WBC Disorders: Leukemia

Question 1

What is leukopenia?

Answer 1

Decreased circulating WBCs due to reduced production or accelerated destruction

Question 2

What is the only treatment for aplastic anemia?

Answer 2

Stem cell graft

Question 3

Which cells are affected by aplastic anemia?

Answer 3

All blood cells

Question 4

Leukopenia is associated with…

Answer 4

increased infections

Question 5

What are some symptoms of leukopenia?

Answer 5

Malaise, chill, fever

Question 6

What does neupogen do?

Answer 6

Tells neutrophils to divide

Question 7

Is leukopenia neoplastic?

Answer 7

No, non-neoplastic

Question 8

Is leukocytosis neoplastic?

Answer 8

No, non-neoplastric

Question 9

What is leukocytosis?

Answer 9

Increased circulating number of mature non-neoplastic WBCs (commonly due to infection)

Question 10

Leukocytosis may be confused with…

Answer 10

leukemias (leukemoid reaction)
Looks like leukemia, but it’s not

Question 11

What are some examples of leukocytosis?

Answer 11

• Polymorphonucleocytosis
• Eosinophilic leukocytosis
• Monocytosis
• Lymphocytosis

Question 12

What is polymorphonucleocytosis?
What is its usual cause?

Answer 12

Increased neutrophils
Bacterial infection

Question 13

What is eosinophilic leukocytosis?
What is its usual cause?

Answer 13

Increased eosinophils
Parasite

Question 14

What is lymphocytosis?
What is its usual cause?

Answer 14

Increased lymphocytes
Viral infection

Question 15

Is leukemia neoplastic?

Answer 15

Yes

Question 16

Is lymphoma neoplastic?

Answer 16

Yes

Question 17

Lymphoid (agranulocytes) and monocytes accumulate…

Answer 17

in masses

Question 18

What is lymphadenitis?

Answer 18

Inflammation of lymph nodes (acute or chronic)
Large, painful lymph node (generally not cancer)

Question 19

What is lymphadenopathy?

Answer 19

Enlarged/swollen lymph nodes
Can be silent (scary); more associated with neoplasia

Question 20

Lymphadenitis is almost always seen with…

Answer 20

lymphadenopathy

Question 21

Lymphadenopathy can occur independent of…

Answer 21

lymphadenitis

Question 22

What are leukemias?

Answer 22

Neoplastic disorders of uncontrolled proliferation of hematopoietic stem cells characterized by replacement of bone marrow with malignant cells

Question 23

Leukemic cells “spill” into blood and may infiltrate…

Answer 23

visceral organs

Question 24

What method of diagnosis is used for leukemias?

Answer 24

Flow cytometry

Question 25

What are the classifications of leukemias on the basis of cell type involved?

Answer 25

* Lymphocytic leukemia * Myelogenous leukemia

Question 26

What is lymphocytic leukemia?

Answer 26

Derived from lymphoid stem cells (T cells and B cells)

Question 27

What is myelogenous leukemia?

Answer 27

Derived from myeloid stem cells (granulocytes, monocytes, megakaryocytes) ie. non-lymphoblastic

Question 28

What are the classifications of leukemias based on the state of maturity of cell/clinical presentation?

Answer 28

* Acute leukemias * Chronic leukemias

Question 29

What is the histology of acute leukemias?

Answer 29

Immature neoplastic cells (leukemic blasts) due to block in differentiation of stem cell precursor

Question 30

What is the origin of neoplastic cells of acute leukemias?

Answer 30

May be lymphocytic or myelogenous stem cell origin

Question 31

Which type of leukemia will have an abrupt, stormy onset?

Answer 31

Acute leukemia

Question 32

What are the symptoms of acute leukemias?

Answer 32

Related to depression of normal marrow function: fatigue, fever, bleeding, bone pain, organomegaly, and CNS involvement

Question 33

What is the histology of chronic leukemias?

Answer 33

More well-differentiated, mature leukocytes

Question 34

Which cells are predominantly affected by chronic leukemias?

Answer 34

Predominantly granulocytes

Question 35

Which type of leukemia has an insidious onset that's rather slow?

Answer 35

Chronic leukemia

Question 36

What is the symptomology of chronic leukemia?

Answer 36

None or vague: anemia, fatigue and weakness, weight loss, organomegaly over a longer period of time

Question 37

90% of all childhood leukemias are...

Answer 37

acute lymphocytic leukemia

Question 38

90% of adult acute leukemias are...

Answer 38

acute myelogenous leukemia

Question 39

With acute lymphocytic leukemia, transformed B-lymphocytes are myeloperoxidase...

Answer 39

negative

Question 40

With acute myelogenous leukemia, transformed cells are myeloperoxidase...

Answer 40

positive

Question 41

Is CNS involved in acute lymphocytic leukemia?

Answer 41

Yes, lumbar spinal tap may be done

Question 42

If acute lymphocytic leukemia is not treated, what is the result?

Answer 42

Close to 100% fatality in weeks-months

Question 43

Acute myelogenous leukemia is Auer rod...

Answer 43

positive

Question 44

What is the role of Vitamin A therapy in acute myelogenous leukemia?

Answer 44

Tries to force differentiation

Question 45

What is the effect of gene fusion yielding abnormal retinoic acid receptor in acute myelogenous leukemia?

Answer 45

Blocks differentiation increasing neoplasm chance

Question 46

With acute myelogenous leukemia, what is WBC count?

Answer 46

Increased

Question 47

25% of all leukemias in older males is....

Answer 47

chronic lymphocytic leukemia

Question 48

Describe the cells of chronic lymphocytic leukemia

Answer 48

Mature, better differentiated lymphocytes, B cells

Question 49

Chronic lymphocytic leukemia is the leukemic counterpart of...

Answer 49

small lymphocytic lymphoma; it has virtually identical blood histology but a different origin

Question 50

What are the symptoms of chronic lymphocytic leukemia

Answer 50

Same as acute but longer Asymptomatic or vague symptoms: infection, fatigue, organomegaly

Question 51

15-20% of all leukemias are...

Answer 51

chronic myelogenous leukemia

Question 52

Chronic myelogenous leukemia most often involves which cells?

Answer 52

Fairly mature granulocytes

Question 53

What is the common mutation in chronic myelogenous leukemia?

Answer 53

Philadelphia (Ph) chromosome, translocation resulting in bcr-c-abl gene (tyrosine kinase stuck in ON position)

Question 54

With chronic myelogenous leukemia, what can possibly turn tyrosine kinase OFF?

Answer 54

Gleevec antibody

Question 55

What are the symptoms of chronic myelogenous leukemia?

Answer 55

Non-specific symptomology

Question 56

Chronic myelogenous leukemia is difficult to treat What happens about 50% of the time?

Answer 56

Blast crisis

Question 57

What is a Philadelphia chromosome?

Answer 57

Translocation between chromosomes 9 and 22 aka t(9:22)