Intro to Hematologic Malignancies (complete) Flashcards
What are the main manners in which hematologic malignancies manifest?
1) Leukemia
2) Lymphoma
3) Extramedullary myeloid tumor (granulocytic sarcoma)
How do the different manifestations of hematologic malignancies overlap?
Example: Chronic lymphocytic leukemic and small lymphocytic leukemia
Same disease
Difference: where the disease primarily is — blood and BM (CLL) or lymph nodes (SLL)
Describe high grade lymphomas
- May present as a rapidly enlarging mass
- High WBC count w/ near replacement of normal cells in BM
Similar concept to acute leukemia
Describe low grade lymphomas
- Mild — mildly enlarge lymph nodes
- Subtle symptoms
- Often noticed incidentally on CBC results performed for another reason
Similar concept to chronic leukemia
Describe acute leukemias
- More aggressive, rapidly growing
- High WBC count w/ near replacement of normal cells in BM
- Low platelets, neutrophils, and RBCs
Similar concept to high grade lymphoma
Describe chronic leukemias
- Subtle symptoms, gradual
- Often noticed incidentally on CBC results performed for another reason
Similar concept to low grade lymphoma
Discuss recurrent translocations in certain hematologic malignancies in regard to the clinical care of patients
- Used as diagnostic markers
- Presence suggests they play a critical role in development of the hematologic malignancies with which they are associated
Eg — CML: t(9;22)
What are 3 viruses known to have oncogenic roles in some cases of lymphoma?
1) Epstein-Barr virus (EBV)
2) Human T cell leukemia virus-1 (HTLV-1)
3) Kaposi sarcoma herpesvirus/Human herpesvirus-8 (KSV/HHV-8)
What are the incidences of leukemia and lymphoma in adult populations?
LK: 10th most frequent — rate=12.5
LP: 7th most frequent (non-Hodgkin) — rate=19.6
What are the incidences of leukemia and lymphoma in childhood populations?
LK: 37% of childhood cancers (most common type)
LP: 24% of childhood cancers (third most common type)
What are the currently recommended classifications for hematologic malignancies?
1) Myeloid malignancies
2) Lymphoid malignancies
3) Other
What are myeloid malignancies? (Think classification)
Arise from mature/immature members of …
1) granulocytic,
2) monocytic,
3) erythroid,
4) megakaryocytic, and/or
5) mast cell lineages
What are lymphoid malignancies? (Think classification)
Arise from mature/immature members of ….
1) B cell,
2) T cell, or
3) NK cell lineages
What are ‘other’ malignancies? (Think classification)
Arise from histiocytes or DCs
- Rare
- Will not be discussed further — just know there’s a classification group for this
Which parameters are used to help classify hematologic malignancies?
1) Microscopic appearance of malig cells
2) Histologic growth pattern (in BM, lymph, other)
3) Presence/absence of cytogenetic/molecular findings
4) Relative amount of malignant cells in blood/BM
5) Presence/absence of cell surface/cytoplasmic/nuclear markers
What are the basic functional categories for hematologic malignancies?
1) Acute leukemias
2) Myelodysplastic syndrome (MDS)
3) Myeloproliferative neoplasms (MPNs)
4) Classical hodgkin lymphoma (CHL)
5) Non-Hodgkin Lymphoma
6) Plasma cell neoplasms
What are the basic expected findings in the blood and marrow for acute leukemias?
- Rapid accumulation of immature cells in BM
- Usually -blasts accumulate — myeloid or lymphoid
- Often replace normal BM cells causing cytopenias
What are the basic expected findings in the blood and marrow for Myelodysplastic syndrome (MDS)?
- Clonal pop’n derived from neoplastic HSM takes over BM
- No longer capable of making normal blood cells
- Falling peripheral blood cell counts
What are the basic expected findings in the blood and marrow for Myeloproliferative neoplasms (MPNs)?
- Neoplastic clonal proliferations of BM
- Where clone makes normal functioning blood cells but makes TOO MANY of them
- Classified based on underlying cytogenetic abnormality, type of blood cell overproduced, and other stufff
What are the basic expected findings in the blood and marrow for classical hodgkin lymphoma (CHL)?
- Driven by HRS cells (which are derived from B cells)
- Disease is its own clinical entity
What are the basic expected findings in the blood and marrow for Non-Hodgkin Lymphoma?
Refers to any malignancy derived from mature B cells (excluding CHL or plasma cell neoplasms), T cells, or NK cells
What are the basic expected findings in the blood and marrow for plasma cell neoplasms?
Includes…
1) MGUS
2) plasmacytoma
3) multiple myeloma
What is leukemia?
- Heme malignancies where chief manifestation involves blood and marrow
- Diseases of both lymphoid and myeloid cells — mature and immature
What is lymphoma?
- Heme malignancy derived from lymphocytes or precursors
- Manifests as a mass! unlike leukemia
