Lecture 18

Question 1

Acute Myelogenous Leukemias

Answer 1

immature progenitor cells accumulate in bone marrow

Question 2

Myelodysplastic Syndromes

Answer 2

ineffective hematopoiesis and resistant peripheral blood cytopenias

Question 3

Chronic Myeloproliferative Disorders

Answer 3

Increase production of one or more terminally differentiated myeloid elements -> increased peripheral blood counts

Question 4

Essential Thrombocythemia (ET)

Answer 4

Overproduction of platelts

Question 5

Polycythemia Vera (primary polycythemia)

Answer 5

• Abnormality of bone marrow -> erythrocytosis (overproduction of RBCs)
• JAK2 Mutation: increase stem cell sensitivity to erythropoietin
• Symptoms: increased blood viscosity, occlusion of vessels, plethora (ruddy, red color), hypertension

Question 6

Secondary Polycythemia (Erythrocytosis)

Answer 6

Due to prolonged hypoxia, EPO-producing tumors, Hb genetic defects, increased affinity to oxygen

Question 7

Myelofibrosis

Answer 7

• Extensive collagen deposition by non-neoplastic fibroblasts (increased deposition of reticulin fibers) caused by neoplastic megakaryocytes
• Fibrinogenic factors PDGF and TGFB

Question 8

Platelet Derived Growth Factor

Answer 8

Regulates fibroblast and smooth muscle cell growth and division

Question 9

TGFB

Answer 9

Cytokine that regulates cell processes (fibrosis and tissue repair)

Question 10

Chronic Myelogenous Leukemia (CML)

Answer 10

• neoplastic clonal expansion of bone marrow precursors
• Increased number of granulocytes
• Symptoms: night sweats, fatigue, weight loss, hypercellular bone marrow, hepatomegaly, splenomegaly
• Increased WBC, Decreased NAP (Neutrophil Alkaline Phosphatase: enzyme found in neutrophils), Decreased RBC, Increased uric acid

Question 11

What are the stages of CML?

Answer 11

1. Chronic stable phase (1-5 years)
2. Accelerated/Transformation Phase (appearance of blast cells and decrease RBC and platelet counts
3. Blat crisis (number of blasts in bone marrow decreases)

Question 12

Acute Lymphoblastic Leukemia (ALL

Answer 12

Block in stem cell differentiation at early age (impacts children); acute onset; Leukemia blasts grow quickly (immature blood cells) and crowds bone marrow to prevent RBCs, WBCs, and platelet growth

Question 13

Chronic Lymphocyte Leukemia (CLL)

Answer 13

Block in differentiation occurs later (adults); insidious onset; increase in lymphocytes with chromosomal abnormality, decreased RBCs

Question 14

Hodgkin’s Disease

Answer 14

Malignant transformation of B cells in lymph nodes (Reed-Sternber cells); contiguous pathway

Question 15

Non-Hodgkin Lymphoma

Answer 15

Malignant disease of lymphoid tissue (no Reed-Sternberg cells); unpredictable spread

Question 16

Multiple Myeloma

Answer 16

Clonal proliferation of neoplastic plasma cells committed to plasmacytic differentiation (plasma cells produce cytokines to activate the formation of osteoclasts)