Hemeonc 13 Flashcards
Malignancies of hematopoietic stem cells, Characterized by the uncontrolled growth of abnormal white blood cells and deficiencies of normal hematopoietic cells
(Growth of the abnormal cells is clonal)
Leukemias
Primitive cells that can:
- -make more primitive cells just like itself (self-renewal)
- -make lots of mature cells of different types
- -Source of all blood cells
- -Resides in the bone marrow
- -Normally quiescent (dormant)
Hematopoietic stem cells
What is the largest tissue in the body?
bone marrow
How would you expect an acute leukemia to present as far as lab values?
TYPICALLY, with low blood counts across the board (except WBC, which could be high or low)
True or False, hematopoietic stem cells produce hundreds of billions of cells every day in a healthy person
True
200B-RBC, 200B-PLT, 70B-WBC
When you think ACUTE leukemia, you should think?
Rapid proliferation, immature malignant WBC’s
When you think CHRONIC leukemia, you should think?
Slow proliferation, partially differentiated mature WBC’s
T-cells, B-cells, and natural killer cells come from what type of cell?
Lymphoid cell
RBC’s, PLT, granulocytes, come from what type of cell?
Myeloid cell
What cell is experiencing malignancy in an ALL?
ALL=acute lymphoid leukemia, the Lymphoblast (acute is immature, therefore the blast cell)
What cell is experiencing malignancy in an AML
acute = blast
Myeloblast cell
Which leukemia is most common and highly curable in children?
ALL
If all blood counts in acute leukemia are low (except WBC, could be high or low), what types of symptoms would you expect?
anemia, infection(WBC malfunctioning), bleeding (along with fever, fatigue, wt loss common in all cancer)
Also lymphadenopathy, splenomegaly, bone pain, meningeal symptoms, metabolic derangement (electrolyte imbalance, etc)
what is the term for “thick blood” due to a white count >50,000?
Leukostasis
how can you definitively determine whether a leukemia is ALL or AML?
bone marrow bx
If you suspected an acute leukemia and your patient had gingival hyperplasia, which would you suspect?
AML
Which leukemia has multiple classifications with many different genetic mutations?
AML
What cytogenetic factor will cause AML patients to likely need a transplant even after remission?
high number of mutations, because recurrence is so likely
What is the typical tx plan for AML?
Induction chemo-one round
consolidation chemo x 3-4 cycles
eval for transplant
What is the typical tx plan for ALL?
Induction chemo x 6-12 months
Maintenance chemo x 2 years
eval for transplant
prophylactic intrathecal injections of chemo since these patients are more likely to have invasion of CSF
your patient has Asymptomatic leukocytosis
Fatigue, weight loss, fever, night sweats
Splenomegaly (95%) and early satiety. What is her most likely leukemia classification?
Chronic stable phase CML or chronic stable phase CLL
How do you treat a patient who has entered into the blast crisis of CML?
Just like an acute myeloid leukemia
What is the name of a daily oral medication that can maintain remission for years?
Gleevec
How do you manage asymptomatic CLL? When would you escalate treatment?
observation/watchful waiting.
Begin chemo for new symptoms or disease progression. May add Rituxan.
transplant rare and controversial
