WBCs Disorders and Leukemias Flashcards
What are the two common features of leukemias?
- WBC precursors in the bone marrow
2. Increased malignant WBCs in peripheral blood
What are the two major classes of leukemias?
- Myeloid (granulocyteic-monocytic)
2. Lymphoid (lymphocytic)
Which type of leukemia are children more commonly affected by?
Children = acute
Which type of leukemia are adults more likely to have?
Adults = chronic
What virus has implicated as a cause of Burkitt Lymphoma?
EBV
Name 3 complications common to all leukemias
- Anemia
- Recurrent infection
- Uncontrolled bleeding
*Pancytopenia
What is the most common cause of death in leukemia?
overwhelming infection, ie sepsis
Immature B-cell leukemia with lymph node involvement
Acute Lymphoblastic leukemia (ALL)
What is the most common form of leukemia in children <5?
Acute lymphoblastic leukemia
Describe the clinical features of acute lymphoblastic leukemia
- Bone pain and arthralgia
- Pancytopenia
- bleeding into skin and internal organs
- Enlarged lymph nodes
- Mild splenomegaly
In the FAB- French American British classifications of acute leukemias who are L1 and L2 distinguished?
L1 Acute Lymphoblastic is principally pediatric and has a uniform nucleus
L2 Lymphoblastic has irregular nucleus
What is the prognosis for Acute Lymphoblastic leukemia?
No treatment = dead in 3-5 months
Treatment =>90% cure
–prognosis better in children
What is the most common acute leukemia?
Acute myeloid leukemia
Who is most commonly affected by acute myeloid leukemia?
older people
How is acute myeloid leukemia diagnosed?
Bone marrow biopsy showingn >20% myyeloblasts
Which leukemia is associated with radiation (ex. atomic bombs), cytoxic chemotherapy, benzene exposure, cigarette smoke
Acute myeloid leukemia
Which type of leukemia is associated with Auer rods?
Acute Myeloid Leukemia
What are the two cytochemical markers used for diagnosis of AML?
- Myeloperoxidase
2. Nonspecific Esterase (NSE)
Are cytoplasmic granules associated with AML or ALL?
AML
Which type of infection is especially seen in AML?
fungal
Clinical features of AML?
- Splenomegaly
- Lymphadenopathy
- Testicular enlargement
- Infiltrates into the retina and choroid
- CNS may be involved with infiltrates
Prognosis of AML?
Most die within 6 months
Chemo can induce remission, but almost all will relapse. 30% 5 year survival
What is a key clinical feature of chronic lymphocytic leukemia
bilateral axillary
Chronic lymphocytic leukemia shares many of the same features as ________
small cell lymphocytic lymphoma
What should be expected in patient with histological finding of lymphocytes >15,000 in peripheral blood
Chronic lymphocytic leukemia
Which condition will show show many abnormal looking lymphocytes called smudge cells on a peripheral smear?
Chronic lymphocytic leukemia
Which is the most common form of myeloproliferative syndrome? (Chronic or acute)
Chronic
What is the difference in cell maturity between chronic myelogenous leukemia and chronic lymphocytic leukemia?
Chronic myelogenous leukemia is a maligant disease with granulocytes in all stages of maturation
chronic lymphocytic leukemia is a malignant disease of adult lymphoid cells (indistinguishable from mature lymphocytes)
What specific chromosomal abnormality is associated with 95% of patients with Chronic myelogenous leukemia?
Philadelphia chromosome - reciprocal translocation between chromosome 9 and 22 –>produces uncontrolled tyrosine kinase.
How is chronic myelogenous leukemia diagnosed?
- High WBC count
2. FISH (fluorescence in-situ hybridization)
Is there a better prognosis or worse prognosis if you are in the 95% of people who have the reciprocal translocation for chronic myelogenous leukemia?
better prognosis with it
The presence of _______ in CML cells is strong evidence of its disease causing role
tyrosine kinase
Which chromosome is technically the philadelphia chromosome?
22
What might you suspect if a bone marrow smear and peripheral blood smear showed granulocytes in all stages of maturation and rouleux formation (ex. metamyelocytes, myelocytes)?
Chronic myelogenous leukemia
What two clinical findings are a result of accelerated clotting found in Chronic Myelogenous Leukemia?
- Splenomegaly
2. Thrombosis
After 2-3 years of chronic phase in CML, 50% of the time it will progress to an accelerated phase which usually ends in a ___________ that resembles acute leukemia
“blast crisis”
Does chemotherapy work well for CML patients?
chemo yields unsatisfactory results and most will die in 3-5 years.
70% 3 year survival with BM + radiation + chemo
