Heamatology - White Blood Cells Disorders Flashcards
What is leucopenia?
An abnormally low white cell count
What is the level of leucopenia that indicates moderate to severe?
<0.5 x 10^9 /L
Associated with a progressive increase in risk and severity of infection, and increase in recurrent infections.
What do levels of < 0.2 × 10 9 /L associated with in leucopenia?
High mortality from overehelming infection
What is the lower limit neutrophil count of normal (except in Afro- Caribbean races and in the Middle East, whereitis1.5×109 /L)?
2.5 × 10^9 /L
What is leucocytosis?
An increase in nukbers of circulating whit blood cells
What causes leucocytosis?
Primary—caused by bone marrow disease
Secondary—reactive leucocytosis caused by the normal response of bone marrow to abnormal conditions, e.g., infection.
What are the factors that influence peripheral blood lymphocyte count?
- Size of the myeloid and lymphoid precursor and storage cell pools
- Rate of release of cells from the storage pools
- Proportion of cells that are adherent to blood vessel walls at any time
- Rate of extravasation of cells from the blood into tissues.
What is lymphoma?
Any malignancy of lymphoid tissue ( both irgans and cells)
What is leukaemia?
Progessive and malignant disease of blood forming organs
Lymphoma or leukaemia ?
- adults
- more common
- its cells will not appear in thr bloodstream
Lymphoma
Lymphoma or leukaemia?
- chilhood cancer
- excess of white blood cells in the bloodstream
Leukaemia
Malignant growth in the bone marrow leading to an increased number of circulating immature or abnormal leukocytes which do not function properly.
Leukaemia
In leukamea, immature white blood cells lead to?
Reduced immune function
Common features of leukemias are?
Bone matrow failure (anaemia, thrombocytopenia, leucopenia)
Gout
Metastasis
What are rhe symptoms of acute leukaemia?
Anaemia
Neutropenia
Thrombocytopenia
What factors predict poor prognosis in ALL?
Increase age
High white cell count
Cytogenetic abnormalities
Poor response to treatment
What is the classificstion of acute lymphocytic leukaemia?
L1 - Small uniform blast cells with scanty cytoplasm
L2 - Large heterogeneous blast cells with nucleoli and low nuclear– cytoplasmic ratio have more cytoplasm and more prominent nucleoli
L3 - Basophilic vacuolated blast cells
What other classification is used for ALL?
numerical change
structural abnormality
Between which ages is ALL more common?
2 and 4 years of age
What is the most important prognostic feature of childhood ALL?
Minimal residual disease (MRD) testing with molecular monitoring using PCR of mutated genes or immunoglobulin gene rearrangements and leukaemic cells MRD status
Patients who are MRD- negative after induction therapy carry a lower relapse risk than those who are MRD- positive and such patients undergo intensification of subsequent treatment, why?
To reduce the relapse risk
What causes ALL?
Over 80% due to malignancies in precursors of B-lymphocytes (the rest is T-cell leukaemias)
What is the cause of AML?
Immature progenitor cells accumulate in the bone marrow
What are the usual sympotms of AML?
Anaemia
Neutropenia
Thrombocytopenia
What are the different types of white blood cell disorder?
Acute lymphocytic leukaemia - ALL
Chronic lymphocytic leukaemia - CLL
Acute myeloid lymphoma - AML
Chrinic myeloid leukaemia - CML
What are the phases of CML?
Chronic - anemia, splenomegaly
Accelerated - dominance of malignat clone of myeloid cell
Blast crisis - transformation to AML
