Leukemia and WBC diseases Flashcards
General causes of neutropenia
Reduced marrow production
Increased destruction
Peripheral pooling
Hereditary causes of neutropenia due to reduced marrow production
Kostmann syndrome
Wiskott-Aldrich syndrome
Cyclic neutropenia
Mutation in Kostmann syndrome
Mutation in anti-apoptosis HAX-1 gene
Mutation in Wiskott-Aldrich syndrome
WAS gene
Mutation in cyclic neutropenia
Neutrophil elastase
Causes of ineffective granulopoiesis
Vit B12 deficiency
Folate deficiency
MDS
Acquired causes of marrow suppression in neutropenia
Chemotherapy
Aplastic anemia
Infections
Lymphopenia cut-off in children under 6
<2000
Congenital cause of lymphopenia
DiGeorge syndrome
Lymphopenia caused by Cushing Syndrome
cortisol excess leads to redistribution of lymphocytes
Iatrogenic causes of neutrophilic leukocytosis
G-CSF
GM-CSF
Corticosteroids
General causes of neutrophilic leukocytosis
Acute inflammation
Iatrogenic
Myeloproliferative disorders
Miscellaneous neoplasms
Asplenia
Toxic granulation of neutrophils
Reactive change associated with acute inflammation
Dark, coarse granules in cytoplasm
Dohle bodies in neutrophils
Reactive change associated with acute inflammation
Bluish cytoplasmic inclusions due to dilated ER
General causes of eosinophilia
Allergy
Parasitic infections
Neoplasms
HES
Pulmonary eosinophilia
Neoplasms associated with eosinophilia
Hodgkin’s lymphoma
Chronic myeloproliferative neoplasms
Pulmonary syndromes associated with eosinophilia
Loeffler’s syndrome
Eosinophilic granulomatosis with polyangitis/EGPA/Churg-Strauss
General causes of basophilia
Allergic reactions - hyperacute sensitivity
CML
General causes of lymphocytosis
Infection, acute and chronic
Parasite - toxoplasmosis
Neoplasm
Neoplasms associated with lymphocytosis
CLL
NHL
General causes of monocytosis
Chronic bacterial infections
Protozoa - malaria
Neoplasms
Neoplasms associated with monocytosis
Chronic myelomonocytic leukemia (CMML)
AML subtypes
Examples of chronic bacterial infections
TB
Brucellosis
Infectious endocarditis
Typhoid
Definition of leukemoid reactions
Increase in WBC count that mimics leukemia, but is caused by infection or another disease
2 general types of leukemoid reaction
Myeloid
Lymphoid type
General causes of myeloid type leukemoid reaction
Bacterial infections
Severe hemorrhage
Acute hemolysis
Post op/trauma stress
Splenectomy
Characteristics of neutrophils in myeloid type leukemoid reaction
Toxic granules
Cytoplasmic vacuolations
Dohle bodies
LAP in CML
Markedly reduced
LAP in leukemoid reactions
High
Characteristic of draining lymph nodes and related infection
Increased neutrophils - bacterial
Lymphoid cell proliferation - viral
Increased plasma cells - immune reaction
Definition of leukemia
Neoplasm of blood forming cells, primarily affecting bone marrow
Clinical presentation of acute leukemia
Short history
Signs of bone marrow failure
Organ involvement
Variable leukocytosis and cytopenias
Clinical presentation of chronic leukemia
Slow progressive history or incidental finding
Organ involvement
Leukocytosis
Marrow infiltration by mature cell types
Main cell type implicated in ALL
Lymphoblasts
Main cell types implicated in AML
Myeloblasts
Main cell types implicated in CML
Platelets
Basophils
Neutrophils
Eosinophils
Monocytes
Main cell type implicated in CLL
B lymphocytes
Method of finding chromosomal abnormalities
Karyotyping
Methods of finding molecular abnormalities
FISH
PCR
Sequencing
Auer rods are seen in this cell and disease
Myeloblasts in AML