Hem Malignancies Flashcards
Overview of Hematological Malingancy Categorization and Nomenclature
Leukemia: white blood: too many cells in blood
Lymphomas: masses in lymph nodes or soft tissues
Diff is: Leukemias are liquid, lymphomas are masses
Acute Leukemia: lethal in weeks wo tx. More sensitive to chemo.
Chronic: may survivie many years without tx.
Differentiate between Lymphoid and myeloid malignancies
Myeloid: give rise to granulocytes, RBCs, platelets, etc.
Lymphoid: give rise to B cells, T cells, NK cells, etc.
Describe the nomenclatures of acute leukemias
2 types:
Acute Myeloblastic L: from granuloctyes, RBC, platelet
- Most common in adults,
- FAB catergorization: M0-M7 based on morphological apprearance.
- WHO classification: to describe the type
Acute Lymphoblastic L: From B, T, NK cells
- Common in children
- Two types B-ALL and T-ALL
- more aggressive.
TUmor cells develop in teh marrow and suppress other cells in marrow.
Define myeloproliferative diseases and identify clinical and genetic differences amongst these diseases
all these are from myeloid stem cells
Chronic Myeloproliferative: dz where marrow makes too many RBCs, platelets, or WBCs.
Polycythemia Vera:
- JAK2 mut
- HIgh levels of RBCs
- Survival less than 1 yr,
- Tx: Periodic phlebotomy/chemo
Essential Thrombocythemia
- JAK2 or MPL mut
- Too many Megakaryocytes
- Asymptomatic until late life
Primary myelofibrosis
- JAK2 ro MPL mut
- Fibrosis and atypical Megakaryocytes
- 1-8 yrs survival
Chronic Myelogenous Leukemia
- BCR ABL gene mut
- Too many granulocytes and megakaryocytes
- untreated progress to Acute leukemia in 5 yrs
- Tx: Imatinib or stem cells
Describe the major divisions in classification of lymphomas
all these are from Lymphoid stem cells
Hodgkins Lymphoma:
+ Reed Sternberg Cells (huge cells with multinucleus)
- usually in one lymph node region and spread predictably
- Tx: radiation/chemo w/ good cure rate
Non Hodgkins Lymphoma:
- Reed sternberg Cells
- Follicular lymphoma - Germinal center b cell, BCL-2 mut, indolent
- Extranodal marginal zone lymphoma, post germinal center b cell, NFkB mut
- Diffuse large B cell lymphoma - Germinal center, BCL-6, BCL-2, aggressive
- Burkitt Lymphoma - Germinal center b cell, c-MYC, very aggressive, EBV
Chronic Lymphocytic Leukemia
- Not assoc with single gene mutation - mulit factorial
- older people
- smudge cells - fragile
- pnts asysmptomatic at dx
Identify key clinical features and laboratory values that allow for differentiation of PLASMA CELL DISORDERS
Multiple Myeloma
- comp of Mature B cells (plasma cells)
- Rouleaux formation - stacked RBCs
- M prot in urine/serum
- Lytic bone lesions
Solitary Plamacytoma
- Big mass of clonal plasma cells
- Low levels of Monoclonal antibodies (M prot) in serum
- Risk of progression to Multiple Myeloma
Primary Amyloidosis
- tons of plasma cells that produce monoclonal LIGHT CHAINS, which are misfolded and form deposits
- cause organ prob
Monoclonal Gammopathy of Uncertain Significance (MGUS)
- see monoclonal immunoglobin prot in serum/urine without evidence for malignancy of plasma cells or b lymphocytes.
- can progress to multiple myeloma
POEMS syndrome - Polyneuropathy, Organomegaly, Endocrinopathy, Monoclonal Protein, Skin changes
Overview of common diagnostic techniques used for hematological malignancies
Leukemias: Peripheral blood smear, bone marrow biopsy
Lymphoma: lymph node biopsy
Plasma Cell neoplasm: Bone marrow biopsy
Morphology: sending sample for staining
- AML: auer rod seen
- Mult My - homogenious cells in marrow
Immunophenotyping via flow cytometry.
HIstochemistry: biopsy - to see if ab markers present.
Cytogenetics: karyotype, FISH
Serum protein elecrophoresis
What are key chemotherapeutic terms associated with treatment of hematologic malignancies?
Induction therapy: Initial tx given for cancer. goal is to induce remission of dz by reducing number of cells.
Consolidation therapy: Tx given following induction therapy, goal is to eliminate any undetectable cancer cells
Maintenance therapy: Therapy given after pnt has acheived remission. goal is to maintain remission and reduce risk of relapse.
Adjuvant therapy: given with prmary therapy.
Palliative therapy: lessens the symptoms adn improve QOL
Salvage therapy: Tx given after others have failed.
Describe Myelodysplastic syndrome
Not making enough blood cells. can progress to acute myeloid leukemia
Remember to look at the charts shown in lectures to help organize
Yeah!!