Disorders of White Blood Cells Flashcards
Acute vs. Chronic Leukemia
and both?
Acute: >20% blasts, children, auer rods in myeloid blasts
Chronic: mature neoplasms, <20% blasts, middle age or older adults
Both: normo/normo anemia with varying platelet and leukocyte counts
Acute Myeloid Leukemia (AML)
Blast count, appearance, differentiate from ALL
> 20% blasts
Nucleoli, loose chromatin
Myeloblasts have Auer rods which are not in lymphoblasts
Chronic Myeloid Leukemia (CML)
Blast count, appearance, mutation, progression risk
<20% blasts
All stages of left shift
Philadelphia chromosome, t(9;22), BCR/ABL1
Accelerate into blast crisis - acute myeloid leukemia and may see auer rods
Acute Lymphocytic Leukemia (ALL)
Blast count, appearance, differentiate, T or B?
> 20% blasts
Nucleoli and chromatin
Will not have auer rods
T or B cells cannot be differentiated without flow cytometry
Chronic Lymphocytic Leukemia (CLL)
Diff appearance
High number of lymphocytosis
Many mature lymphs, some promyelocytes, not many blasts
Smudge cells - albumin prep
Acute Promyelocytic Leukemia (APL)
Diff appearance, telling feature, mutation, critical issue?
Mostly promyelocytes, agranular
Bi lobed butterfly appearance
t(15;17)
Promyelocyte granules have procoagulants that initiate DIC when lysed if given wrong treatment
Acute Monocytic Leukemia
Monocytic cell range, appearance
> 80% are monocytic, mostly promonocytes
Appear loose and folded
Polycythemia Vera
What is it, smear review, mutation
Increased and unregulated RBC production
Smear won’t indicate abnormal RBCs but may have leukocytosis
JAK2
Essential Thrombocythemia
What is it, smear review, mutation
Increased platelet production of megakaryocytes in bone marrow
Platelet clumping
JAK2
Primary Myelofibrosis
What is it, smear review, mutation
Increased in bone marrow fibroblasts and fibrosis
Teardrop cells, pancytopenia
JAK2
Dysplastic Changes of WBC
Neutropenia, monocytosis, pseudo pelger huet, hypo or abnormal granulation, no granules in promyelocytes, granules in blasts, left shift, uneven N:C ratio
Dysplastic Changes of RBCs
Dimorphic population, poikilocytosis, anemia, inclusions, NRBCs
Dysplastic Changes of Platelets
Giant, hypogranular, abnormal adhesion or aggregations, micromegakaryocytes
Buffy Coat
Used for, procedure, cannot be used for
Used for low WBC counts
Whole blood, centrifuge, pipette small amount of buffy coat, plasma, and red cells, mix and make slide
Cannot be used for platelet or red cell morphology estimates because no longer looking at whole blood
Prolymphocytic Leukemia
Prolymph count, appearance, arise from, smear issue
> 55% prolymphocytes
One very large nucleoli, many lymphocytes on smear
Can rarely arise from CLL
Many smudge cells -albumin prep
Hairy Cell Leukemia
Type, appearance, CD marker
Mature B cell neoplasm,
Hairy projections
CD103
Plasma Cell Leukemia
Percentage, type, smear appearance, CD marker
> 20% plasma cells
Mature B cell neoplasm, aggressive multiple myeloma
Dark periphery with pale hof near eccentric nucleus, will see rouleaux
CD38, CD 138
Richter’s Transformation
What is it
Chronic lymphocytic leukemia turning into aggressive large B cell lymphoma
Follicular Lymphoma
Telling sign
Butt cells
Mantle Cell Lymphoma
Appearance
Irregular nuclear contours
Burkitt Lymphoma
Type of lymphoma, telling sign
Non Hodgkin’s lymphoma
Hole punch cells
Sezary Syndrome
Type, telling sign, CD marker
Cutaneous T cell lymphoma
Cerebriform/brain shaped nucleus
CD4
Albumin Preps
Procedure, cannot use for
6:1 blood to albumin
Make push smear
Cannot use for platelet estimet or RBC morphology
Stem Cell CD Marker
CD34
All Leukocytes CD Marker
CD45
B-Cell CD Marker
CD19, many are CD20
T Cell CD Marker
CD3, CD4, CD8
Monocyte CD Markers
CD14
Monocytes and Myeloid Cell CD Markers
CD13, CD33
Myeloid Markers
CD11b, CD11c
