitors/stem cells?

Answer 1

Non-lymphoidal: morphology
Progenitor/SC: immunophenotyping

Question 2

What characterise haematological malignancies?

Answer 2

• Increased numbers of abnormal & dysfunctional cells (haemopoiesis problem)
• Loss of normal activity (eg affected immune function)

Question 3

What is acute leukaemia?

Answer 3

Proliferation of abnormal progenitors with block in differentiation/maturation (eg Acute myeloid leukaemia)

Question 4

What is chronic myeloproliferative disorders/neoplasm?

Answer 4

Proliferation of abnormal progenitors, but NO differentiation/maturation block (eg chronic myeloid leukaemia) –> meaning there would be a very high number of cells

Question 5

What causes haematological malignancies?

Answer 5

Genetic, epigenetic, environmental interaction
Acquired somatic mutations in regulatory genes (driver mutations)
Usually multiple ‘hits’

Question 6

How to classify different types of haematological malignancy?

Answer 6

Cells undergoing neoplastic transformation at different developmental stages

Involvement of different anatomical regions unique to the cell-type, either at the point of origin, or after migration

Different clinicopathological characteristics

Immunophenotyping would help

Question 7

What are the classification subtypes?

Answer 7

Leukemia is were bone marrow and blood are involved

Lymphoma is when lymph nodes are involved

‘Blastic’ refer to more primitive cells - related to maturation arrest
‘Cytic’ refers to less primitive compartments

Question 8

What are features of histological aggression?

Answer 8

Large cells, with high nuclear-cytoplasmic ratio, prominent nucleoli, rapid proliferation

Acute leukaemias present with failure of normal production more commonly than chronic