WBC disorders Flashcards
infectious mononucleosis “mono”
self-limiting lymphoproliferative disorder–lymphocytes growing too much; infection of B lymphocytes caused by Epstein-Barr virus
Mono transmission
EBV-contaminated saliva most prevalent in teens/young adults bc spread through saliva and fluid
mono onset
insidious, 4-8 week incubation period
mono sx
nonspecific–lymphoadenopathy (swollen nodes in neck and armpit), hepatitis (swollen liver), splenomegaly (swollen spleen), tired, throat sore, body ache
mono labs
inc WBCs; 95% lymphocytes–very high
mono progression
2-3 weeks of acute phase; 2-3 months lethargy, debility
mono tx
treat sx, supportive, sleep, hygiene, hydration
myelodysplastic sx
group of related hematologic dx char by chx in quantity or quality of bone marrow elements; blood cells could not mature, accum, or short life
myelodysplastic sx
cytopenias (low blood count)–anemia, infection and spon bleeding or bruising
who does myelodysplastic sx affect?
most over 65
myelodysplastic sx cause
unknown, maybe enviro trigger
myelodysplastic sx diagnosis
labs and bone marrow biopsy
myelodysplastic sx tx
depends on severity, supportive, chemo, GCSF, erythrypoietin, bone marrow transplant
leukemias
Malignant neoplasms of cells originally derived from a single
hematopoietic cell line
Leukemic cells char and locations
Are immature and unregulated (undifferentiated), Proliferate in bone marrow, Circulate in blood, Infiltrate spleen, lymph nodes
how are leukemias classified?
according to their predominant cell type and acute vs chronic condition
acute lymphotic (lymphoblastic) leukemia
most common childhood leuk; higher survival rate
chronic lymphocytic leukemia
most common in older adults; Relatively mature lymphocytes that are immunologically incompetent; S&S: fatigue, wt loss, anorexia, infections
acute myelocytic leukemia
mostly an adult disease; low 5-year survival rate
lymphocytic leukemia
affects lymphoid stem cells especially lymphocytes
myelocytic
affects myeloid stem cells esp granulocytes
chronic myelocytic leukemia
Leukocytosis with immature cell types (presents with increased granulocyte count); S&S: fatigue, wt loss, diaphoresis, bleeding, abdominal discomfort from splenomegaly
cause of leukemia
unknown; inc exposure to radiation
Leukemic cells
Are an immature type of WBC; Capable of increased rate of proliferation/have prolonged life
span; Cannot perform function of mature leukocytes → are ineffective
as phagocytes; Interfere with maturation of normal bone marrow cells (including
RBC & platelets)
acute leukemias
sudden, stormy onset; dec mature WBC, dec RBC, dec platelets, kids refuse to walk and bone pain
acute leukemia diagnosis
based on blood/bone marrow tissue; find immature WBCs (blasts), may constitue 60-100% of cells
Chronic leukemia
more insidious onset, often diagnosed during routine blood check
leukemia tx
goal is remission; start with cytotoxic chemo, move to stem cell transplant (bone)
Risks of leukemia tx
infection, rejection, relapse
Malignant lymphomas
Neoplasms of cells derived from lymphoid
tissue
* Hodgkin Disease
* Non-Hodgkin Disease
Hodgkin disease
Characterized by painless, progressive, rubbery enlargement of
a single node or group of nodes – usually in neck area and nonspecific sx; Reed-Stenberg cell
Reed-Stenberg cell
distinctive tumor cell found with lymph biopsy; distinctive–for Hodgkins diagnosis
Hodgkins cause
unknown, maybe EBV, genetic predis, exposure to toxins
Hodgkin diagnosis
Diagnosis: peripheral blood analysis, lymph node biopsy, bone
marrow exam, radiographic evaluation (CT, MRI, PET)
Hodgkins tx
Chemotherapy- standard- doxorubicin
(Adriamycin), bleomycin, vinblastine, and dacarbazine; 2-8
cycles
* Radiation
* Stem Cell Transplant
Non-Hodgkin disease
Neoplastic dx of lymphoid tissue; spreads early to liver, spleen, bone marrow; char by painless, superficial lymphadenopathy, also extranodal sx; caught later, harder to diagnosis bc no distinguishing cell type
Etiology of non-Hodgkin
unknown
Non-Hodgkins diagnosis
similar to Hodgkins, inc extranodal sites–lymph tissue at non-lymph sites
Non-Hodgkins tx
chemotherapy, radiation, refractory cases- stem cell transplant; Rituximab (Rituxan), ibritumomab tiuxetan (Zevalin), tositumomab (Bexxar) & others
Multiple myeloma (Plasma cell myeloma)
atypical proliferation of “M” protein immunoglobulin which is a monoclonal antibody; inc osteoclast activity (bone b/d), can’t maintain humoral immunity–get sicker
Myeloma sx
bone pain/frac, also sx r/t impaired RBC and WBC count
Who is more likely to get myeloma
men, around age 65, African Americans
Myeloma CM
slow and insidious; anemia, bleeding, hypercalcemia from seeping out of bones, skeletal pain (often 1st sx)
Multiple myeloma diagnosis
lab, radiography, bone marrow exam; look for bone b/d and monoclonal antibody protein serum and urine; pancytopenia (all cells dec), hypercalcemia, elevated serum creatinine, Bence Jones proteins in urine; Xray osteolytic lesions
Multiple myeloma tx
watch, corticosteroids, promote bone health, chemo, stem cell transplants, adequate hydrations, biophosphates
