Haematological Malignancies

Question 1

What cells are affected in a myeloid malignancy?

Answer 1

Red blood cells
Platelets
Granulocytes (basophils, eosinophils etc)
Monocytes

Question 2

What cells are affected in a lymphoid malignancy?

Answer 2

T Cells

B cells

Question 3

What is the genetic change that results in an acute myeloid malignancy?

Answer 3

A genetic mutation within the haematopoietic stem cell that causes excess proliferation of the myeloid cell without differentiation (multiply and bone marrow fills up with immature cells) and the bone marrow fails

Question 4

What excess of cells are seen on a blood film in acute myeloid malignancies?

Answer 4

Blast cells

Question 5

What is the genetic change that results in a chronic myeloid malignancy/myeloproliferative disorder?

Answer 5

Changes the stem cell by proliferation but differentiation is present so get over production of mature myeloid cells

Question 6

What is the genetic change that results in an acute lymphoblastic leukaemia?

Answer 6

Mutation in stem cell that lead to proliferation with block to differentiation in lymphoid side

Question 7

What is the genetic change that results in a lymphoma?

Answer 7

Mutation events occur in the more mature lymphoid cell
Affinity maturation/somatic hypermutation is the process of the B cells dividing and matching their Ig to the antigen that is being presented by antigen presenting cells done within the germinal centre of the lymph node
Changing the Ig gene can go wrong and mutational events can occur, which can lead to lymphomas

Question 8

What are the different types of lymphadenopathy and what can cause them?

Answer 8

Localised and painful:
Bacterial infection in draining site

Localised and painless:
Rare infections, catch scratch fever, TB
Metastatic carcinoma from draining site- hard
Lymphoma-rubbery
Reactive, no cause identified

Generalised and painful/tender:
Viral infections, EBV, CMV, hepatitis, HIV

Generalised and painless
Lymphoma
Leukaemia
Connective tissue diseases, sarcoidosis
Reactive, no cause identified
Drugs

Question 9

What are the main groups of haematological malignancies?

Answer 9

Acute Leukaemias

• Acute lymphoblastic leukaemia (ALL)
• Acute Myeloid Leukaemia (AML)

Chronic Leukaemias

• Chronic myeloid leukaemia (CML)
• Chronic lymphocytic leukaemia (CLL)

The malignant lymphomas

• Non-Hodgkin lymphoma (NHL)
• Hodgkin lymphoma (HL)

Multiple myeloma

Myelodysplastic syndromes (MDS)

The chronic myeloproliferative diseases (biologically malignant)