Random Cancer Questions Flashcards
cKIT mutation
Mastocytosis
t(9:22) p210
CML
Chronic Myelogenous Leukemia
Jak2 mutations are seen in which disorders? Name them
Myeloproliferative disorders
- Polycythemia Vera (RBCs)
- Essential Thrombocythemia (Platelets)
- Primary Myelofibrosis
Leukoerythroblastic change is seen in the peripheral smear of what myeloproliferative disorder?
What else will you see on it?
Primary Myelofibrosis
Also TEAR DROP RBCs, nucleated RBCs
Why is the spleen so f’ing huge in primary myelofibrosis?
Extramedullary hematopoiesis.
There is no room for it in the bone marrow so it moves to other sites in the body and spills blood cell precursors out into the peripheral circulation
What stain is used on the BM to ID Myelofibrosis?
Reticulin
Why does uric acid increase when you have high cell turnover?
The nuclei are released into the blood and uric acid gets out.
Clear it with ALLOPURINOL
Tx for Polycythemia Vera?
Venesection
Polycythemia Vera and Essential Thrombocythemia can transition to what 2 diseases?
- Primary Myelofibrosis (most common)
2. AML
AML has generalized bone marrow failure associated with its myeloid lineage proliferation. What are the characteristics of bone marrow failure?
Anemia - shortness of breath, chest pain, fatigue
Thrombocytopenia - bleeding
Neutropenia - INFECTION
Congenital form of Aplastic Anemia
Fanconi’s
Primary mechanism of idiopathic aplastic anemia?
Immune-mediated destruction of hematopoietic stem cells.
TEST: What causes Aplastic Anemia in Sickle Cell patients?
PARVOVIRUS
What lab results are characteristic of Aplastic Anemia?
Decreased Reticulocyte Count
HYPOCELLULAR MARROW
Relative lymphocytosis –> in other words, you have severe pancytopenia (RBCs, platelets, granulocytes) but your lymphocytes have longer lives, so it seems like lymphocytosis
What’s the main difference between aplastic anemia and a myelodysplastic syndrome?
They both have pancytopenia, impaired hematopoietic stem cells.
ONE IS NEOPLASTIC AND THE OTHER ISNT
Where do myelodysplasias lead? (uh oh….)
Acute Myelogenous Leukemia
Treatment for Myelodysplasias?
“lidomides”
Thalidomide
Lenalidomide
SCT in younger patients
TEST: Describe an Autologous Hematopoietic Stem Cell Transplant
Stem cells collected from patient’s peripheral blood and stored (very resilient)
Patient’s marrow wiped out with chemo, and stored cells injected back in.
Stem cells somehow find their way back to the bone marrow and set up camp.
When do you usually use HSCT?
Multiple Myeloma/Lymphoma
Can you do an Autologous HSCT in a patient with aplastic anemia or myeodysplasia?
NOPE their stem cells are screwed up. Have to do an Allogenic Hematopoietic Stem Cell Transplant
Can a person with bone lytic lesions have MGUS?
Nope. Any indication of CRAB+ = multiple myeloma
