Immunoproliferative Diseases Flashcards
Are malignant cells primarily present in the bone marrow and peripheral blood
Characterized by the presence of very poorly differentiated blast cells in the bone marrow and peripheral blood
LEUKEMIA
Are malignant cells that arise from lymphoid tissues such as lymph nodes, tonsils, or spleen
LYMPHOMAS
Are cancer cells affecting the PLASMA CELLS which are in charge of producing antibodies
PLASMA CELL DYSCRASIAS
2 types of Leukemia
- MYELOGENOUS LEUKEMIA
2. LYMPHOID LEUKEMIA
Term used to describe the presence of YOUNG or IMMATURE cells
ACUTE
Four types of ALL
- CALLA-expressing precursor B-cell ALL
- PRE-B CELL W/O CALLA
- T-CELL ALL
- MATURE B-CELL
It is the most common type of ALL
CALLA (CD10)-expressing precursor B-cell ALL
Rarest type of ALL
MATURE B-CELL ALL
It is described as a group of disease almost exclusively of B-cell origin
CHRONIC LYMPHOCYTIC LEUKEMIA or LYMPHOMA (CLL)
3 B-cell CD markers
CD19, CD20, CD21
Disease characterized by the presence of malignant lymphocytes that are round and have irregular “hairy” cytoplasmic projections from their surfaces
HAIRY CELL LEUKEMIA
It is a rare, slowly progressive diseases characterized by infiltration of the bone marrow and spleen by leukemic cells WITHOUT the involvement of lymph nodes.
- Striking SPLENOMEGALY
- Absent LYMPHADENOPATHY
HAIRY CELL LEUKEMIA
It is the most common lymphoma characterized by the presence of Hodgkin and Reed-Sternberg cells in affected lymph nodes and lymphoid organs.
HODGKIN LYMPHOMA (HL)
Are large cells with bilobed nuclei and two prominent nucleoli
“OWL EYES” appearance
REED-STERNBERG CELLS (RS)
Lymphoma characterized by the absence of RS cells
NON-HODGKIN LYMPHOMA (NHL)
It is the greatest risk factor of NHL
IMMUNOSUPPRESSION
TRUE or FALSE. The incidence of NHL is greater in women than men.
FALSE
These are conditions characterized by the overproduction of a single immunoglobulin component called myeloma protein (M PROTEIN) or paraprotein by a clone of identical plasma cells.
PLASMA CELL DYSCRASIA/LEUKEMIA
It is the most serious and most common plasma cell dyscrasia.
This condition is characterized by excess malignant mature plasma cells in the bone marrow, a monoclonal immunoglobulin component in the plasma or urine, and lytic bone lesions.
MULTIPLE MYELOMA (MM)
Term used to describe one spike in the gamma region
MONOCLONAL GAMMOPATHY
Type of proteins present in a patient with MM
BENCE JONES PROTEIN
Monoclonal light chains can be found in the blood but are rapidly excreted in the urine (like myoglobin)
Excess kappa or lambda light chains
BENCE JONES PROTEIN
At what temperature does Bence-Jones Protein COAGULATE and DISSOLVE?
COAGULATES = 40-60 degrees Celsius DISSOLVES = 100 degrees Celsius
It is the confirmatory test for the presence of Bence-Jones Proteins
ELECTROPHORESIS
It is characterized by the malignant proliferation of IgM-producing lymphocytes
- Elevated serum monoclonal protein (macroprotein or IgM paraprotein)
WALDENSTROM MACROGLOBULINEMIA
These are antibodies that precipitate at cold temperature and can occlude small vessels in the extremities in cold weather.
CRYOGLOBULINS
These are antibodies that precipitate at cold temperature and can occlude small vessels in the extremities in cold weather.
CRYOGLOBULINS
How can CRYOGLOBULINS be detected?
Blood or plasma sample is refrigerated as the precipitate forms at low temperatures and dissolve upon warnings
It is the test used in the analysis of cell surface marker expression (CD), and diagnosis and classification of leukemias and lymphomas.
IMMUNOPHENOTYPING by FLOW CYTOMETRY
It is the laboratory test used to detect the monoclonal spike in patients with MM. It is also used to detect clonal proliferation of plasma cells.
SERUM PROTEIN ELECTROPHORESIS
How does Serum Protein Electrophoresis detect clonal proliferation of plasma cells?
By detecting the increase in the immunoglobulin (particularly in the gamma region)
It is commonly seen in MM where there is only one spike in the gamma region (Rock and Roll sign)
MONOCLONAL GAMMOPATHY
It is when there is an increase in multiple proteins in the gamma region.
POLYCLONAL GAMMOPATHY
It is a highly sensitive and specific assay that is used to identify the type of monoclonal protein present in the sample.
IMMUNOFIXATION ELECTROPHORESIS (IFE)
What are the two procedures involved in IFE?
- Electrophoresis of the sample (6 lanes on agarose gel)
2. Addition of antisera
Proteins give ______ charge (+ or -) and move towards the _______ (cathode or anode).
Negative (-); ANODE
What does a normal IFE result look like?
Immunoglobulin lane that has BROAD, DIFFUSED bands
Appearance of Monoclonal IgG
DISCRETE, NARROW bands in the IgG region (also in the Lambda region)
Appearance of Monoclonal IgM
DISCRETE, NARROW bands in the IgM and Kappa region
- Negative IgG, IgA, and Lambda
It is the extreme antigen excess that results to the formation of small immune complexes that cannot be visualized.
The precipitation is visible in the OUTER EDGES of the band, not in the center.
POSTZONE EFFECT in IFE
Postzone in IFE will result to false _________ (NEGATIVE/POSITIVE) result.
NEGATIVE
Remedy for Postzone effect in IFE
SAMPLE DILUTION
It is a sensitive procedure that uses capillary electrophoresis to identify monoclonal immunoglobulin components.
- Antibodies to each heavy or light chain isotype are added, allowing the disappearance of monoclonal peaks (subtraction of peaks)
IMMUNOTYPING
Other term for Immunotyping
IMMUNOSUBTRACTION
