Hem & Onc - Pathology (Leukemias & Myelodysplastic syndromes ) Flashcards
Pg. 393-395 in First Aid 2014 or Pg. 364-365 in First Aid 2013 Sections include: -Myelodysplastic syndromes -Leukemias -Chromosomal translocations -
What phrase characterizes leukemia?
Unregulated growth of leukocytes in bone marrow
What general effects can leukemia have on hematologic components?
Unregulated growth of leukocytes in bone marrow –> (1) Increased or decreased number of circulating leukocytes in blood & marrow failure –> (2) Anemia (decreased RBCs) (3) Infections (decreased mature WBCs) (4) Hemorrhage (decreased platelets)
Where can leukemic cell infiltrates be found?
Leukemia cell infiltrates in liver, spleen, and lymph nodes are possible
What are the 3 major kinds of lymphoid neoplasms in leukemia?
(1) Acute lymphoblastic leukemia/lymphoma (ALL) (2) Small lymphocytic lymphoma (SLL) / Chronic lymphocytic leukemia (CLL) (3) Hairy cell leukemia
In what age group do you typically see Acute lymphoblastic leukemia/lymphoma (ALL)?
Age: < 15 years
How can T-cell ALL present, and why?
Mediastinal mass (leukemic infiltration of thymus)
What effect does ALL have on peripheral blood and bone marrow?
Very significant increase (3 arrows up) of lymphoblasts (blood smear shows large nucleus - about 2x size of RBCs instead of the normal standard of being same size)
What are significant markers for ALL?
TdT+ (marker of pre-T cand pre-B cells); CD10+ (pre-B cells only).
What is the ALL response to therapy like? What leads to a better prognosis?
Most responsive to therapy; t(12;21) => better prognosis
Where might ALL spread?
CNS & testes
In what age group do you typically see SLL/CLL?
Age: > 60 years
How does SLL/CLL often present? What is its progression? What is found on peripheral blood smear?
Often asymptomatic; Progresses slowly; Smudge cells in peripheral smear
With what hematologic condition is SLL/CLL associated?
Autoimmune hemolytic anemia
What is the difference between SLL and CLL, if any?
SLL same as CLL, except CLL has increased peripheral blood lymphocytosis or bone marrow involvement
What age group does hairy cell leukemia typically affected? How is it characterized/defined?
Age: Adults; Mature B-cell tumor in the elderly
How does hairy cell leukemia appear on blood smear?
Cells have filamentous, hair-like projections
What stain was used for hairy cell leukemia? What change has been made related to this diagnosis technique?
Stains TRAP (tartate-resistant acid phosphatase) positive; TRAP stain largely replaced with flow cytometry.
How is hairy cell leukemia treated, and what kind of compound is this?
Cladribine (2-CDA), an adenosine analog (resistant to adenosine deaminase degradation)