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Leukemia Flashcards

1
Q

Do leukemias circulate?

A

Because they are circulating tumors, they are metastatic

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2
Q

Is radiation therapy best for leukemia?

A

NO because need full body radiation

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3
Q

Lymphoma are tumors that are located where?

TX?

A

tumor localized in lymph tissue

can use radiation therapy bc localized

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4
Q

is it true that Leukemia/lymphoma may be the same?

A

same tumors in different areas

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5
Q

Plasma Cell Myeloma
tumors localized or
B cells sit in bony structures

A

localized tumors

B cells sit in bony structures

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6
Q

non specific s/s

A

malase, weakness, fever, night sweats, infection

lymphadenopathy

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7
Q

When are these cancers disocvered

A

during normal cbc

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8
Q

Naming schemes for these cancers:

Major gatergory is cell type

A

Myeloid vs lymphoid

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9
Q

Lymphoi cell types give you what?

Myeloid cell types give you what cells

A

lymphoid- B cell, t cell, NK cells

myeloid- RBC, platelet

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10
Q

Myeloproliferative example

A

thrombocytosis
polycythemia

too many of particular cell type

cells are “normal” like rather than cancerous

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11
Q

thrombocytosis

A

too many platelets

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12
Q

Mylodisplastic

A

cells are less differentiatied

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13
Q

myelodysplastic/myeloproliferative

A

too many messed up/abnormal cells

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14
Q

Lymphoid neoplasms affect what cells?

A

B cell neoplasm
T & NK cell neoplasm

Hodgkin disease
Non hodgkin

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15
Q

Lymphoblastic/lymphocitic

A

precursor cell that became transformed with less fucntionality

lymphocitic—more normal have more normal function

more anaplastic cells = less functioning = more symptomatic

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16
Q

What are 3 Viral risk factors for these cancers?

A

Contracting HTLV-1, HIV & EBV

human t cell luekemia virus

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17
Q

What are other risk factors for these cancers?

A

RADIATION- damage to stem cells for breast cancer (as an example) can lead to leukemia after some years

CHEMICALS- smoking, benzene, bioflavinoids

DISEASES- MANY

downs/klienfelters also increased risk for leukemia

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18
Q

Diagnosing: clincially present how

A

Present w symp related to bone marrow suppression and organ dysfunction

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19
Q

What are some symptoms of bone marrow suppression

A

Leucopenia - lack of all functioning WBC
when you have leukemia have overabundance of whatever wbc is affected, leuekopenia here is talking about lack of functional WBC

Anemia- hematocrit less than 30%
Thrombocytopenia

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20
Q

Infiltration symptoms

A 
Lymphadenopathy 
extension of bone marrow out of marrow cavities and into joints  
      triggers pain, swelling 
weight loss, anorexia 
hepatomegaly, splenomegaly
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21
Q

Special symptoms:
Chrnoic myelogemous leukemia n

Acute myelogenous leukemia

acute lymphocytic leukemia

A

tenderness to sternum

Overgrown gums

menigial involement

22
Q

Key to diagnosis vs defninitive diagnosis

A

CBC

bone marrow/lymph node sample

23
Q

Chemotherapy treatment goal

A

Induce remission
remission induction- remove detectable neoplastic cells

Post remission- elminiate undetectable cells

Maintenance- prolong remission

STem cell transplat to rescue marrow

24
Q

Time period for remission?

A

6-7 years free of detectable cells

25
PROBLEM with chemo
Drugs are specific for neoplasm but also very personalized to individual drugs induce apoptosis
26
Bone marrow transplant
reintorduce stem cells after chemo and radiation
27
Allogeneic Transplant Definition Problem
Donation from matched donor ID twin only way to get exact match run risk of rejecting transplant AND graft vs host disease can attack host body
28
Autogous transplant
take out good stem cells put them back miss one tumor cell and cancer will be back
29
Myeloid Neoplasms What are they?
One or more stem cell become transformed, proliferate inside bone marrow accumulate inside marrow until released inside circulation cells are still multipotent means they can still go down any path
30
WHat are myeloproliferative diseases
Look normal and function normal just too many cells discovered on accident
31
Myelodysplastic and AML cells morphology is?
cell morphology and functionally are abnromal
32
Less normal cells = ?
less functional, more s/s worse prognosis
33
Chronic Myeloid Leukemia Characteristics - Onset? - Special char? - Cell chars - TREATMENT??
Onset is 40-50 yrs Malignant granulocytes carry Philadelphia chromosome Cells are normal, more mature and function more normal High granulocyte count, splenomegaly Treatment: does not respond to chemo very well d/t genetic change Only tx is allogenic marrow tx, hopefully donor blood cells kill off cancer cells use donor against you autologous tx not very effective Survival length is ~2 years
34
What is the philadelphia chromosome? How is it created?
Chromosome is result of translocation swapping b/w chromosome 9 and 22 Part where they are transplanted create a new "fusion gene" ---- bcr/abl
35
Precursor luekmeia see what kind of segmention
not as much segmented nuclei
36
Acute Myeloid Leukemia affects who Composes what % of Acute Leukemia
Primarily disorder of adult ~64 y/o 80% of acute leukemias are AML
37
``` AML cell characteristics What type of genetic problem is present? How many subtypes present? Treatment? ```
``` AML Large NON SEGMENTED NUCLEI Translocations/Inversions * subtypes present M0-M7 HIGHLY individualized ```
38
``` Lymphoid Neoplasms Cause is what types of cells? (3 types) Cells in blood/bone marrow are what? Cells in lymphoid tisue? Classified how? ```
B, T, NK cells (lymphoid cells) Circulating in bone marrow/blood-Leukemia Localized in lymphoid tissues are lymphomas By cell type rather than stage but can have subgroups based on maturity
39
Precursor Cell Neoplasms vs Mature Cell Neoplasms
Arrest development in early blast stage ---lymphobalstic---early, less normal, less fucnitonal Mature Cell Neoplasms - more differentiated, often in peripheral sites, more developed
40
Chronic Lymphoid Leukemia What percent of all US What 2 versions What type is more severe?
``` 30% of all US leukemia cases 2 Versions Malignant B cell precursor (95%) T Cell Precursors (5%) T cell is more severe/agressive ```
41
CLL B Cell type usually symptomatic or no? When symptomatic biggest tell? Malignant cells invade lymphoid tissue and bone marrow Prognosis VARIES!
NO, usually asymptomatic NO ANTIBODY PRODUCTION BC NO B CELLS Go into lymph nodes, tonsils, appendix Lymphadenopathy/ Enlarged spleen Onset 65-70 y/o, survivability 8-24 yrs post dx
42
Acute Lymphoblastic Leukemia aka? 2 Versions What kind of Abnormal cell? Present as leukemias! B cell type is what type of genetic issue?
aka Acute Lymphoblastic Lymphoma B cell version 80%, T cell 20% abnormal lymphoblasts-immature- early precursor ``` B cell type is translocation error Cells dont mature, accumulate in blood and bone marrow As they accumulate they stop production of normal cells ```
43
Acute Lymphoblastic Leukemia Affects who the most? Symptoms Cure rate in children vs adult
CHILDREN Bone pain! Bruisng, fever, infections, fatigue, ab pain enlarged spleen, liver 80% cure rate in children, <10 in adults
44
Hairy Cells Leukemia Type of leukemia? Prevelance? Cell type: b or t?
Chronic, lymphocytic leukemia Rare but highly treatable B CELL PHENOTYPE--hairs on cells early precursor cells more so than others thats why they are so big may be sex linked?
45
Plasma Cell Myeloma Aka? Malignant disorder of what kind of cell? Invade bone, nodes, liver, spleen, kidneys Men or women affected more?
Multiple Myeloma Plasma Cells Lots of tumor sites!! Men
46
Plasma Cell Myeloma Start one cell that is transformed Bence Jones Protein
Becomes dominant so antibodies become monoclonal all antibodies are coming from the same plasma cell, lose the ability to make other kinds of antibodies Antibodies build up in bloodstream causes BENCE JONES PROTEINS BJP: Light chains in urine- confirm dx bone and renal damage,hypercalcemia osteoclasts destroy bone
47
Hodgkins Disease ``` It is a malignant lymphoma -Name defining feature -Where do they come from -Spread and growth pattern? ```
Defining feature is Reed Sternberg cells RS cells- from b cells in lymph nodes Grow and spread in a predictable manner -metastasis occurs along contiguous lymphatic pathways
48
What virus is found in RS cells frequently in Hodgkins disease?
EBV
49
What are the two types of Hodgkin disease?
- Rare lymphocyte predominance type | - Classical (4 subtypes)
50
``` Hodgkin Disease is usually asymptomatic? name s/s? Where does it BEGIN How is staging determined how many stages? ```
Yes, early on Lymph node enlargement, fever, night sweats, pruritus, weight loss, malaise Begins in cervical nodes ``` Staging dependent on s/s and location of nodes 4 stages 1A no clinical symp 1B clinical symp at staging 2A asymptom, spread to back 2B symptomatic, spread to back still 3A/3B...4A/4B ect just depends how far disseminated it is ```
51
Non Hodgkins Lymphoma What cell type? clonal or nonclonal? RS cells? Spread pattern? Etiology?
B,T, NK cell lymphoma clonal NO RS CELLS Unpredictable UNKNOWN
52
Hodkins vs non hodgkins Pattern of spread Extranodal disease SIte of Disease Extent of Disease B cell affected?
H: Contigous NH: not H: Uncommon NH: more common: gi, testes, Bones H: Medialstinal involvement, bone marrow and liver NH: opposite H: often localized NH: not H: Common NH: uncommon

Medical Physiology (4 decks)

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