HEMATOLOGY - alterations in leukocyte function: leukemia Flashcards
EXAM 2 content
what is leukemia? what does it do?
leukemia = clonal malignant disorder = hematopoietic cells makes new cells with the same genetic mutation
- different types BUT all types have – uncontrolled proliferation of malignant leukocytes –> bone marrow overcrowded & decreased production + function of normal hematopoietic cells
what haves if the same genetic mutation keeps happening?
cells of same genetic mutation –> prevents cells maturation + activities progrowth signaling pathways –> prevents apoptosis (programmed cell death)
what are the two types of leukemia?
- myeloid leukemia = RBC, WBC, & plates
- lymphoid leukemia = B & T cells
- acute leukemia
- chronic leukemia
what types of disorders are under myeloid leukemia?
- myelodysplastic syndrome (MDS)
- acute myeloid leukemia (AML)
- chronic myeloid leukemia (CML)
what are the types of disorders under lymphoid leukemia?
- acute lymphoblastic leukemia (ALL)
- chronic lymphoblastic leukemia (CLL)
what is acute leukemia?
the predominant cells are – undifferentiated or immature cells (blasts cells)
- abrupt & rapid onset
- fatal without treatment
what is chronic leukemia?
the predominant cell is – more differentiated but does NOT function normally
- slow progressive
- insidious onset
what is the pathophysiology of leukemia?
abnormal immature WBCs (leukemic blasts) fill in bone marrow –> spills into blood –> leukemic blasts crowd out bone marrow –> proliferation of other cells to decrease (pancytopenia = reduced WBCs, RBCs, & plates) –> genetic translocations (mitotic errors) in leukemic blasts (??? asked a q to profs, fill in later) –>
1. immature cells increase proliferation, have decrease sensitivity to apoptosis, & its premature release in circulation
2. immature cells infiltrate & accumulate in liver, spleen, lymph nodes, & other organs
what are the risk factors of leukemia?
environmental
- radiation exposure
- exposure to cigarette smoke
genetic
- leukemia reappears in families
other diseases
- past chemotherapy: bc of suppressed bone marrow
- HIV
- hepatitis C
what are the general manifestations for leukemia?
- anemia: decreased RBC, Hgb & Hct
- bleeding: decreased plates (thrombocytopenia) –> purpura, petechiae, ecchymosis & hemmorhage
- infection: opportunistic infections –> fever & chills
- weight loss: due to anorexia & hypoalbuminemia
- bone pain: if leukemic cells infiltrate bone or intramedullary infection
- liver, spleen & lymph node enlargement: if leukemic cells infiltrate here
- elevated uric acid level: due to increase catabolism of proteins & nucleic acids
- neurologic: due to leukemic infiltration or cerebral bleeding –> headache, vomit, & blurred vision
what are the diagnostic procedures to determine if someone has leukemia? which one of the most definitive way to diagnose?
- CBC with differential: specifically counts # of WBCs & detects abnormal cells
- bone marrow biopsy: sample of bone under a microscope – THE MOST DEFINITIVE WAY TO DIAGNOSE CANCER
what is our end goal to treating leukemia?
REMISSION = disappearance of s/s of cancer
- if some have partial that is just decrease of s/s
since leukemia is a cancer, what is the primary treatment? how does it work?
chemotherapy – divided into two phases
1. induction = attain remission
2. post remission = retaining remission
- need higher doses of chemo
what are other forms of treating leukemia?
- radiation therapy
- chemo + stem cell transplant
even tho we are treating leukemia, what can it result into?
myelosuppression
- decrease production of myeloid cells –> PANCYTOPENIA
