Malignant Haematology Concepts Flashcards
What is malignant haemopoesis characterised by?
Increased numbers of abnormal and DYSFUNCTIONAL cells
Loss of normal activity
Loss of normal activity of haemopoiesis can cause which type of haematological cancer?
Acute leukaemias
Loss of normal activity of immune function can cause which type of haematological cancer?
Certain lymphomas
Name 4 reasons why malignant haemopoiesis may occur?
Increased proliferation
Lack of differentiation
Lack of maturation
Lack of apoptosis
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
Increased proliferation
- proliferation of abnormal progenitors
Block of differentiation
or
Block of maturation
Acute myeloid leukaemia - morphology
Variety of cells in the bone marrow is replaced by a population of uniform looking cells.
There is loss of haemopoietic reserve.
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
Increased proliferation
- proliferation of abnormal progenitors
NO block of differentiation/maturation
Chronic myeloid leukaemia - morphology
Large number of normal cells
List some causes of haematological malignancies
Genetic, epigenetic, environmental interaction
Somatic mutations in growth regulatory genes - Driver mutations
Haematological malignancies are usually as a result of one single catastrophic event. True or false?
False
- usually due to multiple hits
It is common for one single mutation to cause a haematological malignancy. True or false?
False
- unusual
What is a clone?
Population of cells derived from a single parent cell
Which type of mutation has the ability to select clones?
Driver mutation
Describe a driver mutation
Selects clones.
- The ‘parent cell’ of the clone has a genetic change and this is now shared by the daughter cells in the clone
Clones are identical and there are no changes within the clone. True or false?
False
- the genetic backbone will be the same although there can be some additional changes
Normal haemopoiesis is monoclonal/polyclonal ?
Polyclonal
- i.e. there are several different clones of cells coming from the same parent cell
Malignant haemopoiesis is monoclonal/polyclonal?
Monoclonal
- there is one single parent cell that is dominating haemopoiesis
What is more likely to be polyclonal - normal/malignant haemopoiesis?
Normal haemopoiesis
Driver mutations are selected during the evolution of cancer.. Why is this?
They have a growth advantage on the cells
Different types of haematological malignancies are based on 4 things:
- Based on lineage
- Based on developmental stage within lineage
- Based on anatomical site involved
- Based on speed of presentation
Types of haematological malignancies based on lineage
- myeloid
- lymphoid
Types of haematological malignancies based on developmental stage within lineage
Primative cells (failure of cells to differentiate and mature) - e.g. acute lymphoblastic leukaemia
Mature cells
- eg chronic lymphocytic anaemia
Types of haematological malignancies based on anatomical site involved - blood (and marrow) involvement =
Leukaemia
Types of haematological malignancies based on anatomical site involved - lymph node involvement with lymphoid malignancy =
lymphoma
Plasma cell malignancy in the marrow. What is this called?
Myeloma
Chronic lymphocytic leukaemia only involves the blood/marrow. True or false?
False
- this is an exception as it can also involve lymph nodes
What is histologically and clinically more aggressive:
- acute leukaemia
- chronic leukaemia
Acute leukaemia
What is histologically and clinically more aggressive:
- low grade lymphoma
- high grade lymphoma
High grade lymphoma
Features of histological aggression
Large cells
High NC ratio
Prominent nucleoli
Rapid proliferation
Features of clinical aggression
Rapid progression of symptoms
Acute leukaemia present with a failure of normal _____ function
Bone marrow
Chronic myeloid leukaemia - where is the problem in haemopoiesis?
Haemopoietic stem cells
Acute myeloid leukaemia - where is the problem in haemopoiesis?
Myeloid precursors
Acute lymphoblastic leukaemia - where is the problem in haemopoiesis?
Lymphoid precursors
Lymphoma - where is the problem in haemopoiesis?
Differentiating/maturing lymphocytes
Chronic lymphocytic leukaemia - where is the problem in haemopoiesis?
Blood
Bone marrow
Lymph node
Myeloma - where is the problem in haemopoiesis?
Plasma cells
