Malignancy in Hematology Flashcards
How to identify NORMAL, more mature NON-lymphoid cells?
- morphology
- cell surface Ag (glycoprotein A= RED cells)
- enzyme expression (myeloperoxidase- neutrophils)
How to identify normal, PROGENITOR cells?
- Immunophenotyping (cell surface Ags)
- Cell culture ASSAY
- Animal models
What occurs in Malignant Haemopoiesis?
- incr. no. of ABNORMAL and dysfunctional cells
- LOSS of normal activity
- —-haemopoeisis/ immune function
What causes the prodn of abmormal cells, and thus dysfunctional activity?
- incr. proliferation
- lack of differentiation
- lack of maturation
- lack of apoptosis
What is the pathophysiology of Acute leukemia?
Give an example of an Acute leukemia.
- proliferation of ABNORMAL progenitors
- with BLOCK in DIFFERENTIATION/ MATURATION
- Acute myeloid leukemia
What is the pahtophysiology of Chronic myeloproliferative d.o?
- also PROLIFERATION of abnormal progenitors
- –NO differentiation/ Maturation block
ex: CHRONIC myeloid leukemia
What causes haematological malignancies?
- somatic mutation in regulatory genes (DRIVER mutation vs PASSENGER mutation)
- usually MULTIPLE hits (more than single event)
- genetic, epigenetic, env. interaction
- recurrent cytogenic abnormalities (not causal)
What are driver mutations?
mutations that provide a selective GROWTH advantage
- thus promotes CANCER development
aka CANCER gene
Is malignant haemopoiesis MONOCLONAL or POLYCLONAL?
- MONOCLONAL
Wht is a clone?
popn of cells derived from a SINGLE parent cell
—-parent cell has a driver mutation that is shared with daughter cells
—-clones may diversify; but they contain similar backbone
How to screen kids who develop ACUTE LYMPHOBLASTIC LEUKEMIA?
Guthrie cards
What are the haematological malignancies based on ?
- Lineage (myeloid/ lymphoid)
- Developmental stage
- Anatomical site
What are the diff. malignancies seen developed in lymphoid lineagee?
Acute Lymphoblastic leukemia
>Chronic Lymphocytic Leukemia
>Myeloma
What are the diff. sites of haematological malignancies?
- blood: LEUKAEMIA
2. Lymph node involvement: LYMPHOMA
AT what sites does chronic lymphocytic leukaemia manifest?
in blood and lymph nodes
Where does myeloma manifest?
plasma cell malignancy in MARROW
Which is more CLINICALLY aggressive?
Acute leukemias and HIGH-grade LYMPHOMAS
—-aggressive due to RAPID progression of SX
What are the histological fts of aggression?
- large cells with HIGH nuclear-cytoplasmic ratio
- Prominent nucleoli
- Rapid proliferation