SM_262b: Intro to Heme Malignancies Flashcards
Describe the types of hematopoietic cells
Types of hematopoietic cells
Hematologic malignancies are classified by ____, ____, ____, and ____
Hematologic malignancies are classified by cell of origin, cell maturation, presence of genetic abnormalities, and clinical findings
Describe hematopoietic cell differentiation
Hematopoietic cell differentiation
Myeloid WBCs include ___, ___, ___, and ___
Myeloid WBCs include neutrophils, eosinophils, basophils and mast cells, and antigen-presenting cells (macrophages and dendritic cells)
Lymphoid WBCs are ____, ____, and ____
Lymphoid WBCs are B cells, T cells, and NK cells
Describe normal peripheral blood smear
Normal peripheral blood smear
Describe tissues of the hematopoietic and immune system
Tissues of the hematopoietic and immune system
- Peripheral blood
- Primary lymphoid (cells originate and develop): bone marrow, thymus
- Secondary lymphoid (immune response is activated): lymph nodes, tonsils, spleen, other tissues such as MALT
Primary lymphoid tissues are where ___
Primary lymphoid tissues are where cells originate and develop
- Bone marrow
- Thymus
Secondary lymphoid tissues are where ___
Secondary lymphoid tissues are where immune response is activated
- Lymph nodes
- Tonsils
- Spleen
- Other tissues such as MALT
Describe the myeloid lineage
Myeloid lineage
Neutrophils are part of the ___ immune system and function to ___
Neutrophils are part of the innate immune system and function to ingest and kill pathogens
- 70% of all WBCs
- Called granulocytes, polymorphonuclear cells
Myeloid classification includes ____ and ____
Myeloid classification includes RBC derived (erythroid) neoplasms and megakaryocytic neoplasms
Lymphocytes are involved in ___ immunity
Lymphocytes are involved in adaptive immunity
Describe the lymphoid lineage
Lymphoid lineage
Describe B cells
B cells
- CD19+
- Humoral immunity
- Express antibody on cell surface (B cell receptor)
- Differentiate into plasma cells and memory cells
B cells originate and mature in ___
B cells originate and mature in bone marrow
Describe T cells
T cells
- CD3+
- CD4+ helper and CD8+ cytotoxic
- Originate in bone marrow and mature in thymus
Describe NK cells
NK cells
- CD56+ and CD16+
- Directly kill infected cells and tumor cells
- Contain and secrete cytotoxic granules
Describe histiocytic dendritic cell lineage
Histiocytic dendritic cell lineage
- Clonal proliferative lesions of “professional antigen presenting cells”: macrophages and dendritic cells
- Classification is somewhat unclear: some are myeloid-derived and others are thought to be derived from non-hematopoietic stromal cells
Lymphoma is ___
Lymphoma is neoplasms derived from lymphoid cells and typically applied to tissue-based (lymph, spleen, etc) neoplasms
Leukemia is ___
Leukemia is neoplasms originating in the blood and bone marrow, including both myeloid and lymphoid origin
Myeloid sarcoma is ___
Myeloid sarcoma is myeloid neoplasms involving the tissue
Describe ambiguity with leukemia / lymphoma terminology
Ambiguity with leukemia / lymphoma terminology
- No strict criteria
- Historical naming practices can apply: hairy cell leukemia, mantle cell lymphoma
- Some malignancies commonly involve both tissue and bone marrow / blood so the names are combined: chronic lymphocytic leukemia / small lymphocytic lymphoma, B lymphoblastic leukemia / lymphoma
WHO classification of hematologic malignancy relies on a combination of ___, ___, ___, and ___ features
WHO classification of hematologic malignancy relies on a combination of morphologic, phenotypic, molecular / genetic, and clinical features
Describe the approach to WHO classification for hematologic malignancy
Approach to WHO classification for hematologic malignancy
- Lineage?: myeloid, lymphoid, histiocytic / dendritic cell
- Are cells immature or mature?: acute / precursor / immature, chronic / mature
- Is there recurrent cytogenetic or molecular abnormality?
Describe broad WHO hematologic malignancy classification categories
WHO hematologic malignancy classification categories
___, ___, and ___ are used to determine lineage
Morphology, flow cytometry, and immunohistochemistry are used to determine lineage
Describe categories of lymphoid neoplasms
Lymphoid neoplasms
- Precursor lymphoid neoplasms: B lymphoblastic leukemia / lymphoma, T lymphoblastic leukemia / lymphoma
- Mature lymphoid neoplasms: Hodgkin lymphoma, non-Hodgkin lymphoma (B cell type, T/NK cell type)
Describe categories of myeloid neoplasms
Myeloid neoplasms
- Precursor myeloid neoplasms: acute myeloid leukemiia, acute myeloid leukemia with recurrent genetic abnormalities
- Mature myeloid neoplasms: myelodysplastic syndrome, myeloproliferative neoplasm, myelodysplastic syndrome / myeloproliferative neoplasm
Blast is a ___
Blast is a hematopoietic stem cell precursor
- Open chromatin, visible nucleoli, high nuclear:cytoplasmic ratio, expression of phenotypic markers of immaturity (CD34, CD117, TdT, CD1a)
Acute leukemia involves ____ in the peripheral blood or bone marrow
Acute leukemia involves ≥ 20% blasts in the peripheral blood or bone marrow
- Can be less with certain defining genetic abnormalities
Myelodysplastic syndromes and myeloproliferative neoplasms are ___
Myelodysplastic syndromes and myeloproliferative neoplasms are malignant neoplasms of myeloid cells with maturation
Myelodysplastic syndromes show ___ and involve ___
Myelodysplastic syndromes show significant dysplasia (abnormal cell changes in myeloid lineages) and peripheral blood cytopenias
- Myeloid lineages: RBCs, granulocytes, megakaryocytes
Myeloproliferative neoplasms involve ___
Myeloproliferative neoplasms involve elevated peripheral blood counts
___ is used to evaluate for hematologic malignancy
Bone marrow biopsy is used to evaluate for hematologic malignancy
- Aspirate (liquid)
- Core biopsy (tissue)
