Leukemia, Lymphoma, & Anemia

Question 1

What is leukemia?

Answer 1

A malignant disorder of hematopoietic stem cells, leading to excessive proliferation of abnormal white blood cells in the bone marrow, which interferes with normal hematopoiesis​

Question 2

What are the main types of leukemia?

Answer 2

Acute lymphocytic leukemia (ALL) – Common in children, rapid progression.

Acute myeloid leukemia (AML) – Affects both children and adults, poor prognosis in elderly.

Chronic lymphocytic leukemia (CLL) – Common in older adults, slow progression.

Chronic myeloid leukemia (CML) – Associated with the Philadelphia chromosome (t9;22), progresses from chronic to blast crisis phase.

Question 3

What are common symptoms of leukemia?

Answer 3

Anemia (fatigue, pallor), thrombocytopenia (easy bruising, bleeding), frequent infections, bone pain, hepatosplenomegaly, and weight loss

Question 4

What is the hallmark genetic mutation in CML?

Answer 4

BCR-ABL fusion gene due to Philadelphia chromosome (t9;22)​

Question 5

What are the laboratory findings in leukemia?

Answer 5

Elevated or reduced WBC count, anemia, thrombocytopenia, blast cells in peripheral blood, and possible chromosomal abnormalities (e.g., t(9;22) in CML).

Question 6

What is the Philadelphia chromosome, and which leukemia is it associated with?

Answer 6

The Philadelphia chromosome (t(9;22), BCR-ABL fusion gene) is associated with Chronic Myeloid Leukemia (CML), leading to increased tyrosine kinase activity.

Question 7

How is leukemia diagnosed?

Answer 7

Blood test (CBC): Increased or decreased WBCs, anemia, thrombocytopenia.

Bone marrow biopsy: Confirms leukemic blast cells.

Cytogenetic analysis: Detects chromosomal abnormalities (e.g., Philadelphia chromosome in CML).

Question 8

How is leukemia treated?

Answer 8

Chemotherapy (first-line for acute leukemias).

Targeted therapy (e.g., imatinib for CML).

Bone marrow transplant for severe cases.

Supportive therapy (blood transfusions, antibiotics)

Question 9

What is the most common leukemia in children?

Answer 9

Acute lymphocytic leukemia (ALL)​

Question 10

What is lymphoma?

Answer 10

Lymphoma is a malignancy of lymphoid tissue, affecting lymphocytes and the immune system. It primarily occurs in lymph nodes but can involve extranodal sites.

Question 11

What are the two major types of lymphoma?

Answer 11

Hodgkin Lymphoma (HL) – Characterized by Reed-Sternberg cells.

Non-Hodgkin Lymphoma (NHL) – A heterogeneous group of lymphoid malignancies, including diffuse large B-cell lymphoma (DLBCL) and follicular lymphoma.

Question 12

What is the key histological marker of Hodgkin lymphoma?

Answer 12

Reed-Sternberg cells (large, binucleated B-cells)

Question 13

What are symptoms of lymphoma?

Answer 13

Painless lymphadenopathy - often in the neck, night sweats, fever, weight loss (“B symptoms”), pruritus, hepatosplenomegaly.

Question 14

What is the most common type of non-Hodgkin lymphoma (NHL)?

Answer 14

Diffuse large B-cell lymphoma (DLBCL)​

Question 15

What infections are associated with lymphoma?

Answer 15

Epstein-Barr virus (EBV) → Hodgkin lymphoma, Burkitt lymphoma.

Helicobacter pylori → Gastric MALT lymphoma

Question 16

What is the characteristic histological finding in Hodgkin Lymphoma?

Answer 16

Reed-Sternberg cells – large, binucleated or multinucleated cells with prominent nucleoli (“owl’s eye appearance”).

Question 17

How is lymphoma diagnosed?

Answer 17

Lymph node biopsy, immunophenotyping, flow cytometry, PET/CT scan, bone marrow biopsy.

Question 18

What is the Ann Arbor staging system used for?

Answer 18

It is used to the staging of lymphoma based on lymph node involvement and systemic symptoms:

Stage I: Single lymph node region.

Stage II: Two or more lymph node regions on the same side of the diaphragm.

Stage III: Lymph nodes on both sides of the diaphragm.

Stage IV: Disseminated disease.

Question 19

What is the characteristic translocation in Burkitt lymphoma?

Answer 19

t(8;14) → c-MYC overexpression​

Question 20

How is lymphoma treated?

Answer 20

Hodgkin Lymphoma: ABVD chemotherapy (Adriamycin, Bleomycin, Vinblastine, Dacarbazine), radiation therapy.

Non-Hodgkin Lymphoma: Chemotherapy (e.g., CHOP regimen – Cyclophosphamide, Doxorubicin, Vincristine, Prednisone), immunotherapy (e.g., Rituximab for B-cell NHL).

Question 21

How does NHL differ from HL in terms of spread?

Answer 21

NHL spreads non-contiguously (randomly) while HL spreads contiguously (from one node to the next)

Question 22

What is anemia?

Answer 22

A condition characterized by a reduced number of RBCs or decreased hemoglobin, leading to impaired oxygen transport​

Question 23

What are the four primary causes of anemia?

Answer 23

1) Blood loss (acute trauma, chronic GI bleeding).

2) Increased RBC destruction (hemolytic anemia).

3) Decreased RBC production (iron deficiency, bone marrow failure).

4) Nutritional deficiencies (B12, folate, iron)

Question 24

What is the most common anemia worldwide?

Answer 24

Iron deficiency anemia​

Question 25

What are common symptoms of anemia?

Answer 25

Fatigue, pallor, shortness of breath, tachycardia, dizziness, cold intolerance, spoon-shaped nails (koilonychia in iron deficiency anemia), glossitis.

Question 26

What are key laboratory findings in iron deficiency anemia?

Answer 26

- Low MCV (microcytic anemia) - Low ferritin, high TIBC - Hypochromic RBCs with increased central pallor

Question 27

What are three major manifestations of anemia?

Answer 27

1) Fatigue, pallor, tachycardia (due to decreased oxygen transport). 2) Dyspnea, dizziness (due to tissue hypoxia). 3) Glossitis, brittle nails (koilonychia) in iron deficiency

Question 28

What are characteristics of hemolytic anemia?

Answer 28

1) Premature RBC destruction. 2) Increased reticulocyte count (bone marrow compensation). 3) Jaundice (due to increased bilirubin from RBC breakdown)​

Question 29

What causes vitamin B12 deficiency anemia?

Answer 29

Dietary deficiency (vegans) Pernicious anemia (autoimmune destruction of parietal cells, leading to lack of intrinsic factor) Malabsorption (Crohn’s disease, gastric bypass)

Question 30

How does B12 deficiency anemia differ from iron deficiency anemia?

Answer 30

B12 deficiency → Megaloblastic anemia (large RBCs), neurological symptoms (paresthesias). Iron deficiency → Microcytic anemia (small RBCs), pallor, fatigue​

Question 31

What is the main treatment for iron deficiency anemia?

Answer 31

Oral ferrous sulfate (iron supplement), dietary changes, treating underlying cause (e.g., GI bleeding)​

Question 32

Why do pregnant women need more iron?

Answer 32

Increased demand for fetal erythropoiesis and maternal blood volume expansion​.