Hem Malignancies Flashcards

1
Q

Overview of Hematological Malingancy Categorization and Nomenclature

A

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.

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2
Q

Differentiate between Lymphoid and myeloid malignancies

A

Myeloid: give rise to granulocytes, RBCs, platelets, etc.
Lymphoid: give rise to B cells, T cells, NK cells, etc.

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3
Q

Describe the nomenclatures of acute leukemias

A

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.

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4
Q

Define myeloproliferative diseases and identify clinical and genetic differences amongst these diseases

all these are from myeloid stem cells

A

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
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5
Q

Describe the major divisions in classification of lymphomas

all these are from Lymphoid stem cells

A

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
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6
Q

Identify key clinical features and laboratory values that allow for differentiation of PLASMA CELL DISORDERS

A

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

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7
Q

Overview of common diagnostic techniques used for hematological malignancies

A

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

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8
Q

What are key chemotherapeutic terms associated with treatment of hematologic malignancies?

A

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.

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9
Q

Describe Myelodysplastic syndrome

A

Not making enough blood cells. can progress to acute myeloid leukemia

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10
Q

Remember to look at the charts shown in lectures to help organize

A

Yeah!!

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