Hematologic Malignancies Flashcards
cancer of leukocytes?
cancer of lymphocytes?
cancer of plasma cells?
leukemia
lymphoma
multiple myeloma
lymphoid progenitor cells
lymphoblast
myeloid progenitor cells
myelobast
term used relating to blood and body tissues that make it
Hematologic
term for diseases in which abnormal cells divide without control and can invade nearby tissues
Malignancy
can spread to other body parts through blood and lymph systems
Malignant cells
abnormal mass of tissue that forms when cells grow and divide more than they should or do not die when they should
Neoplasm
types of neoplasm
Benign neoplasm (not cancer)
Malignant neoplasm (cancer)
Hematologic Malignancies/Neoplasms include
leukemias
lymphomas
myelodysplastic syndromes (preleukemias)
Initiate in a hematopoietic cell as a result of acquisition of 1 or more mutations in key genes that regulate cell growth (proliferation), survival, differentiation, or maturation
Hematologic Malignancies/Neoplasms
Occur in hematopoietic cells of all lineages and at various stages of their development
Hematologic Malignancies/Neoplasms
T/F
Most hematologic neoplasms are localized
F
Most are SYSTEMIC at initiation of malignant process.
FACTORS RELATED TO OCCURRENCE OF LEUKEMIA
Genetic
Immunological factors
Viral and bacterial agents
Environmental exposure
Chemical and drug exposure
Occupational exposure
Secondary causes
top 5 killer-cancer in the Philippines
Leukemia
most common leukemia type? age groups affected? survival rate?
lymphoid leukemia
Filipino children and elderly over 70 y/o
5-year survival rate of only 5.2%
a disease, usually of leukocytes, in the blood and bone marrow? 2 forms of this disease?
LEUKEMIA
- Acute Leukemia
- Chronic Leukemia
Predominant cell type of Acute Leukemia
precursor cell or blast
Predominant cell type of Chronic Leukemia
Mature
Onset of Acute Leukemia
Sudden
Onset of Chronic Leukemia
Insidious
Symptoms of Acute Leukemia
Fever (neutropenia-induced infection)
Mucocutaneous bleeding (thrombocytopenia)
Fatigue (anemia)
Symptoms of Chronic Leukemia
Variable,
nonspecific; some
asymptomatic
Acute Leukemia WBC count
Variable
Chronic Leukemia WBC count
Increased
Acute Leukemia progression without treatment
Rapid; weeks to months
Chronic Leukemia progression without treatment
Slower; months to years
type of leukemia with symptoms of short duration
acute
type of leukemia with symptoms of long duration
chronic
type of leukemia with many immature cell forms in bone marrow and/or peripheral blood
acute
type of leukemia with mostly mature cell forms in bone marrow and/or peripheral blood
chronic
type of leukemia with elevated total leukocyte count
acute
type of leukemia with total leukocyte count that range from
extremely elevated to lower than normal
chronic
general term for malignancy that starts in the lymph system, mainly in the lymph nodes? types?
LYMPHOMAS
- Hodgkin Lymphoma
- Non-Hodgkin Lymphoma
Proliferation of malignant lymphocytes with a basophilic vacuolated cytoplasm with starry sky pattern due to numerous tangible body macrophage that are arrested at certain stages of maturation
HODGKIN LYMPHOMA
Hallmark of HODGKIN LYMPHOMA
Reed-Sternberg cell
large binucleated/multinucleated cell resembles owl’s eye appearance with each nucleus bearing a very large nucleolus
Reed-Sternberg cell
NON-HODGKIN LYMPHOMA is aka
Diffuse large B-cell lymphoma
Reed-Sternberg is absent but mixed population of
lymphocytes, histiocytes, eosinophils and some plasma cells are present.
NON-HODGKIN LYMPHOMA
cells overgrows, forming a mass or tumor that is located in the bone marrow
MYELOMA
Overproduction of various types of immature or mature leukocytes in BM and or peripheral blood
Leukemia
Solid malignant tumors of lymph nodes
Lymphoma
Overproduction of plasma cells in BM with concurrent abnormal production of proteins
Myeloma
cell types in leukemia
leukocytes of myelogenous or lymphocytic cell type
Site of malignant cells in leukemia
malignant cells freely trespass BB barrier
Site of malignant cells in lymphoma
malignant cells initially confined to organs containing MONONUCLEAR PHAGOCYTE CELLS (lymph nodes, spleen , liver, BM)
Site of malignant cells in myeloma
Plasma cells forms a mass/tumor located in BM
can spill over into the circulating blood and present a leukemic appearing picture on a PBS
Lymphomas
LEUKEMIAS are derived from the ancient Greek words:
leukos - “white”
haima - “blood”
rapid, clonal proliferation in bone marrow of lymphoid or myeloid progenitor cells known as lymphoblasts and myeloblasts, respectively
Acute leukemia
T/F
When the proliferation of blasts overwhelms the bone marrow, blasts are seen in the peripheral blood and the patient’s symptoms reflect suppression of hematopoiesis
T
T/F
For most cases of acute leukemia, the causes directly related to the development of the malignancy are UNKNOWN.
T
exceptions that exist as cause of acute leukemia
toxins - induce genetic changes leading to a malignant phenotype
Environmental exposures known to lead to hematopoietic malignancies
radiation
exposure to organic solvents (benzene)
T/F
Rarely, leukemias can be seen in patients with known familial cancer predisposition syndromes
T
Induced DNA damage in hematopoietic cells due to alkylating agents and other forms of chemotherapy
Therapy-related leukemias
classification devised in the 1970s and 1980s
French-American-British (FAB) classification of acute leukemias
based largely on morphologic characteristics and examination of routine histologic stain preparations to distinguish lymphoid neoplasms from myeloid neoplasms
French-American-British (FAB) Classification
French-American-British (FAB) Classification is separated into 3 broad leukocytes groups
- Myelogenous
- Monocytic
- Lymphocytic
Major types of leukocytic leukemias can be classified as acute or chronic according to leukocyte group in FAB Classification
▪ Acute or Chronic Myelogenous
▪ Acute or Chronic Monocytic
▪ Acute or Chronic Myelomonocytic
▪ Acute or chronic Lymphocytic Leukemia (CLL)
Published in 2001 and updated in 2008 and 2016, in collaboration with the Society for Hematopathology and the European Association for Haematopathology
World Health Organization (WHO) Classification
classification considers clinical features, morphology, immunophenotyping, cytogenetics, and molecular genetics
World Health Organization (WHO) Classification
Uses broad categories of mature lymphoid neoplasms, myeloid neoplasms, and acute leukemia
World Health Organization (WHO) Classification
More precise classification of many of the leukocyte neoplasms based on recurring chromosomal and genetic lesions found in many patients.
World Health Organization (WHO) Classification
Subtypes of ACUTE MYELOID LEUKEMIAS by FAB Classification
M0
M1
M2
M3
M4
M4eo
M5a
M5b
M6
M7
Subtype:
Acute myeloid leukemia, minimally differentiated
M0
Subtype:
Acute myeloid leukemia, without maturation
M1
Subtype:
Acute myeloid leukemia, with maturation
M2
Subtype:
Acute promyelocytic leukemia
M3
Subtype:
Acute myelomonocytic leukemia
M4
Subtype:
Acute myelomonocytic leukemia with eosinophilia
M4eo
Subtype:
Acute monocytic leukemia, poorly differentiated
M5a
Subtype:
Acute monocytic leukemia, well differentiated
M5b
Subtype:
Acute erythroleukemia
M6
Subtype:
Acute megakaryocytic leukemia
M7