Intro to Hematologic Malignancies

Question 1

Is there such a thing as a benign hematologic neoplasm?

Answer 1

no

Question 2

Leukemia

Answer 2

Transforming event often takes place in a multipotent stem cell

chief manifesation is involvement of the blood and marrow (affecting both lymphoid and myeloid, mature/immature)

Question 3

Acute Leukemia

Answer 3

Hematopoetic malignancy, rapid progressing. Cells take over marrow

Comes to clinical attention because of low platelets, neutrophils, RBCs, etc

Transforming event in marrow that causes one lineage of cells to be unable to differentiate (plus other genetic hits that cause rapid proliferation)

Cells are often blasts

Question 4

Chronic Leukemia

Answer 4

Refers to either Chronic Lymphocytic Leukemia or Chronic Myelogenous Leukemia

Slow progression
Increase WBC due to accumulation of mature WBCs

No symptoms, usually

Prolonged course, can transform to more aggressive disease

Question 5

High Grade Vs. Low Grade

Answer 5

High Grade- Rapidly enlarging, aka acute, very high WBC with near replacement of normal cells in marrow and blood

Low Grade- Mildly enlarged lymph nodes. aka chronic, noticed incidentally

Question 6

t(9;22)

Answer 6

Philedelphia chromosome, CML

Question 7

Three Viruses that can cause lymphoma

Answer 7

Epstein Barr Virus

Human T Cell Leukemia Virus-1 (HTLV-1)

Kaposi Sarcoma Herpesvirus/Human Herpesvirus 8 (KSHV/HHV-8)

Question 8

Epstein Barr Virus

Answer 8

Hodgkin Lymphoma, Kurkitt Lymphoma, and some non-Hodgkin lymphomas

Question 9

Human T Cell Leukemia Virus-1 (HTLV-1)

Answer 9

Adult T-Cell Leukemia/lymphoma

Question 10

Kaposi Sarcoma Herpesvirus/Human Herpesvirus 8 (KSHV/HHV-8

Answer 10

Primary Effusion Lymphoma

Question 11

Contrast the incedences of leukemia and lymphoma in adult populations versus childhood populations.

Answer 11

Leukemia is the most common type of childhood cancer, and lymphoma is the third most common childhood cancer by type. In adults, not at much.

Question 12

Recall the currently recommended classification system for hematologic malignancies

Answer 12

WHO classification in 2008

Question 13

Terminology- Myeloid

Answer 13

Resemble cells of granulocytic, monocytic, erythroid, megakaryocytic and/or mast cell lineages

Question 14

Terminology- Lymphoid

Answer 14

Resememble cells of the B/T and NK cell lineages

Question 15

Multiparameter Classification System

Answer 15

• Microscopic appearance
• Histologic growth patterns in marrow lymph or tissue
• Specific cytogenetic or molecular findings
• Relative amount of malignant cells in marrow/blood
• Presence/absence of certain cell markers

Question 16

Lymphoma

Answer 16

chief manifestation is a solid mass tumor, derived from lympocytes or their precursors. Normally in lymph nodes but can be sometimes extranodal

Question 17

Extramedullary Myloid Tumor

Answer 17

Heme malignancy, solid mass of myeloid cells and their

Question 18

Myelodysplastic Syndrome (MDS)

Answer 18

Group of coniditions where marrow is ovetaken by neoplastic clone. Dysplasia, leading to persisntly low blood counts in 1+ lineages

Question 19

Myeloproliferative Neoplasm (MPN)

Answer 19

Clone takes over marrow, and over produces cells of 1+ lineages, leading to hyperplasia and increased blood count

Question 20

Classical Hodgkin Lymphoma

Answer 20

Neoplastic cells derived from B CElls

Question 21

Non-Hodgkin Lymphoma

Answer 21

All the different malignancies of mature lymphocytes, subdivided to B cell derived NHLs (majority)
T cell/NK Cell NHLs (minority)

Question 22

Plasma Cell Neoplasm

Answer 22

Inclues MGUS, plasmacytoma, multiple myeloma