Week 3 Flashcards
Are most haemopoietic malignancies acquired or inherited?
acquired
Are most haemopoietic malignancies systemic or localised?
systemic
Are most haemopoietic malignancies genetic in origin or outside acquired?
genetic in origin
Do leucocyte neoplasms originate in a single leukaemic cell or multiple cells?
single - clonal - cells travel in bloodstream, lymph system
Are most treatments for leucocyte neoplasms localised or systemic
systemic
List some examples of reasons for the direct cause of malignancy. DNA damage caused by…..
- Environmental toxins
- Radiation
- Chemotherapy
- Organic solvents
- Viruses
- Epstein-Barr (Burkitt lymphoma)
- Human T-cell lymphotropic virus type 1 (HTLV-1)
What are the 2 classification schemes?
French-American-British (FAB)
World Health Organisation (WHO)
What is the FAB scheme based largely on?
Morphology, histology
What does the WHO add to the FAB scheme?
- Adds or replaces morphology based classification with
- Cytogenetics (chromosome analysis)
- Molecular level changes (gene / protein level changes)
- Focus on elements that control proliferation, maturation, apoptosis
What are the first two genetic lesions discovered were in leucocyte malignancies?
- Philadelphia chromosome – Chronic Myeloid Leukaemia - t(9;22)
- Burkitt lymphoma - t(8;14)
What is the translocation that characterises leukaemic cells in Chronic Myeloid Leukaemia (CML)
Philadelphia chromosome
Also seen in ALL, AML
In the Philadelphia chromosome there is reciprocal translocation between chromosome _______ and chromosome ______
22,9
Tumour suppressor genes code for ________ that resist malignant __________
proteins, transformation
Defective or missing p53 gene results in
mutations in daughter cells
What are 4 things that gene disruptions may affect?
- Normal differentiation
- Transcription
- Cell signalling
- Apoptosis
Lymphomas and lymphocytic leukaemias are _________ lesions of the _______ system
neoplastic, lymphoid
Diagnosis of lymphomas is based on a combination what 4 things?
- Morphology
- Immunophenotype
- Molecular genetic characteristics
- Clinical findings
Internal components of a lymph node include
• Cortex • Paracortex • Medullary cords • Sinuses Capsule, Follicles, Lymphatics
How can antigenic stimulation result in lymph node enlargement?
B cells have been coded to recognise a certain antigen and proliferate. They produce antibodies against that particular antigen and fight the virus or infection.
35 sub types of Lymphomas they are generally divided into two main types which are:
- Hodgkin lymphoma
* Non-Hodgkin lymphoma
What is the strongest risk factor for lymphomas?
Altered immune function:
• Immunocompromised
• Autoimmune disease
• Some bacterial and viral infections
35 sub types of Lymphomas they are generally divided into two main types which are:
- Hodgkin lymphoma
* Non-Hodgkin lymphoma
What is the most common form of haematological malignancy in Australia?
Lymphoma
What is an example of mature B-cell lymphoma?
Burkitt lymphoma
Is Burkitt lymphoma a Hodgkin lymphoma or a Non-Hodgkin lymphoma?
Non-Hodgkin lymphoma
What is the most common cutaneous T-cell lymphoma?
Mycosis fungoides
Mycosis fungoides is found in the ______ and ______ and may spread to regional lymph nodes.
epidermis, dermis
Sezary syndrome is a variant of mycosis fungoides with _________ ________ _______.
circulating tumour cells
Cerebriform nuclei are commonly found in patients with ……
Mycosis fungoides/Sezary syndrome
What is an example of mature T-Cell lymphoma?
Mycosis fungoides / Sezary syndrome
• Cutaneous lesions
Is Mycosis fungoides/Sezary syndrome an example of a Hodgkin lymphoma or a Non-Hodgkin lymphoma?
Non-Hodgkin lymphoma
What are the two broad categories of Hodgkin lymphoma
- Nodular lymphocyte-predominant Hodgkin lymphoma
* Classical Hodgkin lymphoma
Large ‘Popcorn’ cells • Abundant cytoplasm
• Multilobulated nuclei (popcorn) is a description of the peripheral blood of a patient with
Nodular lymphocyte-predominant Hodgkin lymphoma
Is Nodular lymphocyte-predominant Hodgkin lymphoma a B-Cell or T-Cell neoplasm?
B-Cell
Which lymphoma is this description: Heterogenous group of neoplasms • Derived from germinal centre of lymph node • Four subtypes Diagnostic cell in all subtypes • “Reed-Sternberg cell”
Classical Hodgkin lymphoma
Describe a “Reed-Sternberg cell”
- Large lymphoid cell
- Bi-lobed nucleus or two nuclei
- Abundant eosinophilic cytoplasm
Which Leukaemia is this describing? Morphology (peripheral blood): • Small lymphoid cells • Coarse chromatin • Inconspicuous nucleoli • Scant cytoplasm • Smudge / smear cells common
Chronic Lymphocytic Leukaemia (CLL)
Chronic Lymphocytic Leukaemia (CLL) and Small Lymphocytic Lymphoma (SLL) are derived from what type of cell?
B-Cell
In Chronic Lymphocytic Leukaemia (CLL) andSmall Lymphocytic Lymphoma (SLL) there is an accumulation of small lymphoid cells in: (3)
- Peripheral blood
- Bone marrow
- Lymphoid organs
This is a description of what type of leukaemia?
• Indolent lymphoproliferative disorder of the elderly
• Median age at diagnosis is 65
• Median survival 10 years
• Emerging targeted therapies offer hope of increased
survival
• Patient outcome predicted by:
• Extent of lymphoid organ involvement
• Cytogenetic abnormalities
• Degree of cytopaenias
Chronic Lymphocytic Leukaemia (CLL)
This is a description of what type of leukaemia?
• Rare mature lymphoid leukaemia
• Derived from B- or T-cells
• Involve peripheral blood, bone marrow and spleen
• Lymph node involvement more common in T-cell
• Distinct from CLL
Prolymphocytic leukaemia (PLL)
This is a description of what type of leukaemia? • Small B lymphocytes • Thought to derive from memory B-cell • Abundant cytoplasm • Fine hairy cytoplasmic projections • Cells mainly in bone marrow, spleen • Some in peripheral blood • Lymph node involvement is rare
Hairy cell leukaemia
What does Pancytopaenia mean?
Low counts for all three types of blood cells: red blood cells, white blood cells, and platelets
What does Cytopenia mean?
Occurs when one or more of your blood cell types is lower than it should be
What is DIC?
Disseminated intravascular coagulation (DIC) is a rare but serious condition that causes abnormal blood clotting throughout the body’s blood vessels.
List the main types of therapy used for leucocyte neoplasms: (5)
- Chemotherapy
- Radiation therapy
- Supportive therapy
- Targeted therapy
- Stem cell transplantation
List 3 types of supportive therapy for leucocyte neoplasms.
- Erythropoietin
- Granulocyte colony stimulating factor (G-CSF) (look up when these would be used?)
- Granulocyte macrophage colony stimulating factor (GM-CSF)
This is a description of what type of therapy?
Aim to leave normal cells untouched
E.g.
• Philadelphia chromosome discovered in 1960
• In 2000 an agent that targets the product of the t(9;22)
translocation was developed
• Tyrosine kinase inhibitor, e.g. Imatinib
Targeted therapy
Are most haemopoietic malignancies acquired or inherited?
acquired
What is the difference between Small Lymphocytic Lymphoma (SLL)
and Chronic Lymphocytic Leukaemia (CLL)
Diagnosis based on principal site of involvement
• CLL: Peripheral blood and bone marrow
• SLL : Lymph nodes, other lymphoid organs
What is the term for a blood film where both small and large RBC’s are present?
Dimorphic
