Hematologic Malignancy Flashcards
Blast crisis
Happens in CML when chronically dividing cells develop new mutations that make them VERY RAPIDLY dividing. Emergency. Likely to kill patient. Treat with HSCT ASAP.
Should HCST be done in asymptomatic CML?
Yes. Prophylactic for blast crisis which is often lethal. HCST itself does however confer 10-15% mortality so it is a discussion to be had with patient.
Philadelphia chromosome
Chromosome 9 and 21 translocation in CML
BCR-ABL which is a constitutively active tyrosine kinase
BCR ABL
Constitutively active tyrosine kinase in CML. Created by Philadelphia chromosome.
Too many myeloblasts Neutropenia Anemia Thrombocytopenia Afebrile Gradual/progressive May be asymptomatic
CML
Myeloblasts Crowd out other cell types due to competition for nutrients
anemia sx including fatigue and possible exertional SOB
thrombocytopenia petichiae and bleeding
neutropenia infections
Baseline afebrile b/c chronic not activating immune system and immune system not working well
Types of myeloid cells
Erythrocytes
Monocytes
Platelets (via megakaryocytes)
Granulocytes: neutrophils, basophils, eosinophils
Are cells differentiated in CML?
Partially, retain some function, sorta straddles that myloproliferative versus malignant phenotype
Hepatosplenomegaly is more common in ____ (CML/CLL)
CML
Lymphadenopathy is more common in _____ (CML/CLL)
CLL
Types of CLL
So many.
B cell is most common.
Are cells differentiated in CLL?
Kinda
Mutations in CLL
Unknown
Markers in CLL
Varies along subtypes
CD19, CD5, CD20, CD23 are common
CML tx
Imatinib or other tyk inhibitors
BCR ABL is a TYK
Quick division is more common in ____ (CML/CLL) while not enough death is more common in ____ (CML/CLL)
Quick division is more common in CML while not enough death is more common in CLL
