1. MYELOGENOUS LEUKEMIA 2. LYMPHOID LEUKEMIA

1. CALLA-expressing precursor B-cell ALL 2. PRE-B CELL W/O CALLA 3. T-CELL ALL 4. MATURE B-CELL

Immunoproliferative Diseases Flashcards by MA LIZETTE VELASCO

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

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Are malignant cells that arise from lymphoid tissues such as lymph nodes, tonsils, or spleen

LYMPHOMAS

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Are cancer cells affecting the PLASMA CELLS which are in charge of producing antibodies

PLASMA CELL DYSCRASIAS

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2 types of Leukemia

MYELOGENOUS LEUKEMIA

2. LYMPHOID LEUKEMIA

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Term used to describe the presence of YOUNG or IMMATURE cells

ACUTE

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Four types of ALL

CALLA-expressing precursor B-cell ALL
PRE-B CELL W/O CALLA
T-CELL ALL
MATURE B-CELL

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It is the most common type of ALL

CALLA (CD10)-expressing precursor B-cell ALL

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Rarest type of ALL

MATURE B-CELL ALL

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It is described as a group of disease almost exclusively of B-cell origin

CHRONIC LYMPHOCYTIC LEUKEMIA or LYMPHOMA (CLL)

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3 B-cell CD markers

CD19, CD20, CD21

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Disease characterized by the presence of malignant lymphocytes that are round and have irregular “hairy” cytoplasmic projections from their surfaces

HAIRY CELL LEUKEMIA

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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

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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)

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Are large cells with bilobed nuclei and two prominent nucleoli
“OWL EYES” appearance

REED-STERNBERG CELLS (RS)

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Lymphoma characterized by the absence of RS cells

NON-HODGKIN LYMPHOMA (NHL)

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It is the greatest risk factor of NHL

IMMUNOSUPPRESSION

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TRUE or FALSE. The incidence of NHL is greater in women than men.

FALSE

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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?

1. 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