Lymphoma, Leukemia, Multiple Myeloma Flashcards by Sara Fieger

Malignant neoplasms of blood forming tissues

Leukemia

How well did you know this?

Not at all

Perfectly

Classifications of leukemia is determined by

Cell line affected (lymphoid or myeloid)

2. Acute or chronic condition

How well did you know this?

Not at all

Perfectly

Acute leukemias

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

Clinical picture: fulminant presentation and more aggressive course of disease

How well did you know this?

Not at all

Perfectly

Chronic leukemias

Cells are a mixture of immature and mature cells

Clinical picture: subclinical, more indolent course

How well did you know this?

Not at all

Perfectly

Types of leukemia/cells

ALL

LymphoBLASTS

How well did you know this?

Not at all

Perfectly

Types of leukemia/cells

CLL

MATURE lymphocytes

How well did you know this?

Not at all

Perfectly

Types of leukemia/cells

AML

MyeloBLAST

How well did you know this?

Not at all

Perfectly

Types of leukemia/cells

CML

Immature and mature myeloid cells

How well did you know this?

Not at all

Perfectly

Overall causes of leukemia?

Unknown

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

How well did you know this?

Not at all

Perfectly

General s/s of leukemia

Fatigue, petechiae, ecchymoses, mucous bleeding, constitutional symptoms

How well did you know this?

Not at all

Perfectly

most common leukemia in children

ALL

How well did you know this?

Not at all

Perfectly

ALL incidence

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

M > F

How well did you know this?

Not at all

Perfectly

ALL clinical presentation

Nonspecific symptoms

Abrupt onset, typically present w/ infection

May have lymphadenopathy or hepatosplenomegaly

How well did you know this?

Not at all

Perfectly

ALL evaluation

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)

How well did you know this?

Not at all

Perfectly

Sudan black stain

ALL

POSITIVE

How well did you know this?

Not at all

Perfectly

ALL treatment

CXR (rule out mediastinum involvement)

CT scan (r/o brain)

Chemo and radiation

Blincyto (bispecific T cell engages)

How well did you know this?

Not at all

Perfectly

ALL survival rates

Adults have 30-40% prognosis

Children 80%

How well did you know this?

Not at all

Perfectly

CLL

MC leukemia in adults

Results from acquired injury to DNA of single cell in marrow

Clonal malignancy of B CELLS**

How well did you know this?

Not at all

Perfectly

CLL clinical picture

Pts > 65 y.o.

Lymphadenopathy, fatigue, hypogammaglobulinemia

Increased infections

CBC evaluation

CLL

Elevated WBC (>20,000)

Lymphocytosis

Anemia, thrombocytopenia

CLL treament

Supportive until development of symptoms

Chemo/radiation

AML

Quickly progresses

Myeloid cells arrest in BLAST stage, crowding out

Adults or children (15-39)

AML presentation

Significant WBC elevation

Leukostasis possible due to high [blast] in blood

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

Purpra/petechiae =

AML Diagnosis

Bone marrow exam – SUDAN NEGATIVE

AUER RODS**

Blasts in peripheral blood smear

Treatment of AML

Chemo Transfusions Abx as needed Bone marrow transplants

CML associated with

prior radiation exposure 40-60 years of age Typically have thromboCYTOSIS

Presentation of CML

Early/initial phase: non specific symptoms Terminal phase: blast crisis, splenomegdaly

CML evaluation

Elevated WBC LAP score is low B12 elevation ThromboCYTOSIS Philadelphia chromosome

Phases of CML

Chronic phase (fewer than 5% blast) Accelerated (6-30% blast) Blastic phase (30%+) -- WORST

CML treatment

Tyrosine Kinase Inhibitors (first line to stablize WBC count) Ex. Gleevec CML often terminates with blast crisis - death (typical survival 5-7 yrs)

Neoplasticism proliferation of one of cell types of lymphopoietic reticular tissue

Lymphoma Typically in lymph nodes (lymphadenopathy)

Two types of lymphoma

Hodgkin's Non-Hodgkin's

Hodgkin lymphoma cause

Cause unknown Increased risk if infected with mono Typically occurs in young adults to elderly

Hodgkin lymphoma Arises ___

Arises in single node or chain Spreads anatomically contagious lymph tissues

Presentation Hodgkin lymphoma

LYMPHADENOPATHY in neck, mediastinum, abdomen B symptoms Pruritis

Lymph node biopsy of Hodgkin lymphoma shows

Reed-sternburg cell ****

Staging of Hodgkin lymphoma

Based on number of affected nodes Treatments vary, but 80% curable

Non-Hodgkin lymphoma Def.

Group of neoplasticism lymphoid cells disseminated they the entire body No Reed-Steenburg cells

Non-Hodgkin lymphoma origination

Either T or B cells ' Typically painless presentation

MC lymphoma in children

Burkitt's lymphoma Translocation on chromosome 8 to 14

Staging lymphomas (4)

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

Clinical presentation of Burkett lymphoma

Americans: abdominal cavity African: jaw

Multiple myeloma

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

Multiple myeloma presentation

Black, elderly Proliferation of plasma cells, osteopathic bone lesions Hypercalcemia symptoms (weakness, weight loss, constipation) and bone fractures (osteoclasts activation) Freq. infections

CBC of multiple myeloma

Anemia

Labs multiple myeloma

Bence jones proteinuria Hypercalcemia Full body skeletal survey Serum electrophoresis (spike = M protein)

CML and Philadelphia chromosome

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