WBC Disorders: Leukemia Flashcards
What is leukopenia?
Decreased circulating WBCs due to reduced production or accelerated destruction
What is the only treatment for aplastic anemia?
Stem cell graft
Which cells are affected by aplastic anemia?
All blood cells
Leukopenia is associated with…
increased infections
What are some symptoms of leukopenia?
Malaise, chill, fever
What does neupogen do?
Tells neutrophils to divide
Is leukopenia neoplastic?
No, non-neoplastic
Is leukocytosis neoplastic?
No, non-neoplastric
What is leukocytosis?
Increased circulating number of mature non-neoplastic WBCs (commonly due to infection)
Leukocytosis may be confused with…
leukemias (leukemoid reaction)
Looks like leukemia, but it’s not
What are some examples of leukocytosis?
- Polymorphonucleocytosis
- Eosinophilic leukocytosis
- Monocytosis
- Lymphocytosis
What is polymorphonucleocytosis?
What is its usual cause?
Increased neutrophils
Bacterial infection
What is eosinophilic leukocytosis?
What is its usual cause?
Increased eosinophils
Parasite
What is lymphocytosis?
What is its usual cause?
Increased lymphocytes
Viral infection
Is leukemia neoplastic?
Yes
Is lymphoma neoplastic?
Yes
Lymphoid (agranulocytes) and monocytes accumulate…
in masses
What is lymphadenitis?
Inflammation of lymph nodes (acute or chronic)
Large, painful lymph node (generally not cancer)
What is lymphadenopathy?
Enlarged/swollen lymph nodes
Can be silent (scary); more associated with neoplasia
Lymphadenitis is almost always seen with…
lymphadenopathy
Lymphadenopathy can occur independent of…
lymphadenitis
What are leukemias?
Neoplastic disorders of uncontrolled proliferation of hematopoietic stem cells characterized by replacement of bone marrow with malignant cells
Leukemic cells “spill” into blood and may infiltrate…
visceral organs
What method of diagnosis is used for leukemias?
Flow cytometry
What are the classifications of leukemias on the basis of cell type involved?
- Lymphocytic leukemia
- Myelogenous leukemia
What is lymphocytic leukemia?
Derived from lymphoid stem cells (T cells and B cells)
What is myelogenous leukemia?
Derived from myeloid stem cells (granulocytes, monocytes, megakaryocytes)
ie. non-lymphoblastic
What are the classifications of leukemias based on the state of maturity of cell/clinical presentation?
- Acute leukemias
- Chronic leukemias
What is the histology of acute leukemias?
Immature neoplastic cells (leukemic blasts) due to block in differentiation of stem cell precursor
What is the origin of neoplastic cells of acute leukemias?
May be lymphocytic or myelogenous stem cell origin
Which type of leukemia will have an abrupt, stormy onset?
Acute leukemia
What are the symptoms of acute leukemias?
Related to depression of normal marrow function: fatigue, fever, bleeding, bone pain, organomegaly, and CNS involvement
What is the histology of chronic leukemias?
More well-differentiated, mature leukocytes
Which cells are predominantly affected by chronic leukemias?
Predominantly granulocytes
Which type of leukemia has an insidious onset that’s rather slow?
Chronic leukemia
What is the symptomology of chronic leukemia?
None or vague: anemia, fatigue and weakness, weight loss, organomegaly over a longer period of time
90% of all childhood leukemias are…
acute lymphocytic leukemia
90% of adult acute leukemias are…
acute myelogenous leukemia
With acute lymphocytic leukemia, transformed B-lymphocytes are myeloperoxidase…
negative
With acute myelogenous leukemia, transformed cells are myeloperoxidase…
positive
Is CNS involved in acute lymphocytic leukemia?
Yes, lumbar spinal tap may be done
If acute lymphocytic leukemia is not treated, what is the result?
Close to 100% fatality in weeks-months
Acute myelogenous leukemia is Auer rod…
positive
What is the role of Vitamin A therapy in acute myelogenous leukemia?
Tries to force differentiation
What is the effect of gene fusion yielding abnormal retinoic acid receptor in acute myelogenous leukemia?
Blocks differentiation increasing neoplasm chance
With acute myelogenous leukemia, what is WBC count?
Increased
25% of all leukemias in older males is….
chronic lymphocytic leukemia
Describe the cells of chronic lymphocytic leukemia
Mature, better differentiated lymphocytes, B cells
Chronic lymphocytic leukemia is the leukemic counterpart of…
small lymphocytic lymphoma; it has virtually identical blood histology but a different origin
What are the symptoms of chronic lymphocytic leukemia
Same as acute but longer
Asymptomatic or vague symptoms: infection, fatigue, organomegaly
15-20% of all leukemias are…
chronic myelogenous leukemia
Chronic myelogenous leukemia most often involves which cells?
Fairly mature granulocytes
What is the common mutation in chronic myelogenous leukemia?
Philadelphia (Ph) chromosome, translocation resulting in bcr-c-abl gene (tyrosine kinase stuck in ON position)
With chronic myelogenous leukemia, what can possibly turn tyrosine kinase OFF?
Gleevec antibody
What are the symptoms of chronic myelogenous leukemia?
Non-specific symptomology
Chronic myelogenous leukemia is difficult to treat
What happens about 50% of the time?
Blast crisis
What is a Philadelphia chromosome?
Translocation between chromosomes 9 and 22 aka t(9:22)
