Lymphoid and Myeloid Disorders Flashcards

1
Q

Normal blood film

A

Erythrocytes
Bi concave discs
Thinner parts appear transparent as more light can get through
Lymphocytes and neutrophils and small platelets dotted throughout

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Acute leukaemia
Mechanism

Leads to

A

Proliferation of primitive precursor cells usually only found in bone marrow
Proliferation w/out differentiation

Primitive cells replace normal bone marrow cells
No space for normal cells to mature

Anaemia - Palor and lethargy
Neutropenia - immunocomprised
Thrombocytopenia - bleeding
Bone pain due to marrow infiltration

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Leukaemia Acute

A

Lymphoid
Acute lymphoblastic leukaemia

Myeloid
Acute myeloid leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Leukaemia chronic

A

Lymphoid
Chronic lymphatic leukaemia

Myeloid
Chronic myeloid leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Histology of acute leukaemia

A

Leukaemic cells are abundant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Acute lymphoblastic leukaemia

Treatment

A

Common in children
Proliferation of lymphoblasts in bone marrow
85% survival rate - esp in girls, 1-10, low WBC and certain morphology
Poor prognosis in adults

Induction
Consolidation chemo and or craniospinal irradiation
Maintenance chemotherapy
Bone marrow transplantation only if relapse

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Acute myeloid leukaemia

Relevant subtype
Treatment

A
Malignant proliferation of myeloblasts in bone marrow
Affects adults
Poor prognosis 15-50% 5 year survival 
Most relapse
6 subtypes 

Gum infiltration in acute monocytic subtype M5
Cyclical high dose chemo (induction and consolidation with no maintenance)
Sometimes transplant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Chronic lymphatic leukaemia

Histology

A
Proliferation of mature lymphocytes 
usually B cells
Most common 
Affects elderly >65 years
Presents with anaemia, infections, lymphadenopathy and splenomegaly 
Lymphocytosis 
Good prognosis 
Survival > 10 years is norm 
Treats only advanced disease 

Dense nuclei of lymphocytes
Chronic therefore

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Chronic myeloid leukaemia

Treatment and mechanism of it

Histology

A

Gradual onset
High WBC and splenomegaly

Chromosome translocation between 9-22
BCR-ABL oncogenes 
3 phases 
- chronic 
-accelerated
- blast crisis 

Treatment
- imatinib
blocks abnormal oncogene activity
molecular remission can occur

Bone marrow cell transplant

Myeloblasts with open DNA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Myelodysplasia

Mechanism

Who does it affect

Presenting condition

Treatment

A

Premalignant condition of heamopoietic precursors i.e. bone marrow cells
disease of elderly
asymptomatic sometimes
may present with anaemia, thrombocytopenia and pancytopenia
several subtypes
variable course
can transform to acute myeloid leukaemia
treatment - supportive, bone marrow transplantation in the young

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Lymphoma

Types

A

Hodgkin

Non-hodgkin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Hodgkin lymphoma

Types
Diagnostic cell
Treatment

A
Painless lymphadenopathy 
B symptoms - sweats, weight loss, fever 
Two peaks 15-35 years, >55
10 year survival 90% rate 
4 subtypes 

Reed-Sternberg cell

Chemo, radiotherapy, stem cell transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Non-Hodgkin lymphoma

Two grades

A

Indolent/low grade e.g follicular lymphoma
Gradual onset
May be asymptomatic
Incurable, median survival 10 years
Chemotherapy, radiotherapy, transplantation

Aggressive, high grade e.g diffuse large B cell lymphoma
Rapidly progressive
Usually symptomatic
Potentially curable
Treatment - chemotherapy, radiotherapy, transplantation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Myeloproliferative disorders

A

Polycythaemia rubra vera
- red cell proliferation

Chronic myeloid leukaemia
- white cell proliferation

Essential thrombocythaemia
- platelet proliferation

Myelofibrosis
- marrow stroma proliferation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Polycythaemia is

11.50-14 haemoglobin - females
12-16 - haemoglobin - males

A
Erythrocytosis 
Increase in circulation of red cells
Primary
- PRV
- thrombosis
- splenomegaly, hepatomegaly
- venesection, aspirin and myelosuppression treatments 
- myelofibrosis and AML can result  
Secondary 
- hypoxia
- inappropriate erythropoietin secretion - renal tumour
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Thrombocytosis

>1500 count

A

Primary

i. e thrombocythaemia
- uncontrolled malignant proliferation of megakaryocytes (origin of platelets)
- platelets > 600
- arterial and venous thrombosis
- treated with aspirin, hydroxycarbamid, anagrelide and interferon

Secondary
- bleeding, infection, inflammation and malignancy

17
Q

Multiple myeloma

A

Malignant proliferation of plasma cells in bone marrow

Plasma cells are terminally differentiated B lymphocytes that produce immunoglobulin

Myeloma has monoclonal immunoglobulin in blood and urine

18
Q

Symptoms of myeloma

A

Lytic lesions in bones
Hypercalcaemia due to bone resorption - thirst, polyuria confusion and constipation
Hyper viscosity - high levels of immunoglobulin making blood thick
Renal failure
Anaemia
Infections

19
Q

Histology of myeloma

A

Abnormal presence of plasma cells in bone marrow and holes in skull

20
Q

Myeloma
Diagnosis

Treatment

A

Blood and urine
x rays and CT/MRi
Bone marrow

Chemotherapy
Thalidomide, bortezomib
Radiation
Stem cell transplantation