Lymphoproliferative Disorders Flashcards
Cancer of WBCs/blood/bone marrow
Leukemia
Increased total WBC count
Leukocytosis
Increased neutrophil count
Neutrophilia
Increased lymphocyte count
Lymphocytosis
Decreased total leukocyte count
Leukopenia
Decreased neutrophil count
Neutropenia
Decreases lymphocytes count
Lympohcytopenia
All blood lineages decreases (WBCs, RBCs, PLTs)
Pancytopenia
Describe a leukemoid reaction
- leukemia like infection
- neutrophilia-significant to marked increase (greater than 50,000/uL)
- definitely NOT leukemia
- response to infection, inflammation, trauma, cancer
- easily confused with chronic myelocytic leukemia (CML)
If we get young neutrophils, they are
Shifting to the left
Bandemia
Shift of neutrophils to the left
Maturation of neutrophils
Promyelocyte Myelocyte Metamyelocyte Band Neutrophil
WBC differential reference ranges
Never let mamma eat beans
Neutrophils 60% Lymphocytes 30% Monocytes 6% Eosinophils 3% Basophils 1%
Myelo’s present
Oh my, shouldn’t have these
Young neutrophils
High WBC are usually due to what
Neutrophils or lymphocytes
Peripheral blood compartments of neutrophils
Circulating pool Marinated pool (adhere to the walls of caps)
What are the 3 different body compartments of neutrophils
Cone marrow, peripheral blood, and extravascualr space
High WBC in trauma
Release of marinated WBCs
Most common reason for neutrophilia
Bacterial infection or trauma
Neutrophilia with a left shift
Acute infections Acute inflammation Drugs Physiological Leukemia
What is the least common cause of neutrophilia
Leukemia
What is reactive leukocytosis (leukemoid reaction) common confused with
Chronic myelocytic leukemia (CML)
Low neutrophil count can indicate
Leukemia
- even though we associate with high WBC
- low because the bone marrow gets squished to death
High lymph count
Viral infection
-can be due to a lymphocytic leukemia
What leukemia is associated with very high lymphocytes circulating
Acute lymphocytic leukemia
> 20% of the cells are blasts
Acute leukemia
What is more telling of leukemia, blood or bone marrow?
Bone marrow
<5% of cells called blasts in the blood and bone marrow
Chronic leukemia
If we are seeing myelos and bands, what are we thinking
Chronic myelocytic leukemia
How is leukoemia diagnosed
Bone marrow
Plasma cell disorder
Multiple myeloma
-microfractures in bones
Signs of leukemia
Anemia, bleeding, night sweats
What blood lines can leukemia occur in
All of them
- myelocytic (neutrophils)
- lymphocytic (lymphocytes_
- erythrocytic (RBC)
Acute leukemia
Blasts >20%
Acute myelocytic
Acute lymphocytic
Chronic leukemia
Chronic myelocytic leukemia
Chronic lymphocytic leukemia
Which chronic leukemia has all mature neutrophils
Chronic lymphocytic leukemia
Diagnostic tests for all leukemia’s
Complete blood count
Bone marrow aspirate
Most common leukemia in children
Acute lymphocytic leukemia
-good outcome
Most common leukemia
Chronic lymphocytic leukemia
-10-20 years to kill you
Worst leukemia
Acute myeloid leukemia
What is the tDt for diagnostic for
ALL
-common in children
Prognosis for ALL
95% remission
tDt
ALL
Primary adult leukemia
AML
Auer rods
AML
Prognosis of AML
25% of surviving at the 5 year mark
-death within weeks if untreated
Needle-like structures in blasts
Auer rods in AML
Characterized by Philadelphia chromosome (9 and 22 translocation)
CML
-this is what differentiates CML from leukemoid reaction
Prognosis
60% five year survival
-Gleevec increases chances, >80% remission
The only leukemia that you have a good chance of just not treating, just watchful waiting
CLL
What leukemia has a marked lymphocytosis (75-98%)
CLL
Prognosis of CLL
Can live for 10 years
Why dont we treat CLL
Because you live a long time with it, and treatment could diminish quality of life
Which leukemia is commonly disocereved accidentally
CLL
Cancer arising in the lymphatic system
Lymphomas
If the lymph node is swollen and painful
Not lymphoma, it will not be in pain if it is lymphoma
Which lymphoma is easier to treat
Hodgkins
What is a Reed-Sternberg cell indicative of
Hodgkin’s lymphoma, this is what separates this from non-hodgkins
Which lymphoma has a better outcome
Hodgkin
What age groups are most affected by lymphoma
Mid 20s and then mid 50s
-bimodal
Plasma cells replace bone marrow in this type of cancer. Causing fractures in the lower back
Multiple myeloma
Lab findings of multiple myeloma
Monoclonal protein spike in urine and blood
Bence jones protein is a light chain that is toxic to the kidneys, shows up in urine and blood, will lead to kidney failure
Protein that is diagnostic off multiple myeloma
Bence jones protein
Stage I lymphoma
Cancer is located in a single lymph node groups
Stage II lymphoma
Two or more lymph node groups on one side of the diaphragm
Stage III lymphoma
Cancer has spread to both sides of the diaphragm, or involves true spleen
Stage IV lymphoma
Cancer involves liver, bone marrow, or lung, brain
-highly metastasized
