Concepts in malignant haematology Flashcards
monocyte morphology
kidney shaped nucleus
how can we identify normal progenitors/stem cells?
immunophenotyping
Malignant haemopoiesis is usually characterised by :
- increased numbers of abnormal & dysfunctional cells
- loss of normal activity
acute leukaemia is characterised by:
Proliferation of abnormal progenitors
with block in differentiation/maturation
(e.g. Acute Myeloid Leukaemia)
Chronic myeloproliferative disorders/neoplasm (MPN)
Proliferation of abnormal progenitors,
but NO differentiation/maturation block
(e.g. Chronic Myeloid Leukaemia)
are haematological malignancies usually due to hereditary or acquired genetic mutations?
acquired
usually multiple ‘hits’ - contribution from recurrent cytogenetic abnormalities (e.g. deletions, chromosomal translocations etc)
is normal haemopoiesis polyclonal or monoclonal
polyclonal
what is a clone
population of cells derived from a single parent cell
is malignant haemopoiesis polyclonal or monoclonal
monoclonal
age of presentation of acute lymphoblastic leukaemia (ALL)
2-5
why are there so many different subtypes of haematological malignancies (4 points)
- Cells at different developmental stages can undergo neoplastic transformation
- Involvement of different anatomical regions unique to the cell-type, either at the point of origin, or after migration
- Different clinicopathological characteristics (clinical and biological behaviour)
- Patterns of antigen expression/signature (suggestive of developmental stage) –immunophenotyping/immunohistochemistry have a critical role in diagnosis
Classifying cancers of the haemopoietic and lymphoid systems (4 points)
Site
Lineage (myeloid or lymphoid)
Stage of development/histology (more primitive compartment or less primitive compartment)
Preservation of differentiation/maturation
what language/terms do we use to differentiate between more and less primitive stage of development in haem malignancies
“blastic” - more primitive
“high grade”, “low grade”, “cytic” - less primitive
which are more aggressive - acute or chronic leukaemias
acute
Features of histological aggression:
large cells with high nuclear-cytoplasmic ratio, prominent nucleoli, rapid proliferation
Acute leukaemias present (more commonly than chronic leukaemias) with failure of normal blood cell production, true or false
true
Acute lymphoblastic leukaemia:
blood/marrow involving primitive, lymphoid malignancy
Acute myeloid leukaemia:
blood/marrow involving, primitive, myeloid malignancy
Chronic lymphocytic leukaemia:
blood/marrow involving, less primitive, lymphoid malignancy
High grade B/T cell (non Hodgkin) lymphoma:
nodal, lymphoid malignancy, less primitive, clinically aggressive
Low grade B cell (non Hodgkin) lymphoma:
nodal, lymphoid malignancy, less primitive, clinically less aggressive
Hodgkin lymphoma:
nodal, lymphoid malignancy, less primitive, less aggressive
Myeloma
plasma cell malignancy
usually, not exclusively, in the bone marrow
Chronic myeloproliferative neoplasms disorders:
primitive, myeloid compartment, maturation preserved (e.g. chronic myeloid leukaemia)
