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Leukemia/Lymphoma Flashcards

1
Q

leukemias are classified into (2) and additionally by (2)

A
  1. Acute vs. Chronic

2. myeloid vs. lymphoid

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2
Q

Lymphomas are classified as (2)

A
  1. Hodgkin’s lymphoma

2. non-Hodgkin’s

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3
Q

Leukemias involve:

Lymphomas are:

A
  • involve the bone marrow and blood

- “solid tumors” of the immune system

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4
Q

MALT tissue

A

mucosa associated lymphoid tissue–pyers patches, cobblestoning in throat, ^ T-cells

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5
Q

Leukemias and lymphomas further classified as (2)

A
  1. T cell

2. B cell

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6
Q

leukemia can emerge from

A

any blood cell line (i.e. basophilic leukemia, monocytic leukemia, etc.)

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7
Q

(3) aspects the reflect on leukemia presentation

A
  1. number and functional ability of immune system cells
  2. Infiltration/ replacement of normal hematopoietic compliment
  3. invasion/infiltration of lymph nodes (spleen, skin, etc.)
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8
Q

in lymphoma pt will have _______ number of circulating immune cells, but these cells…

A

greater,

won’t function normally

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9
Q

For exam know, in regards to each leukemia (2)

A
  1. what population gets them

2. key presentation feature for each

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10
Q

most common leukemia in the western world

A

Chronic lymphocytic leukemia CLL (30% of all)

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11
Q

1st and 2nd most common leukemia findings

A
  1. lymphadenopathy

2. splenomegally (infiltrated spleen)

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12
Q

CLL occurs in

A

older adults 70yo, males (least aggressive type)

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13
Q

Dx for CLL

A

BM Bx

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14
Q

Often begins w/ INDOLENT lymphocytosis and PAINLESS lymphadenopathy

A

CLL Chronic lymphocytic leukema

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15
Q

CLL stages

A

Stage 0: lymphocytosis

1: lymphocytosis w/ lymphadenopathy
2: organomegaly (spleen/liver)
3: Anemia
4: Thrombocytopenia

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16
Q

Most common leukemia in childhood and adolescence

A

acute lymphocytic leukema ALL (2-5 yo, white>black, male>female)

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17
Q

ALL prognosis

A

very aggressive, but treatable leukemia

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18
Q

ALL may present similar to

A

flu, but will not clear up

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19
Q

W/ ALL CNS r/o w/

A

lumbar puncture (looking for ALL in CNS)

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20
Q

Dx of ALL

A

bone Bx (hypercellular-blast dominate picture)

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21
Q

Tx for ALL (2) steps

A
  1. Induction therapy: aggressive chemo (daunrubicin)

2. Remission induction: “maintenance therapy” (chemo/rad)

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22
Q

radiation induced leukemia w/ highest incidence in mid 40 age group

A

Chronic Myelogenous leukemia CML

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23
Q

CML course

A

indidious, indolent course–progresses through 3 phases if not treated

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24
Q

Chronic myelogenous leukemia dx by

A

Philadelphia Chromosome-ID’s and confirms Dx

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25
wonder drug for those displaying the Philadelphia Chromosome
Imatinib (Gleevec)--
26
_____% of those w/ CML are asymptomatic
50%
27
The most common ACUTE leukemia in adults
Acute Myelogenous Leukemia AML (average age 65yo)
28
*smeer for AML
Auer Rods
29
AML associated w/
environmental factors (radiation, benzene)
30
AML may demonstrate
Tumor Lysis syndrom due to high turn-over of cells--Dx BM bx
31
Complication of chemo in the tx of pt's w/ very high WBC count
Tumor Lysis syndrome
32
Tumor lysis syndrome (rapid lysis of cells dumping their contents) leads to (3)
1. Hyperkalemia 2. hyperphosphatemia + hypocalcemia 3. hyperuricemia --> renal failure
33
a heterogenous group of hematologic disorders which share these characteristics
Myelodysplasia/Myelodysplastic Syndrome (MDS)
34
histology associated w/ abnormal appearing bone marrow
cytopenia
35
MDS pt's share these (3) characteristics
1. cytopenia 2. ineffective blood cell production 3. the tendency to develop leukemia
36
MDS associated w/ (3)
past chemo, radiation, or chem exposure
37
average age of MDS onset
68 yo (ppl who have survived chemo/rad)
38
Patient presenting w/ non-tender palpable lymph nodes, oven cervical; 1/2 will have mediastinal lymphadenopathy at dx
Hodgkin's lymphoma
39
classic finding in Hodgkin's lymphoma
STERNBERG Cells lymph node Bx (cervical)
40
lymphoma associated w/ prior epstain Bar virus infxn
Hodgkin's lymphoma (peaks 20 and 65 yo)
41
1/3 of Hodgkin's lymphoma pt's present w/
``` B symptoms: 1. fever 2. night sweats 3. weight loss A symptoms= No symptoms ```
42
staging method used w/ Hodgkin's lymphoma
Ann Arbor stages
43
Tx for Hodgkin's lymphoma: Stage 1: Stages 1-4:
1: radiation | 2-4: Chemo + radiation
44
all other lymphomas outside of hodgkin's
non-hodgkin's lymphoma
45
The most RAPIDLY progressive human tumor
Burkitt's lymphoma (presentation of lymphadenopathy (^head and neck) or abdominal mass) associated w/ EB virus
46
T cell lymphoma of the skin
Mycosis fungoides
47
3 grades of non-hodgkin's lymphoma
1. Low: small cell type, CLL related, elderly pts 2. Intermediate: large cells, Middle age, B cell origin 3. High: Lymphoblastic Lymphoma--T-cell (^aggressive)
48
a debilitating malignancy that is part of a spectrum of diseases ranging from monoclonal gammopathy of unknown significance MGUS to plasma cell leukemia
Multiple myeloma
49
monoclonal neoplasms of a B cell line
Plasma cell disorder
50
bone marrow is replaced by malignant plasma cell from a single clone
multiple myeloma
51
Plasma cell disorder clinical manifestations are related to (2)
1. expansion of neoplastic cells in marrow | 2. secretions of the cells (immunoglobulin, lymphokines)
52
M protein
A "PARAPROTIEN"--an immunoglobulin produced by Myeloma cells----M protein stands for monoclonal protein (not myeloma)
53
Bence Jones proteins think
Multiple Myeloma
54
Proliferation of tumor cells and activation of osteoblasts results in
lytic lesions (in skull, ribs, vertebrae, and long bones)
55
presentation of multiple myeloma (4)
1. bone pain (worse at night) 2. bac infxn 3. Anemia (normochromic and normocytic) 4. Renal failure (Bence Jones Proteins an immunoglobulin)
56
Dx of Multiple myeloma (4)
1. plasma pt electrophoresis 2. x-ray or MRI 3. BM Bx 4. Bence Jones protein in URINE
57
Tx for Multiple Myeloma (3)
1. Stem cell transplant 2. Thalidomid / Lenalidomide (Revlimid) 3. Radiation for bone pain
58
Plasma cell malignancy also presenting w/ M proteins + sensorimotor peripheral neuropathies
Waldenstrom's Macroglobulinemia
59
MGUS
Monoclonal gammopathy of undetermined significance
60
An ASYMPTOMATIC PREMALIGNANT disorder characterized by limited monoclonal plasma cell proliferation in the BM and ABSENT of end-organ damage
monoclonal gammopathy of undetermined significance MGUS
61
Cryoglobulinemia (hyperviscocity of blood)
Waldenstrom's Macroglobulinemia

HemOnc (7 decks)

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