Malignant Haematology Concepts

Question 1

What is malignant haemopoesis characterised by?

Answer 1

Increased numbers of abnormal and DYSFUNCTIONAL cells

Loss of normal activity

Question 2

Loss of normal activity of haemopoiesis can cause which type of haematological cancer?

Answer 2

Acute leukaemias

Question 3

Loss of normal activity of immune function can cause which type of haematological cancer?

Answer 3

Certain lymphomas

Question 4

Name 4 reasons why malignant haemopoiesis may occur?

Answer 4

Increased proliferation
Lack of differentiation
Lack of maturation
Lack of apoptosis

Question 5

Acute myeloid leukaemia - how does it occur?

Use 1 or more of the following:
Increased proliferation 
Lack of differentiation
Lack of maturation
Lack of apoptosis

Answer 5

Increased proliferation
- proliferation of abnormal progenitors

Block of differentiation
or
Block of maturation

Question 6

Acute myeloid leukaemia - morphology

Answer 6

Variety of cells in the bone marrow is replaced by a population of uniform looking cells.

There is loss of haemopoietic reserve.

Question 7

Chronic myeloid leukaemia - how does it occur?

Use 1 or more of the following:
Increased proliferation 
Lack of differentiation
Lack of maturation
Lack of apoptosis

Answer 7

Increased proliferation
- proliferation of abnormal progenitors

NO block of differentiation/maturation

Question 8

Chronic myeloid leukaemia - morphology

Answer 8

Large number of normal cells

Question 9

List some causes of haematological malignancies

Answer 9

Genetic, epigenetic, environmental interaction

Somatic mutations in growth regulatory genes - Driver mutations

Question 10

Haematological malignancies are usually as a result of one single catastrophic event. True or false?

Answer 10

False

- usually due to multiple hits

Question 11

It is common for one single mutation to cause a haematological malignancy. True or false?

Answer 11

False

- unusual

Question 12

What is a clone?

Answer 12

Population of cells derived from a single parent cell

Question 13

Which type of mutation has the ability to select clones?

Answer 13

Driver mutation

Question 14

Describe a driver mutation

Answer 14

Selects clones.

- The ‘parent cell’ of the clone has a genetic change and this is now shared by the daughter cells in the clone

Question 15

Clones are identical and there are no changes within the clone. True or false?

Answer 15

False

- the genetic backbone will be the same although there can be some additional changes

Question 16

Normal haemopoiesis is monoclonal/polyclonal ?

Answer 16

Polyclonal

- i.e. there are several different clones of cells coming from the same parent cell

Question 17

Malignant haemopoiesis is monoclonal/polyclonal?

Answer 17

Monoclonal

- there is one single parent cell that is dominating haemopoiesis

Question 18

What is more likely to be polyclonal - normal/malignant haemopoiesis?

Answer 18

Normal haemopoiesis

Question 19

Driver mutations are selected during the evolution of cancer.. Why is this?

Answer 19

They have a growth advantage on the cells

Question 20

Different types of haematological malignancies are based on 4 things:

Answer 20

1. Based on lineage
2. Based on developmental stage within lineage
3. Based on anatomical site involved
4. Based on speed of presentation

Question 21

Types of haematological malignancies based on lineage

Answer 21

• myeloid

- lymphoid

Question 22

Types of haematological malignancies based on developmental stage within lineage

Answer 22

Primative cells (failure of cells to differentiate and mature) 
- e.g. acute lymphoblastic leukaemia 

Mature cells
- eg chronic lymphocytic anaemia

Question 23

Types of haematological malignancies based on anatomical site involved - blood (and marrow) involvement =

Answer 23

Leukaemia

Question 24

Types of haematological malignancies based on anatomical site involved - lymph node involvement with lymphoid malignancy =

Answer 24

lymphoma

Question 25

Plasma cell malignancy in the marrow. What is this called?

Answer 25

Myeloma

Question 26

Chronic lymphocytic leukaemia only involves the blood/marrow. True or false?

Answer 26

False

- this is an exception as it can also involve lymph nodes

Question 27

What is histologically and clinically more aggressive:

• acute leukaemia
• chronic leukaemia

Answer 27

Acute leukaemia

Question 28

What is histologically and clinically more aggressive:

• low grade lymphoma
• high grade lymphoma

Answer 28

High grade lymphoma

Question 29

Features of histological aggression

Answer 29

Large cells
High NC ratio
Prominent nucleoli
Rapid proliferation

Question 30

Features of clinical aggression

Answer 30

Rapid progression of symptoms

Question 31

Acute leukaemia present with a failure of normal _____ function

Answer 31

Bone marrow

Question 32

Chronic myeloid leukaemia - where is the problem in haemopoiesis?

Answer 32

Haemopoietic stem cells

Question 33

Acute myeloid leukaemia - where is the problem in haemopoiesis?

Answer 33

Myeloid precursors

Question 34

Acute lymphoblastic leukaemia - where is the problem in haemopoiesis?

Answer 34

Lymphoid precursors

Question 35

Lymphoma - where is the problem in haemopoiesis?

Answer 35

Differentiating/maturing lymphocytes

Question 36

Chronic lymphocytic leukaemia - where is the problem in haemopoiesis?

Answer 36

Blood
Bone marrow
Lymph node

Question 37

Myeloma - where is the problem in haemopoiesis?

Answer 37

Plasma cells