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FU17 Hematology > Lymphoma, Leukemia, Multiple Myeloma > Flashcards

Lymphoma, Leukemia, Multiple Myeloma Flashcards

1
Q

Malignant neoplasms of blood forming tissues

A

Leukemia

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2
Q

Classifications of leukemia is determined by

A
  1. Cell line affected (lymphoid or myeloid)

2. Acute or chronic condition

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3
Q

Acute leukemias

A

Typically immature blast cells (found in both bone marrow and peripheral blood)

Clinical picture: fulminant presentation and more aggressive course of disease

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4
Q

Chronic leukemias

A

Cells are a mixture of immature and mature cells

Clinical picture: subclinical, more indolent course

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5
Q

Types of leukemia/cells

ALL

A

LymphoBLASTS

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6
Q

Types of leukemia/cells

CLL

A

MATURE lymphocytes

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7
Q

Types of leukemia/cells

AML

A

MyeloBLAST

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8
Q

Types of leukemia/cells

CML

A

Immature and mature myeloid cells

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9
Q

Overall causes of leukemia?

A

Unknown

More often in radiation, benzene exposure (cigarettes and soda), genetic predisposition

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10
Q

General s/s of leukemia

A

Fatigue, petechiae, ecchymoses, mucous bleeding, constitutional symptoms

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11
Q

most common leukemia in children

A

ALL

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12
Q

ALL incidence

A

Typically found in children (1-10 yrs, esp. 3-5)

M > F

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13
Q

ALL clinical presentation

A

Nonspecific symptoms

Abrupt onset, typically present w/ infection

May have lymphadenopathy or hepatosplenomegaly

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14
Q

ALL evaluation

A

Lymphoblastic in peripheral blood smear

Crowding out of the other cell lines in bone marrow (anemia, thrombocytopenia, etc)

Typically do a bone marrow aspiration Sudan black stain

Cytogenic studies (B or T cell precursors)

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15
Q

Sudan black stain

ALL

A

POSITIVE

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16
Q

ALL treatment

A

CXR (rule out mediastinum involvement)

CT scan (r/o brain)

Chemo and radiation

Blincyto (bispecific T cell engages)

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17
Q

ALL survival rates

A

Adults have 30-40% prognosis

Children 80%

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18
Q

CLL

A

MC leukemia in adults

Results from acquired injury to DNA of single cell in marrow

Clonal malignancy of B CELLS**

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19
Q

CLL clinical picture

A

Pts > 65 y.o.

Lymphadenopathy, fatigue, hypogammaglobulinemia

Increased infections

20
Q

CBC evaluation

CLL

A

Elevated WBC (>20,000)

Lymphocytosis

Anemia, thrombocytopenia

21
Q

CLL treament

A

Supportive until development of symptoms

Chemo/radiation

22
Q

AML

A

Quickly progresses

Myeloid cells arrest in BLAST stage, crowding out

Adults or children (15-39)

23
Q

AML presentation

A

Significant WBC elevation

Leukostasis possible due to high [blast] in blood

Fatigue, easy bruising, dyspnea, fever, freq. infection

Purpra/petechiae =

24
Q

AML Diagnosis

A

Bone marrow exam – SUDAN NEGATIVE

AUER RODS**

Blasts in peripheral blood smear

25
Q

Treatment of AML

A

Chemo

Transfusions

Abx as needed

Bone marrow transplants

26
Q

CML associated with

A

prior radiation exposure

40-60 years of age

Typically have thromboCYTOSIS

27
Q

Presentation of CML

A

Early/initial phase: non specific symptoms

Terminal phase: blast crisis, splenomegdaly

28
Q

CML evaluation

A

Elevated WBC

LAP score is low

B12 elevation

ThromboCYTOSIS

Philadelphia chromosome

29
Q

Phases of CML

A

Chronic phase (fewer than 5% blast)

Accelerated (6-30% blast)

Blastic phase (30%+) – WORST

30
Q

CML treatment

A

Tyrosine Kinase Inhibitors (first line to stablize WBC count)

Ex. Gleevec

CML often terminates with blast crisis - death (typical survival 5-7 yrs)

31
Q

Neoplasticism proliferation of one of cell types of lymphopoietic reticular tissue

A

Lymphoma

Typically in lymph nodes (lymphadenopathy)

32
Q

Two types of lymphoma

A

Hodgkin’s

Non-Hodgkin’s

33
Q

Hodgkin lymphoma cause

A

Cause unknown

Increased risk if infected with mono

Typically occurs in young adults to elderly

34
Q

Hodgkin lymphoma

Arises ___

A

Arises in single node or chain

Spreads anatomically contagious lymph tissues

35
Q

Presentation Hodgkin lymphoma

A

LYMPHADENOPATHY in neck, mediastinum, abdomen

B symptoms

Pruritis

36
Q

Lymph node biopsy of Hodgkin lymphoma shows

A

Reed-sternburg cell **

37
Q

Staging of Hodgkin lymphoma

A

Based on number of affected nodes

Treatments vary, but 80% curable

38
Q

Non-Hodgkin lymphoma

Def.

A

Group of neoplasticism lymphoid cells disseminated they the entire body

No Reed-Steenburg cells

39
Q

Non-Hodgkin lymphoma origination

A

Either T or B cells ‘

Typically painless presentation

40
Q

MC lymphoma in children

A

Burkitt’s lymphoma

Translocation on chromosome 8 to 14

41
Q

Staging lymphomas (4)

A

1: 1 lymph region
2: 2+ lymphnodes on same side of diaphragm
3: both sides of diaphragm
4: bone marrow, liver involvement

42
Q

Clinical presentation of Burkett lymphoma

A

Americans: abdominal cavity

African: jaw

43
Q

Multiple myeloma

A

Progressive malignancy of plasma cells

Overproduction of immunoglobulin proteins, Bence Jones proteins

Production of lytic lesions in the bone = pathological fractures

Renal damage, freq. infections

44
Q

Multiple myeloma presentation

A

Black, elderly

Proliferation of plasma cells, osteopathic bone lesions

Hypercalcemia symptoms (weakness, weight loss, constipation) and bone fractures (osteoclasts activation)

Freq. infections

45
Q

CBC of multiple myeloma

A

Anemia

46
Q

Labs multiple myeloma

A

Bence jones proteinuria

Hypercalcemia

Full body skeletal survey

Serum electrophoresis (spike = M protein)

47
Q

CML and Philadelphia chromosome

A

Translocation on chromosome 22 (BCR-ABL gene)

Unrestrained activation of mitosis and protection from apoptosis

Increase in number of mutated cells - more of these cells = worse prognosis and more phases

FU17 Hematology (10 decks)

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