Myeloid Disorders Flashcards
What all come under the myeloid disorders
AML
Myeloproliferative neoplasms
Myeloblasts dysplastic disorders
Mpn / mds
Myeloproliferative disorders include
CML
Pcv
Essential thrombocytosis
Myelofibrosis
CML usually occurs in
Middle age and elderly
Clinical features of cml
Dragging pain due to splenomegaly
Hepatomegali
Which translocation occurs in cml
T 9 22occurs in the cml
Abl gene in the 9 th chromosome and bcl gene in the 22 chromosome fuses to form abl bcc gene
With high tyrosine activity
Auto activation occurs and cell proliferation occurs independently of growth factors
Treatment given in the cml is
Imatinib mesylTe
Imatinib messy late is also given in
Gist
Treatment of cml
Along with imatinib mesylate we give stem cell transplantation
Phases of cml
Chronic phase
Accelerated phase
Blast crisis
How can u differentiate blw chronic phase and accelerated phase
In chronic phase the blast count is only <10% only In the accelerated phase lo Blasts are above >10% Persistent thrombocytopenia Increasing tlc Splenomegaly Persistent thrombocytosis
What is blast crisis
Blast count
> 20%
Extra medullary blast prolifer
How can u diagnose cml
Cbp
Hb normals
Platers increase
Tlc increase
Pheripheral smear
College girl appearance
Rapidly dividing cells move from the bone marrow to the periphery
Promyelocytes myelocytes meta myelocytes all come to the pheripheral blood
What abou be aspirate findings in the cml
Myeloid and erythronium ratio
Dwarf megakaryocytes
Pseudo gaucherie cel
Sea blue histiocytes
In which conditions the nap score is increased
In the myeloproliferative diseases except in the Cml Infection Stress Pregnancy Leukamoid reactions
In which conditions nap scores are reduced
In cml
Penh
Myelodysplastic syndrome
What is polycythemia Vera
Major criteria is
increase in the hb content more than 16 in females and males
Jak2 pathway mutation Hematocrit 49 males 48 females Bm tri lineage Pleomorphism in megakaryocytes Minor Erythropoietin levels are low
Most common pathway getting mutated is the pcv
Jak2
Clinical features of the pcv
Hb increase walla
staisis
Neurological abnormalilits
Bleeding disorders Itching Erythropoietin less Hepatosplenomegaly Jak stat
What is primary pcv and secondary pcv
Primary pcv lo erythropoietin levels are low
In the secondary they are high occurs in high altitude places
And in smokers and copd patients
What is the treatment of pcv
Phlebotomy
Essential thrombocytosis
Platelets count must be more than 4.5 lakh
CML exclude
Pcv exclude
Mpn exclude
Megakaryocytes hyperplasia stag horn apprenance occurs
Jak2 v617f. Mpl, calreticulin mutation any one can be seen
Clinical features of essential thrombocytosis
Pain throbbing pain
Parasthesiss
Transient ischemic attack
What is. Myelofibrosis
Here three major and 2 minor criteria is there
Either 3 major or 2 major and 1 minor need to be considered
Major
Atypical megakaryocytes
CML pcv mds mpn exclusion
Jak2v617f , mutation
Minor
Leh incre
Anemia
Splenomegaly
Leukoerythroblastosis
Climb feature of myelofibrosis
Elderly
Splenomegaly
Pathogenesis of myelo
Megakaryocytes hyperplasia valla pdgf increase which is fibrogenic amd fibrosis occur
Lab diagnosis of myelofibrosis
Pancytopenia
Tear drop cells
Leukoerythroblastic blood picture
Bone marrow aspiration of myelofibrosis
Dry tap Also seen in Hairy cell leukaemia Myelofibrosis Metastatic cancer Amlm7
Bm biopsy reticulin fitted are seem
What is langer Hans cell histiocytosis
Proliferation of immature dendritic cells
Brafv600e mutation
What are pheripheral B cell neoplasm
Cll or sll B cell prolymphocytic lymphoma Lymphoplasmocytic lymphoma Splenic and nodal marginal zone lymphoma Extra nodal marginal zone lymphoma Follicular lymphoma Marginal zone lymphoma Hairy cell leukaemia Plasma cell myeloma Diffuse large cell lymphoma Burkett lymphoma
Chronic lymphocytic lymphoma / sll
Age 60-70 yrs
Most common
Del 13 q 11 q 17 p
13 q associated with micro 15 16 deletion
Btk gene mutation increase btk increase B cells increase antibodies
These can attack rbc and platelets
What is evans syndrome
Cll + Aiha+ aithrombocytopenia
Clinical features of cll
Fatigue
Painless lymph node enlargement
Hepatosplenomegaly
Lab findings of cll
Hb decrease Tlc= increase might DLC absolute lymphocytes more than Platelets = norma l