review Flashcards
where is the biopsy done on for a diagnosis of leukemia?
Bone marrow
where is the biopsy done on for a diagnosis of lymphoma?
enlarged lymph node or an extranodal mass
clonal disorders of impaired differentiation and increased proliferation
leukemia
is there bone marrow in leukemia?
yep, normal cells are crowded out
leukostasis is more common in AML or ALL
AML
DIC more common in AML or ALL
AML esp. APL
extramedullary manifestations ALL vs AML
ALL- LN spleen, brain tested
AML- skin, gingiva
tumor lysis occurs in
ALL in the setting of low potassium and low glucose
myeloperoxidase and lysozyme are markers of
myeloid
terminal deoxynucleotidyl transferase are markers of
lymphoid
APL will present with
leukopenia
ALL will express which cell surface antigens
CD10 and CD20
AML will express which cell surface antigens
CD13 and CD33
what test can use cell surface antigens to clarify the cell of origin
flow cytometry
in AML 11q23 t, del5, del7 is a good or bad
bad
in AML t(8;21), inv(16), t(15;17) is good or bad
good
in ALL t(12;21) is good or bad
good
in ALL t(9,22), t(4;11), 11q23 t is good or bad
bad
tumor lysis has two mediccations
- allopurinol to prevent formation of uric acid
2. rubircarse to make uric acid soluble
HIV associated tend to be _______ B-cell lymphoma and they are associated with ____ associated
HIV associated tend to be aggressive B cell lymphoma and they are associated with EBV
long term toxicities of treatment of radiation tend to be
fibrosing
peb-ebstein fevers
high spike periodic fevers seen in Hodgkins
Hodkin patients will tend to have this weird intolerance
alcohol- pain at the site
Classical HL originate from
mature b cell at the germinal center of differentiation
immunostaining reed sternberg cells on a classic hodgkin will show
CD30 and CD15 markers
ABVD is used in ______. what are the drugs? and toxicities associated with
A- doxirubicin: cardiac tox
B- bleomycin: pulm tox
V- vinblastin: Bone Marrow tx and some neuro tox
D- dercabazine: hematologic tox
HD
R-CHOP used in ______. what are the drugs?
R-rituximab C- cyclosphomide H- doxirubicin O- Vincristine P- prednisone
NHL
think of NHL chop for hockey
why are we looking into new therapies for NHL and HD?
long term complication in radiation such as cardiac dx, pulm fibrosis and secondary malignancies
chemo with its secondary leukemia issues and infertility
brentuximab
anti-CD30
nivolumab
PD-1 inhibitor
eosinophils is found in which lymphoma…. NHL or HD?
HD— think of mixed cellurality
smudge cell might be indicative of which leukemia
CLL
CLL has a unmutated and a mutated forms tell me about it
- unmutated means that the mutation happened before the B cell encounterd an antigen and this is a worse prognosis
- mutated means that the mutation happened after the B cell encuntered an antigen and this is a better prognosis
two highest risk factors for CLL
- rai stage III/IV
2. 17p deletion
ibrutinib
BTK inhibitor for CLL
idelafisib
PI3K lambda inhibitor for CLL
venetoclax
BCL2 inhibitor for CLL
mantle cell lymphoma has what type of markers
CD5+ and CD23-
as we learn more abut CLL we found that CLL cells are getting signals from the lymph node microenvironment to stay alive thus this has lead to changes in treatment
we need to take account of the lymph node Microenv. and thus tackling BTK is a good idea
rouleaux formation on peripheral smear why? and what disease
in crease in M protein leading to mor sticky. this is found in multiple myeloma
in multiple myeloma a decrease in B2-microglobulin and a increase in serum albumin is a bad or good prognosis
good pronosis
in multiple myeloma an increase in B2-microglobulin and a decrease in serum albumin is a bad or good prognosis
bad prognosis
Characterized by the dysregulated production of a particular lineage of mature myeloid or erythroid cells with fairly normal differentiation
MPN’s
Characterized by the dysregulated production of a particular lineage of mature myeloid or erythroid cells with abnormal differentiation
myelodysplastic syndrome
MDS that has a favorable course and response to lenalidomide
5Q syndrome
acute GVHD affect the
skin gut and liver
chronic GvHD resembles
autoimmune collagen vascular diseases
cytokeratins, EMA
carcinoma
ER, PR
Breast
PSA
prostate
LCA (CD45)
lymphoma
S-100
melanoma
chromogranin, synaptophysin, NSE
neuroendocrine tumor
Beta-HCG, AFP
Germ cell tumor
vimentin
sarcoma
level 1a
tumor
level1b
host
level 2a
molecular subtype
level 2b
prognostic and/or predictive test
level 2
NGS data
level 2c
serum and BM analysis
level 3
intratumor heterogeneity
level 4
integrated approach
active bone marrow in children
entire skeleton
active bone marrow in adults
spine, pelvis, sternum, ribs and skull
microbe recognition IgG and complement (C3b)
opsonization
internalized killing
phagocytosis
respiratory burst
oxygen dependent neutralization
phagosome-lysosome function with hydrolytic and proteolytic enzymes
non-oxygen dependent
two diseases where eosinophils can be found
- addison’s
2. hodgkin
what leukemia should we consider when we see basophils
CML
sickle cell crisis states:
- vaso-occlusive
- hemolytic crisis
- aplastic crisis
- sequestration crisis
- vaso-occlusive- acute pain exarcebations
- hemolytic crisis- marked increase red cell hemolysis
- aplastic crisis- erythroid aplasia due to parvo B19
- sequestration crisis- splenic pooling of erythrocytes with splenomegaly and shock-like state
different mutation at the beta chain locus on chromosome 11
HbSC
increased MCHC
hereditary spherocytosis
shistiocytes appear with
Microangiopathic hemolytic anemia