General Flashcards
Some patients with Aplastic Anemia have an associated…
Thymoma
4 Characteristics of Paroxysmal Nocturnal Hemoglobinuria
- Chronic Hemolytic Anemia
- Iron deficiency through urinary losses
- Venous thromboembolism (including Budd Chiari)
- Pancytopenia
Paroxysmal Nocturnal Hemoglobinuria cell surface markers
CD55, CD59
3 disorders comprised of acquired hematopoietic stem cell defects
- Aplastic Anemia
- PNH
- MDS
Treatment for Aplastic Anemia
Withdraw offending agent
Cyclosporine and Antithymocyte
Allogeneic HSCT: Curative for patients <50 yo
Treatment for PNH
Eculizumab for symptom reduction
HSCT- long term survival
Prophylactic anticoagulation, iron and folate supplement
Causes of Pure red cell aplasia
Pregnancy, Thymoma, malignancy
Viral or drug toxity
Bone marrow findings in pure red cell aplasia
Clonal CD57 positive T cells
Must have imaging for PRCA
CT to rule out thymoma
Treatment PRCA
Same as aplastic anemia cyclosporine, antithymocyte
Prednisone
Thymectomy
IVIG for AIDS and Parvo B19 patients
Treatment for PRCA with large granular lymphocytosis
methotrexate or cyclosproine
Causes of Neutropenia
Carbamazepine, Phenytoin
PTU
Cephalosporins, Bactrim
Felty syndrome
RA, splenomegaly, neutropenia
Immune associated neutropenia
Felty syndrome
Treatment for Felty
cyclosporine
antithymocite
prednisone
What can be treated with cyclosporine and antithymocyte
Aplastic Anemia
Felty
PRCA
Age for MDS
> 60
Differentials for MDS
B12/Folate deficiency
Alcohol, drug
Acute leukemia
Myeloproliferative syndromes
MDS is precursor to
Acute leukemic syndromes
MDS Bone marrow findings
hypercellular marrow, dysplastic erythroid precursors
MDS will have cytopenia in at least
two lines
Morphologic abnormalities of erythrocytes in MDS
macrocytosis with nucleated erythrocytes and teardrop cells
Subtype of MDS with specific therapy
-5q syndrome
Risk scale for MDS
IPSS-R
High IPSS-R score requires
treatment to prevent AML
Treatment for MDS
HSCT for young people
Azacytidine and decitabine to people at high risk for AML and not candidate for HSCT
Treatment for people at high risk for AML and not a candidate for HSCT
Azacytidine and Decitabine
Treatment of -5q syndrome
Lenalidomide
