White blood cell disorders Flashcards
What 2 cells form after the first differentiation of the multipoint haemotopoietic stem cell
- Common Myeloid progenitor
- Common lymphoid progenitor
What are the 2 types of leukocyte
granular and agranular
Name the agranular leukocytes
lymphocytes
Monocytes
Name the granular leukocytes
Basophil
Neutrophil
Eosinophil
What is leukocytosis and what can cause it
Increased WBCs
- increased production - leukaemia, myeloproliferative diseases
- reactive leukocytosis - 2ry to infection or inflammation
What is Leukopenia and what can cause it
Decreased WBCs
- 2ry to aplastic anaemia
- cyclic neutropenia
- drugs - chemotherapy
- overwhelming bacterial/viral infections (HIV)
- Radiation - 2ry to radiotherapy
What is leukaemia and describe it in its acute form
- Malignant proliferation of WBCs
- Proliferation of immature blast cells in blood and bone marrow
- Reduction in number of normal, mature RBCs and platelets
- Acute lymphoblastic leukaemia (lymphoblasts) = ALL
- Acute myeloid leukaemia (myeloblasts) - AML
Describe the chronic form of leukaemia
- Proliferation of mature cells
- Progresses slowly allowing the bone marrow to keep producing more mature functional cells
- Often asymptomatic
- Chronic lymphocytic leukaemia (lymphocytes) - CLL
- Chronic myeloid leukaemia (myelocytes) = CML
Who is more likely to get Acute lymphoblastic leukaemia (ALL) and who has a poor prognosis
- More common in children
- Poor prognosis in adults
Who is more likely to get Acute myeloid leukaemia (AML) and who has a poor prognosis
- More common in adults
* Poor prognosis in both adults and children
Who is more likely to get CLL and CML
Both forms more common in adults
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CML may progress to acute leukaemia
What are the clinical presentations of acute leukaemias
- Short history of feeling unwell
- May present with neutropenia (susceptible to infections), fever, bleeding tendencies, bruising, anaemia
- Organ infiltration may occur: skin, gums, testes, meninges
- Blood film: leucocytosis ~ circulating blasts and cytopenias
What are the clinical presentations of chronic leukaemias
- Often diagnosed incidentally
- Usually long history of non-specific symptoms
- Splenomegaly is common
- Lymphadenopathy is common in CLL
- Blood film: leucocytosis ~ circulating mature lymphocytes or myeloid cells
What are the dental signs and symptoms of decreased RBCs
- Fatigue
- Pallor
- Inability to perform routine daily activities
What are the dental signs and symptoms of decreased platelets
- Mucosal bleeding
- Petechiae
- Easy bruising and bleeding
What are the dental signs and symptoms of decreased mature, normal, functioning WBCs
- Increased susceptibility to infections
- Poor wound healing
What are the dental signs and symptoms of increased immature, abnormal, dysfunctional WBCs, infiltrating organs
- lymphadenopathy
- gingival enlargement
- abdominal fullness due to enlarged spleen/liver
What are the adjunct supportive therapies that are used to compensate for lack of functioning cell lines in leukaemias
- Red cell transfusion
- Platelet transfusion
- GCSF (granulocyte colony stimulating factor)
What specific treatments are there for leukaemia
- chemotherapy - cytotoxic drugs
- radiotherapy
- targeted therapy
- stem cell transplantation
What are lymphomas and what types are there
These are solid tumours caused by malignant proliferation of the lymphocytes within nodal and extra nodal sites
- Hodgkin’s
- Non-Hodgkin’s
What is hodgkin’s lymphoma caused by and what risk factors are there
B-cell dysfunction resulting in the accumulation of abnormal B cells
• Bimodal age distribution–early 20s and>70
• M>F
• Immunocompromised - HIV/AIDS, chemo- & radio-therapy
• Previous history of infectious mononucleosis
• Positive family history
What are the clinical features of hodgkin’s lymphoma
- Progressive, painless enlargement of lymph nodes esp in neck
- Fatigue
- night sweats
- fever
- anorexia
- weight loss
- bone pain
- jaundice (when disease spreads to liver)
- shortness of breath (when disease spreads to lungs)
- pruritus
- flu-like symptoms
What special investigations are used for hodgkin’s lymphoma
- lymph node biopsy - reed-sternberg cells
- FBC radiographs, CT/MRI and PET scans
