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Hematology > Hematological Malignancies > Flashcards

Hematological Malignancies Flashcards

1
Q

What is CA considered invasive?

A

Breaks the epithelium/BM into the circulation

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2
Q

What are the six main properties of tumor cells?

A
  1. Self sufficiency of growth
  2. Insensitivity to anti-growth
  3. Tissue invasion and metastasis
  4. Limitless replicative potential
  5. Sustained angiogenesis
  6. Evade apoptosis
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3
Q

What are cancers that begin in the skin or in tissues that line or cover the internal organs?

A

Carcinomas

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4
Q

What are cancers that begin in bone, cartilage, fat, muscle, blood vessel, or other CT?

A

Sarcomas

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5
Q

What are cancers that start in blood-forming tissue such as bone marrow, and causes large number of abnormal blood cells to be produced and enter the blood

A

Leukemia

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6
Q

What are cancers that being in the cells of the immune system?

A

Lymphoma and myelomas

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7
Q

How do you distinguish between lymphomas and leukemias?

A

how/where the first present

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8
Q

What is the difference between acute lymphoblastic leukemia vs acute lymphoblastic lymphoma?

A

Both the same disease, but leukemia starts in the blood

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9
Q

What is the difference between acute and chronic leukemia?

A

Acute = generally lethal within weeks w/o treatment

Chronic= can survive years without treatment

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10
Q

What are myeloid/myelogenous/myeloproliferative cancers?

A

Tumors involving the RBC, platelets, or their progenitors

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11
Q

What are lymphoid/lymphoblastic/lymphocytic/lymphoproliferative cancers?

A

Tumors involving the B, T, or NK cells

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12
Q

What are the five different hematological categories?

A
  1. Acut leukemias
  2. Chronic myeloproliferative
  3. Myelodysplastic syndrome
  4. Lymphomas & related lymphoid neoplasms
  5. Plasma cell neoplasms
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13
Q

What are the two types of acute leukemias?

A 
Acute myeloblastic (AML)
Acute lymphoblastic (ALL)
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14
Q

What are the symptoms of acute leukemias?

A

Pancytopenia d/t tumor cells displacing the normal blood elements in the bone marrow

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15
Q

What is the cause of the pancytopenia seen in leukemias?

A

Bone marrow replacement by tumors

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16
Q

What are the features of AML?

A

undifferentiated myeloid blast accumulating in the bone marrow

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17
Q

What is the most common leukemia in the adult?

A

AML

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18
Q

How do you subtype AMLs?

A

Clinical context
Cytogenetics
Molecular features

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19
Q

What is the origin of ALL-T?

A

T lymphocytes

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20
Q

What is the origin of ALL-B?

A

B lymphocytes

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21
Q

What is the origin of acute, monocytic leukemia?

A

Monocytes

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22
Q

What are the six types of AML classifications?

A
  1. AML with recurrent genetic abnormalities
  2. AML with multilineage abnormalities
  3. AML and MDS: therapy related
  4. AML NOS
  5. AML of ambiguous lineage
  6. MDS-RA with excess blasts
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23
Q

What are the two types of acute lymphoblastic leukemia? Which is more common?

A
  1. B-ALL (85% of all cases)

2. T-ALL

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24
Q

In what age group is ALL most common in?

A

children

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25
Q

Are ALL tumors aggressive or slow growing?

A

Aggressive

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26
Q

What are the four major chronic myeloproliferative disorders?

A 
-polycythemia
vera
-primary myelofibrosis
-essential thrombocythemia
-chronic myelogenous leukemia
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27
Q

What are diseases in which the bone marrow makes too many red blood cells, platelets, or certain white blood cells?

A

myeloproliferative disorders

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28
Q

What is the cause of polycythemia vera? Prognosis?

A

JAK2 mutation, causing a high level of funtional RBCs

median survival less than1 year without treatment

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29
Q

What is the treatment for polycythemia vera?

A

Blood removal

Chemo

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30
Q

What is essential thrombocythemia vera? Cause? Prognosis?

A

JAK2 or MPL mutation, causing an overproduction of megakaryocytes

Many pts asymptomatic for 50+ years

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31
Q

What is primary myelofibrosis? Causes? Prognosis?

A

JAK2 or MPL mutation causing fibrosis and atypical megakaryocytes

Median survival time 1-8 years

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32
Q

What is the chromosomal translocation that occurs with CML?

A

chr 9 and 22 cause philidelphia chromosome, and BCR-ABL Y kinase

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33
Q

What is the pathophysiology of CML?

A

Overgrowth of granulocytic and megakaryocytic precursors in the bone marrow

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34
Q

What is the end result of untreated CML? How long does this take to occur in untreated pts?

A

acute leukemia within 5 years

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35
Q

What is the treatment for CML?

A

Imatinib or stem cell transplant

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36
Q

What is myelodysplastic syndrome?

A

a type of cancer in which the bone marrow does not make enough healthy blood cells, and there are abnormal cells in the blood or bone marrow.

37
Q

What can myelodysplastic syndrome lead to?

A

Myeloid leukemia

38
Q

What is the virus that is believed to help cause lymphoid malignancies?

A

EBV

39
Q

What is the pathophysiology of myeloma?

A

Clones of plasma cells

40
Q

What are the cell types, special characteristics, diagnostic criteria for acute lymphoblastic leukemia (ALL)?

A

Immature pre B cells or B cells

Aggressive replacement of bone and brain tissue in children

Characteristic cells on sample

41
Q

What are the cell types, special characteristics, diagnostic criteria for chronic lymphoblastic leukemia (CLL)?

A

mature B cells
Nonaggressive in old people

Lymphocytes no blood film

42
Q

What are the cell types, special characteristics, diagnostic criteria for lymphoma?

A

B cells

Associated with EBV infx. Tend to cause solid lesions

heavy chain rearrangement

43
Q

What are the cell types, special characteristics, diagnostic criteria for multiple myeloma?

A

Plasma cells

Common for olds

Presence of plasma cells in marrow and osteolytic lesions on radiographs

44
Q

What are the cell types, special characteristics, diagnostic criteria for T-cell malignancy?

A

T-cells

rare- may be caused by HTLV1 infx

can behave either as leukemia or lymphoma

45
Q

What are the two types of lymphomas?

A

Hodgkin’s

Non-Hodgkin’s

46
Q

What are the two types of lymphomas and lymphoid neoplasms?

A

Lymphomas

Chronic lymphocytic leukemia

47
Q

What is the major factor in determining the difference between Hodgkin and non-hodgkin’s lymphoma?

A

reed-sternberg cells (found in Hodgkin’s)

48
Q

What are Reed-Sternberg cells?

A

large cells with two or more nuclei, each of which contains a large eosinophilic nucleoli

Found in Hodgkin’s lymphoma

49
Q

large cells with two or more nuclei, each of which contains a large eosinophilic nucleoli = ?

A

Reed-Sternberg cells

50
Q

What are the three types of Non-Hodgkin’s lymphoma?

A

Indolent
Aggressive
Very aggressive

51
Q

Where does Hodgkin’s lymphoma usually arise from?

A

In one lymph node group, and spread in a predictable way

52
Q

How do you treat Hodgkin’s lymphoma?

A

radiation and chemo

53
Q

What is the cell origin, implicated oncogene, and usual clinical behavior of Follicular lymphoma?

A

Germinal B cells

BCL-2

Indolent

54
Q

What is the cell origin, implicated oncogene, and usual clinical behavior of extranodal marginal zone lymphoma?

A

Post-germinal center B cell
NFkappaB

Very indolent

55
Q

What is the cell origin, implicated oncogene, and usual clinical behavior of Diffuse large B cell lymphoma?

A

germinal or post germinal center B cell

BCL-2 (or 2)

Aggressive

56
Q

What is the cell origin, implicated oncogene, and usual clinical behavior of Burkitt’s lymphoma?

A

Germinal B cell

c-MYC

Very aggressive

57
Q

True or false: chronic lymphocytic leukemias are associated with one or two types of chromosomal translocations

A

False–not associated

58
Q

What is the median age of diagnosis of chronic lymphocytic leukemia?

A

70

59
Q

What are the histological findings of CLL?

A

Increased number of small, round lymphocytes

Smudge cells

60
Q

true or false: most patients diagnosed with CLL are asymptomatic at diagnosis

A

True

61
Q

What is the prognosis for CLL?

A

5-11 years

62
Q

What are the six major classifications of plasma cell disorders?

A
  1. multiple myeloma
  2. Plasmacytoma
  3. Primary amyloidosis
  4. Monoclonal gammopathy of uncertain significant (MGUS)
  5. POEMS syndrome
  6. Waldenstrom’s
63
Q

What is multiple myeloma?

A

B cell proliferation, with tumor cells producing full or partial monoclonal igs, with lytic bone lesions

64
Q

Lytic bone lesions are found in what type of CA?

A

Multiple myeloma

65
Q

Rouleaux formation = ?

A

RBC stacking found in multiple myeloma

66
Q

What is solitary plasmacytoma?

A

Solitary mass consisting of a clonal plasma cell tumor, but WITHOUT monoclonal Ig in the serum (or low levels)

67
Q

Solitary plasmacytoma has a risk for progressing to what?

A

Multiple myeloma

68
Q

What is primary amyloidosis?

A

clonal expansion of plasma cells in the bone marrow, that secrete monoclonal light chains

leads to deposits of amyloid in tissues

69
Q

What is M protein?

A

Igs produced by plasma cells in multiple myeloma (can be IgM or others)

70
Q

what is monoclonal gammopathy of uncertain significance (MGUS)? What is the risk of this?

A

Detection of monoclonal ig protein in the serum or urine without evidence for malignancy of the plasma cells or B lymphocytes

Risk for progression to multiple myeloma

71
Q

What is POEMS syndrome?

A 
Plasma cell issue, causing: 
Polyneuropathy
Organomegaly
Endocrinopathy
Monoclonal protein
Skin changes
72
Q

What is Waldenstrom’s macroglobulinemia/lymphoplasmacytic lymphoma?

A

IgM secreting

Associated with hyperviscosity

73
Q

How do you diagnose leukemias?

A

PBS and/or bone marrow biopsy

74
Q

How do you diagnose lymphomas?

A

Lymph node biopsy

75
Q

How do you diagnose plasma cell neoplasms?

A

Bone marrow biopsy

76
Q

What are the four techniques employed when diagnosing leukemias/lymphomas from PBS or bone marrow biopsy?

A

Morphology
Immunophenotyping
histochemistry
Cytogenetics

77
Q

Auer rod on microscopy = ?

A

pathognomonic for acute myelogenous leukemia

78
Q

What is the immuno marker for acute promyelocytic leukemia?

A 
CD 13+
CD33+
CD34-
HLA-DR-
CD9+
79
Q

What are the B cell markers?

A

CD19, 20, ***

80
Q

What are the T cell markers?

A

CD 3, 4 ***

81
Q

What are cytogenetics?

A

karyotyping or FISH

82
Q

What are the four phases of drug trials?

A 
1= get safe dosing
2= does it work?
3 = larger group, same a 2
4 = ongoing
83
Q

What is induction therapy?

A

Initial treatment given for a cancer, with the goal being to induce remission of the disease

84
Q

What is consolidation therapy?

A

Treatment given following induction therapy, with the goal being to eliminate any undetectable cancer cells

85
Q

What is maintenance therapy?

A

Therapy given after pt has achieved remission. goal being to maintain the remission, and reduce the risk of relapse

86
Q

What is adjuvant therapy?

A

Cancer therapy given in addition to the primary therapy to assist with the treatment goal

87
Q

What is palliative therapy?

A

Therapy that lessens the symptoms and improve the quality of life in patient without curing the disease

88
Q

What is salvage therapy?

A

Treatment given after other therapies have failed

Hematology (32 decks)

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