HemaMalig1 Flashcards

1
Q

Describe Hematologic malignancies

A

Presence of a CLONAL malignant population of cells derived from a TRANSFORMED CELL that came from the MARROW

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

3 main manners of malignant hematologic manifestation:

A
  1. Leukemia
  2. Lymphoma
  3. Extramedullary myeloid tumor (granulocytic sarcoma)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Leukemia

A

hematopoietic malignancy derived from stem cell or progenity in blood and marrow.
-ie: granulocytic, monocytic, erythroid, megakaryocytic, and mast cell lineages.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Lymphoma

A

hematopoietic malignancy derived from lymphocytes or their precursors
ie: B cell,T cell, and NK cells lineages

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Extramedullary myeloid tumor

A

(aka granulocytic sarcoma) -
hematopoietic malignancy derived from myeloid cells or their precursors which presents primarily as a solid mass.
ie (granulocytes, monocytes, myeloblasts etc.),

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q
What is the difference between Chronic Lymphocytic Leukemia (CLL) + Small 
lymphocytic Lymphoma (SLL) ?
A

They are the same disease, but where the disease is more involved differs
Blood and marrow - CLL
Solid growths → enlarged lymph nodes - SLL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Grade

A

how much has the tumor cells differentiated? - Clinical aggressiveness of a malignancy, growth rate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Difference between High vs Low grade lymphoma

A
High grade Lymphomas: 
- Rapidly enlarging mass
Low grade lymphomas: 
- Mild degree of lymphadenopathy 
- Present for years 
- Incidentally noticed on imaging study
*If you see lymphoma: think hard mass
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Difference between High vs Low grade Leukemia

A

High grade “acute” Leukemia:
- Very high WBC w. replacement of most normal cells in marrow
Low grade “chronic” Leukemia:
- Subtle symptoms
- Incidentally noticed on CBC for different ailment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Why do Hematologic malignancies love chromosomal translocations?

A

Due to natural susceptibility of genome to translocate during normal periods of genomic instability

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Examples of genomic instability leading to lymphomas containing balanced translocations

A
  1. Initial immunoglobulin/T-cell receptor rearrangement during maturation of B cells/T cells
  2. Class recombination and somatic hypermutation process during activation of B cells
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Class recombination

A

aka isotype switching (ie: IgG to IgM)

- Examples of genomic instability leading to lymphomas containing balanced translocations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Somatic hypermutation:

A

immune sys. adapts to new microbe → diversify B cell receptors → respond to new threats
-Examples of genomic instability leading to lymphomas containing balanced translocations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

List 3 viruses known to have oncogenic roles in some cases of lymphoma.

A
  1. Epstein-Barr virus (EBV):
  2. Human T cell leukemia virus-1 (HTLV-1):
  3. Kaposi sarcoma herpesvirus / Human herpesvirus-8 (KSV/HHV-8):
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Epstein-Barr virus (EBV):

A

Causes: Some cases of

  • classical Hodgkin lymphoma
  • Burkitt lymphoma
  • B cell non-Hodgkin lymphomas
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Human T cell leukemia virus-1 (HTLV-1)

A

Causes adult T cell leukemia/lymphoma (ATLL)

17
Q

Kaposi sarcoma herpesvirus / Human herpesvirus-8 (KSV/HHV-8)

A

Causes:
Primary effusion lymphoma
Kaposi sarcoma (cancer common in pts w AIDS)

18
Q

incidences of leukemia and lymphoma in adult populations

A
Age adjusted incidence rates for all ages: (# new cases per population in given time) 
○ #7 - Non-hodgkin lymphoma 
○ #10 - Leukemia 
\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_ 
Age adjusted cancer death for all races: 
○ #6 - Leukemia 
○ #7 - non-Hodgkin lymphoma 
○ #15 - Myeloma
19
Q

incidences of leukemia and lymphoma in childhood populations

A
○ #1 - Leukemia 
37% of all childhood cancers 
(○ #2 - Brain/CNS tumors) 
○ #3 - Lymphoma 
24% of all childhood cancers
20
Q

WHO Multiparameter Classification System of malignancies

A
  1. Microscopic appearance of the malignant cells
  2. Histologic growth patterns of the malignant cells in the marrow, lymph node, or other tissue
  3. Presence or absence of specific cytogenetic findings or molecular findings
  4. Relative amount of malignant cells present in the marrow or blood
  5. Presence or absence of certain cell surface markers, cytoplasmic markers, and/or nuclear markers
21
Q

Current Basic Functional Categories for Hematologic Malignancies

A
  • ACUTE LEUKEMIAS
  • MYELODYSPLASTIC SYNDROME (MDS)
  • MYELOPROLIFERATIVE NEOPLASMS (MPNs)
  • CLASSICAL HODGKIN LYMPHOMA (CHL)
  • NON-HODGKIN LYMPHOMA (NHL)
  • PLASMA CELL NEOPLASMS
22
Q

General overview of: ACUTE LEUKEMIAS

A

Due to the rapid accumulation of immature cells in the marrow → Immature cells replace many of the normal marrow cells → cytopenias (of some marrow lineages)

23
Q

General overview of: MYELODYSPLASTIC SYNDROME (MDS)

A

Neoplastic clonal population→ takes over the marrow →
cant make normal blood cells in one or more myeloid lineages (dysplasia). →
low blood cell counts

24
Q

General overview of: MYELOPROLIFERATIVE NEOPLASMS (MPNs)

A

Neoplastic clonal population → take over marrow →
makes too many normal functioning myeloid cells (in multiple lineages) →
increased blood counts

25
Q

General overview of: CLASSICAL HODGKIN LYMPHOMA (CHL)

A

neoplastic cells derived from B cells

26
Q

General overview of: NON-HODGKIN LYMPHOMA (NHL)

A

malignancy derived from mature lymphocytes (B cells , T cells, or NK cells), excluding CHL or plasma cell neoplasms.

27
Q

General overview of: PLASMA CELL NEOPLASMS

A

Neoplasms derived from plasma cells, including MGUS, plasmacytoma, and multiple myeloma.