Week 6 Flashcards
AML
acute myeloid leukemia
AML
heterogenous clonal stem cell malignancy where immature hematopoietic cells proliferate uncontrollably
AML results in __
inhibited hematopoiesis seen in neutropenia, anaemia, thrombocytopenia
AML FAB subtype
M0 -7
most common risk factor for AML
radiation
what genetic disorder causes AML
down syndrome
prognositc indicators of AML
age, cytogenetics, molecular genetics
AML chemotherapy
idarubicin
daunorubicin
cytarabine
consolidation with HIDAC
targeted therapy AML
FLT3 inhibitor
CD33 inhibitor
Acute promyelocytic Leukemia have balanced reciprocal translocation between chromosome __
15 & 17
Acute promyelocytic Leukemia is sensitive to __
ATRA, anthracyclines, arsenic trioxide
Acute promyelocytic Leukemia complicated by __
life threatening coagulopathy
Acute Lymphoblastic Leukemia
lymphoid line of blood cell cancers; development of large number of immature lymphocytes
Acute Lymphoblastic Leukemia arises from __
lymphoid progenitor cell sustaining significant multiple genetic damage
Acute Lymphoblastic Leukemia chemotherapy
multiagent chemotherapy
- induction
- consolidation-intensification
- maintenance
Chronic myeloid leukemia
pluripotent hematopoietic stem cell neoplasm
Chronic myeloid leukemia characterized by __
BCR-ABL1 fusion gene from balanced translocation between long arms of chromosome 9 & 22
Chronic lymphocytic leukemia present with __
lymphocytosis
Chronic lymphocytic leukemia present with symptoms such as __
- lymphadenopathy
- splenomegaly
- anemia
- fatigue
- recurring infections
Chronic lymphocytic leukemia diagnosis is confirmed by clonality of __
circulating B lymphocytes confirmed by flow cytometry
GVHD
graft versus host disease
GVHD treatment
- steroids
- MMF/Cellcept
- tacrolimus/cyclosporin
- infliximab
- extracorporeal photopheresis
GVHD occurs after
100 days
areas affected by GVHD
skin, mouth, liver, eyes, lungs, gut, joints
lymph nodes at cervical region
posterior, cervical, pre-auricular, upper cervical, median/lower cervical, supraclavicular
lymph nodes at axillary region
axillary
lymph nodes at epitrochlear
epitrochlear
lymph nodes at mediastinal
paratracheal, mediastinal, hilar, retrocrural
lymph nodes at para-aortic
para-aortic, common iliac, external iliac
lymph nodes at inguinal
inguinal, femoral
lymph nodes at popliteal
popliteal
lymph nodes at mesenteric
celiac, splenic hilar, portal, mesenteric
common lymphoma symptoms
lumps, fatigue, loss of appetite & weight, fever, night sweats
diagnostic work-up & staging of lymphomas
biopsy, imaging, BM aspirate & trephine
BM
bone marrow
diffuse large B cell lymphoma biological prognostic markers
cell of origin, double-hit, molecular subtype
CAR
chimeric antigen receptor
immunotherapy management consists of
monoclonal antibodies, cellular therapy, immunostimulants, CAR
treatment concept
disease factor, patient factor, drug efficacy/toxicity
autologous stem cell transplant
- collection
- processing
- cryopreservation
- chemotherapy
- infusion
CAR T cell therapy
- leukapheresis
- t-cell activation/transduction
- modified T cell expansion
- chemotherapy
- modified T cell infusion
myoblast forms __
granulocytes = eosinophils, basophils, neutrophils
how to differentiate types of cancer
flow cytometry analysis
leukostasis causes ___
high blast count > hyperviscosity > decreased tissue perfusion
leukostasis affects what systems?
CV, pulmonary, GI, CNS
precursor lymphoid neoplasms are __
B & T lymphoblastic leukemia
ALL uses multiagent chemotherapy which causes __
- induction
- consolidation-intensification
- maintenance
what is philadelphia chromosome
reciprocal translocation between chromosome 9 & 22 to create BCR-ABL fusion gene; specific to CML cells
diagnosis of chronic lymphocytic leukemia is done via ___
peripheral blood
stem cell transplant process
preparation > conditioning > stem cell transfusion > engraftment
B cell development process starts & ends from
v-region gene recombination > clonal expansion > somatic hypermutation > selection > close switching > differentiation
areas inside lymph node
geminal centre, mantle zone, marginal zone
hodgkin’s lymphoma is what type
precursor B-lymphoblastic leukemia
low grade lymphomas
slow growing and remains dormant
high grade lymphomas
rapidly growing & aggressive
high grade lymphomas mainly target
brain, eye, spinal cord, intestines
rare place of lymphoma development
brain, eye, skin
burkitt lymphoma
translocation between chromosome 8 with 14
staging of non-hodgkin lymphoma is done via __
ann arbor staging
ann arbor stages are __
stage 1 = single region
stage 2 = 2 or more regions
stage 3 = > 2 regions above & below diaphragm
stage 4 = widespread
diffuse large B cell lymphoma prognostic factors
age, perfusion status, LDH, extranodal site, staging
diffuse large B cell lymphoma biological prognostic markers
cell of origin, double hit translocation, molecular subtypes
Erythrocyte stimulated by
EPO from kidney in response to tissue hypoxia
lifespan of RBCs
120 days
types of leukocytes
monocytes, neutrophils, eosinophils, basophils, lymphocytes
most common leukocytes
neutrophils
leukemias derived from __
immature lymphocytes
lymphomas derived from __
mature lymphocytes
acute vs chronic leukemia
Abrupt onset with marked sign (persistent infection and excessive bleeding) & symptoms vs. insidious onset with mild signs & better prognosis
what diseases causes congestion & enlargment of lymphoid tissue
lymphacenopathy, splenomegaly, hepatomegaly
antacids
alkalize urine to prevent uric acid stone formation
hodgkin lymphoma is characterized by __
large abnormal B cells
hodgkin lymphoma peaks at which stages of life
20 - 30s
60 -70s
hodgkin lymphomas commonly affect ___ lymph nodes
cervical, axillary, inguinal, retroperitoneal
haemophilia A is due to abnormal ___
clotting factor VIII
haemophilia B is due to abnormal ___
clotting factor IX
haemophilia C is due to abnormal ___
clotting factor XI
Diagnostic test for Haemophilia A include
PTT, APTT & coagulation time prolonged
low serum levels of specific clotting factor based on hemophilia type
haemopphilia A treatment
o Desmopressin (DDAVP)
o Replacement therapy for Factor VIII
o Recombinant DNA product (Advate)
o Nplate
desmopressin is used to __
raise clotting factor levels
Nplate is used to stimulate __
platelet production in bone marrow
multiple myeloma management includes ___
curative using bone marrow transplant
symptoms using CRAB relief
CRAB relief stands for __
calcium, renal failure, anemia, bone lesions
most critical test for multiple myeloma is __
bone marrow biopsy
serum protein electrophoresis is used to look for __
IgG M protein
urine protein electrophoresis is used to look for __
bence-jones protein
evidences of end-organ damage include
hypercalcemia, renal insufficiency, anaemia, bone lesions
