malignant hematology Flashcards
leukostasis
occurs when the WBC is over 100 x 10^9 and patient has symptoms, leads to WBC pluggin the vessels, which can result in bleeding, hypoxic respiratory distress, neurological changes, IV fluids or trying to reduce tumor burden with hydroxyurea, try lowering urea levels by using allopurinol and rasburicase, avoid increasing volume
hyperviscosity syndrome is common in what disorder?
waldenstroms
hyperviscosity symptoms
tinnitus, fever, headache, blurry vision, mental fatigue/confusion, stroke, heart failure, bleeding
DIC is common in what disorder
AML
DIC has what typical test findings
widespread activation of coagulation leading to intravascular fibrin formation and thrombotic occlusion consumption of factors that can lead to bleeding
- increased bilirubin and LDH
- decreased fibrinogen
- prolonged PT and aPTT
- increased d-dimer
- thrombocytopenic
DIC treatment
treat the underlying cause
- sever burn
- OBGYN trauma
- snake venom
- infection
febrile neutropenia
- fatal complications with gram negative like pseudomonas
- most common is gram positive bacteria
tumor lysis syndrome
massive tumor cells burst and intracellular metabolites spill can cause increased K and phosphate decreased Ca, can cause crystallization gout and seizures
- very common in T-ALL and burkitts
treatment for febrile neutorpenia
prophylaxis, tailored to microbe
increased ______ raise serum like in waldenstrom macroglobulinemia and meuloma
globulins
treatment of hyperviscosity
plasmapheresis and chemotherapy
spinal cord compression
common in T-ALL and lymphoblastic lymphoma
treatment for spinal cord compression
glucocorticosteriods and radiation
symptoms for spinal cord compression
leg weakness, diminished sensation bowel or bladder disfunction
signs of spinal cord compression
hyperreflexia, babinski sign
gene for acute myeloid leukemia
PML- ABRalpha
what are the side effects of arsenic ?
- teratogenic
- cardiac issues
AML treatment
ATAR + arsenic
chemotherapy 7 + 3 cytarabine and daunrubicin
ALL treatment
- CAR-T
- chemotherapy with maintenance for 3 years
- intrathecal injections to prevent spread to CNS and testes
CLL clinical presentation regarding bug bites
exaggerated response
what is the best method for lymph node biopsy?
FNA < core needle biopsy < surgical excision
indolent
observe until symptomatic
APL has what cytogenic markers?
CD33 and CD13 CD 117
