WBC disorders Flashcards
What is Mononucleosis “Mono” and infection of?
B lymphocytes
What is Mononucleosis “Mono” cased by
Epstein-Barr virus (EBV)
Who is the Mononucleosis “Mono” most prevalent in
adolescence/young adults
what is the mode of transmission for Mononucleosis “Mono”
EBV-contaminated saliva
What is Mononucleosis “Mono”
self limiting lymphoproliferative disorder
what is the patho of Mononucleosis “Mono”
atypical lymphocytes proliferate
what is the onset of Mononucleosis “Mono”
insidious; incubation 4-8 weeks
what are some clinical manifestations of Mononucleosis
lymphadenopathy,hepatitis, splenomegaly, extreme fatigue, lethargy
What lab would you see increased in Mononucleosis
WBC increased(~ 12-18,000); 95% lymphocytes
What is the acute phase of Mononucleosis
2-3 weeks
degree of lethargy for mono
2-3 months
treatment of mono
symptomatic and suppotive
what is Myelodysplastic Syndrome
agroup of related hematologic disorderscharacterized by a change in the quantity and qualityof bone marrow elements
characteristics of Myelodysplastic Syndrome
Affects elderly (> 65)
CM: cytopenias
anemia, infection and spontaneous bleeding or bruising
Etiology: unknown, maybe an environmental trigger
what is the diagnostic for Myelodysplastic Syndrome
laboratory &bone marrow biopsy
treatment for Myelodysplastic Syndrome
Treatment- depends on disease severity- supportive,Granulocyte colony-stimulating factor (G-CSF),erythropoietin, chemotherapy, bone marrow transplant
What are leukemias
Malignant neoplasms of cells originally derived from a single hematopoietic cell line
characteristics of leukemic cells
Are immature and unregulated
(undifferentiated)
Proliferate in bone marrow
Circulate in blood
Infiltrate spleen, lymph nodes
Disease of children and adults
classes of leukemia
Acute lymphocytic (lymphoblastic) leukemia (ALL)*
Chronic lymphocytic leukemia (CLL)**
Acute myelocytic leukemia (AML)
Chronic myelocytic leukemia (CML)
What is the Most common childhood leukemia
Acute lymphocytic (lymphoblastic) leukemia (ALL)*
What is the ** Most common leukemia in older adults
Chronic lymphocytic leukemia (CLL)**
cause of Leukemia
Unkown; adults may be increased with exposure to radiation
4 parts - What is the patho of leukemic cells
Are an immature type of WBC
Capable ofincreased rate of proliferation/have prolongedlife span
Cannot perform function of mature leukocytes→are ineffective as phagocytes
Interfere with maturation of normal bone marrowcells (including RBC & platelets)
Onset of Acute Leukemia
Sudden,stormy
S/S of acute leukemia
related to decreased(mature) WBC, decreased RBC, decreasedplatelets
actue leukemia is diagnosised based on what
Blood/bone marrow tissue ↔ presence of immature WBC’s (blasts)– may constitute 60-100% of cells
onset of chronic leukemia
more insidious
characteristics of CLL
older adults (88.2% 5-year survival rate)
Relatively mature lymphocytes that areimmunologically incompetent
S&S: fatigue, wt loss, anorexia,infections
characteristics of CML
adults & children (69.7% 5-year survival rate)
Leukocytosiswith immature cell types (presents with increased granulocyte count)
S&S: fatigue, wt loss, diaphoresis, bleeding, abdominal discomfort
Treatment of Leukemia
Goal – attain remission
Cytotoxic chemotherapy
Stem Cell Transplant
Allogeneic – volunteer donor
Syngeneic – identical twin
Autologous – patient’s own
Risks of leukemia treatment
Infection
rejection
relapse
what are malignant lymphomas
Neoplasms of cells derived from lymphoid tissue
2 types of malignant lymphomas
hodgkin disease
non-hodgkin disease
characteristics of hodgkin disease
Characterized by painless, progressive, rubberyenlargement of a single node or group of nodes– usually in neck area
what cell can be found in a biopsy of hodgkin disease
Reed-Stenberg cell – distinctive tumor cellfound with lymph biopsy
diagnosis of hodgkin disease
peripheral blood analysis, lymphnode biopsy, bone marrow exam, radiographicevaluation (CT, MRI, PET)
Factors that interact with hodgkin disease
Epstein Barr Virus, geneticpredisposition, exposure to toxins
Clinical manifestations of hodgkin disease
insidious onset; painless enlarged lymph nodes &other nonspecific symptoms
treatments for hodgkin disease
Chemotherapy-
Radiation
Stem Cell Transplant
non-hodgkin disease
Alsoneoplastic disorder of lymphoid tissue
However, spreads early→ liver, spleen & bone marrow
Alsocharacterized by painless, superficiallymphadenopathy; alsoextranodalsymptoms
more common in older adults
clinical manifestation of non-hodgkin disease
painless lymph node enlargement & non-specific symptoms
diagnosis of non-hodgkin disease
similar toHodgkinslymphoma; increasedextranodalsites
treatment of non-hodgkin disease
chemotherapy
radiation
refractorycases- stem cell transplant
Rituximab(Rituxan),ibritumomabtiuxetan(Zevalin),tositumomab(Bexxar) & others
What is Multiple Myeloma
Plasma cell cancer (B cells)
Atypical proliferation of one of immunoglobulins, “M protein” – a monoclonal antibody (→ increased osteoclasts;lead to bone destruction/resorption)
Multiple Myeloma is characterized by
bone pain/fractures; also symptoms r/t impaired production of RBC & WBC
T/F Multiple myeloma makes the body unable to maintain humoral immunity
True
Who is more likely to have multiple myeloma
men>women
avg age 65
Blacks > whites
multiple myeloma clinical manifestations
etiology: unknown
CM: slow and insidious, skeletal pain, hypercalcemia
diagnostic test for multiple myeloma
laboratory, radiographic, bone marrow exam
Monoclonal antibody protein in serum and urine
Pancytopenia
Hypercalcemia
Bence Jones proteins in urine
Elevated serum creatinine
X-rays osteolytic lesions
Treatments for multiple myeloma
watching, corticosteroids, chemotherapy, biologic therapy, stem cell transplant,biphosphonates; adequate hydration
