Module 2.9 Disorders of WBC's Flashcards
REVIEW STEM CELL LINES
ITS ON ONE OF THE FIRST SLIDES
Leukopenia
Decreased # of TOTAL lympohocytes in blood
Neutropenia
specifically deficient in neutrophils
Aplastic Anemia
depletion of all myeloid and lymphoid cells
neonatal neutropenia
consider this when umbilical cord has not fallen off in two weeks
Kostmann Syndrome
Group of diseases resulting in congenital severe NEUTROPENIA
Manifests in infancy with life threatening bacterial infections
Acquired neutropenia causes
Autoimmune (primary or secondary)
Drug-related
Radiation to bone marrow
Hematologic malignancies
Drugs that can cause neutropenia
Penicillin propylthiouracil aminopyrine clozapine chemo
Neutropenia after viral infections
usually transient and resolves within 2 weeks.
S/S of neutropenia
Initially same as bacterial or fungal infections.
Malaise, chills, fever, weakness
But with LOW WBC.
Infectious Mononucleosis is caused by what virus
Epstein-Barr
S/S of Mono
Fever generalized Lymphadenopathy Atypical lymphocytes in blood Hepatitis Hepatosplenomegaly
Lymphomas come from what cell line
lymphoid
Leukemia come from what cell line
either
Plasma cell Dyscrasias come from what cell line
Lymphoid
Non-hodgkin Lymphoma categories
Low grade lymphoma - B-Cell tumors
Intermediate Grade Tumors - B Cell and some T Cell lymphomas
High-grade Lymphomas - Immunoblastic (Bcell), Lymphoblastic (T-Cell) Burkitt and Non-Burkitt lymphomas
Hodgkin Disease
Presence of Reed-Sternberg (looks like OWL eyes) Cell is the landmark feature
Stage A hodgkin disease
Lack constitutional symptoms of cancer
Stage B Hodgkin disease
40% of pt’s diagnosed at this stage.
Significant weight loss, fever, pruritus, night sweats.
Advanced stage hodgkin disease
Fatigue, anemia
multiple organ system involvement.
Where do hodgkin lymphomas originate?
Single node or chain of nodes
Where do non-hodgkin lymphomas originate?
Extranodal sites, then spread to contiguous nodes.
May be viral in origin (epstein-barr or HTLV-1 or human T Lymphocyte virus)
Characteristics of Hodgkin lymphoma presentation
Usually above diaphragm
Single Node enlargement. Painless
Characteristics of Non-Hodgkin lymphoma presentation
Involves nodes below diaphragm (retroperitoneum, pelvis, mesentery)
Higher freq. of infections of all types
WATCH RETUXIMAM VIDEO
WATCH RETUXIMAB VIDEO
Treatments specific to Non-hodgkin Lymphoma
Adjuvant radiation therapy
Retuximab (monoclonal antibodies)
Leukemias originate from
either cell line
Classifications of Leukemias
Acute or Chronic Lymphocytic Leukemia (ALL or CLL)
Acute or Chronic Myologenous leukemia (ALM or CLM)
Lymphocytic anemias involve:
immature lymphocytes and theri progenitors in BM, Spleen, LN’s, CNS, etc.
Myelogenous Leukemias involve
pluripotent myeloid stem cells in BM
Interfere with maturation of all blood cells
Warning signs of acute leukemias
Datigue
Pallor
Weight Loss
Repeated Infections
Complications of acute leukemias
Leukostasis - plugging vessels!
Tumor Lysis syndrome
Hyperuricemia
Blast crisis
Philedelphia chromosome
1st identification of an abnormal chromosome in cancer patients.
Chronic Leukemia characteristics
cells are more well differentiated and not as aggressive.
Criteria for remission in ALL or AML
Less than 5% blasts in bone marrow
Normal blood counts
Absence of cytogenetic abnormalities
Return to pre-illness performance status.
Stages of treatment for acute leukemias
Induction - elicits remission
Intensification - Further reduces leukemic cells
Maintenance - maintains remission.
Tumor Lysis Syndrome
major electrolyte disturbances caused by death of many cancer cells. (hyperkalemia)
Multiple Myeloma
Plasma Cell Dyscrasia
Huge spike in one line of Gamma globulins.
S/S of Multiple Myeloma
Affects bone and BM
Proliferation of osteoclasts - bone reabsorption/destruction.
Pathologic fractures
Hypercalcemia
Proteinuria - BENCE JONES PROTEINS IN URINE
