Chapter 11- Hodgkin Lymphoma & Myeloid Neoplasms Flashcards Preview

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Flashcards in Chapter 11- Hodgkin Lymphoma & Myeloid Neoplasms Deck (30)
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1

Hodgkin lymphoma (HL)
Pathologic Cells

B cells

2

Hodgkin lymphoma (HL)
Patients

Bimodal age
distribution: young
adults (15-34 years)
and older adults
(>55 years)

3

Hodgkin lymphoma (HL)
Unique Features

More predicable than NHLs,

*Reed-Sternberg cells*, arises from a single node, spreads to nearby nodes in a predicable manner, painless lymphadenopathy, fever,
cachexia, pruritus, anemia.

Radiation is a risk for other cancers, previous EBV infection is associated with 70% of cases

4

Hodgkin lymphoma (HL)
Prognosis

Chemotherapy is very effective at managing HL, nearly all live to see
another 5 years after diagnosis and approximately 50% are cured.

5

Acute myeloid leukemia
(AML)
Pathologic Cells

Immature myeloblasts that lose the ability to differentiate

6

Acute myeloid leukemia
(AML)
Patients

Adults, average age
of Dx. is 50 years

7

Acute myeloid leukemia
(AML)
Unique Features

Aggressive, various mutations stops myeloblast differentiation, myeloblasts replace marrow and suppress hematopoiesis, resembles ALL and AML (pancytopenia),
Auer rods

8

Acute myeloid leukemia
(AML)
Prognosis

Poor prognosis even with Tx. (chemotherapy, stem cell transplant, transfusion), average long-term survival is 15-30%

9

Myelodysplastic syndromes
Pathologic Cells

Myeloid stem cells that retain ability to differentiate

10

Myelodysplastic syndromes
Patients

Older adults,
average age of Dx. is
age 50-70

11

Myelodysplastic syndromes
Unique Features

Marrow is replaced by
myeloblasts that retain
capacity to differentiate,
hematopoiesis is disordered and at least one cytopenia is
found in peripheral blood, up to 40% eventually transform
into AML

12

Myelodysplastic syndromes
Prognosis

Median survival is 9 years after diagnosis, very poor prognosis once transitioned to AML

13

Chronic myeloproliferative
disorders (i-iv)
Patients

Adults & older adults

14

Chronic myeloproliferative
disorders (i-iv)
Unique Features

RBC/granulocyte/platelet
proportions are abnormal with an increase of at least one whole blood cell in circulation, may progress into a spent phase, pancytopenia,
splenomegaly

15

Chronic myeloproliferative
disorders
i. Chronic myelogenous
leukemia (CML)

Pathologic Cells

Myeloid stem cells that retain ability to differentiate

16

Chronic myeloproliferative
disorders
i. Chronic myelogenous
leukemia (CML)

Patients

Adults, most commonly age 30-50

17

Chronic myeloproliferative
disorders
i. Chronic myelogenous
leukemia (CML)

Unique Features

Philadelphia chromosome
t(9,22), severe granulocytosis,
severe extramedullary
hematopoiesis causes pulp of spleen to resemble marrow
with severe splenomegaly,
anemia, 50% enter into
accelerated phase (blast crisis)
resembles ALL

18

Chronic myeloproliferative
disorders
i. Chronic myelogenous
leukemia (CML)

Prognosis

Remission is common with tyrosine
kinase inhibitor medications, 70%
cured with stem cell
transplantation, 3-year survival if transitions into aggressive leukemia (blast crisis)

19

Chronic myeloproliferative
disorders
ii. Polycythemia vera

Pathologic Cells

RBCs, increased
production

20

Chronic myeloproliferative
disorders
ii. Polycythemia vera

Patients

Patients with JAK2
mutations develop
PCV

21

Chronic myeloproliferative
disorders
ii. Polycythemia vera

Unique Features

Itching skin or risk for 30% have thrombotic
complications: stroke, M.I., organ infarction (spleen, kidneys)

22

Chronic myeloproliferative
disorders
ii. Polycythemia vera

Prognosis

PCV: low levels of EPO, patients live 1.5-3 years without medical management, but are expected to live 10-20 years after diagnosis with management

23

Chronic myeloproliferative
disorders
iii. Primary myelofibrosis

Pathologic Cells

Myeloid stem cells that retain ability to differentiate

24

Chronic myeloproliferative
disorders
iii. Primary myelofibrosis

Patients

Adults, > 50 years

25

Chronic myeloproliferative
disorders
iii. Primary myelofibrosis

Unique Features

Anemia, thrombocytopenia,
poikilocytes, severe
extramedullary hematopoiesis,
massive splenomegaly,
diagnoses in the late stages

26

Chronic myeloproliferative
disorders
iii. Primary myelofibrosis

Prognosis

Poor prognosis because it’s commonly diagnosed late: 4-5 years after Dx.

27

Chronic myeloproliferative
disorders
iv. Essential
thrombocythemia

Pathologic Cells

Myeloid stem cells that retain ability to differentiate

28

Chronic myeloproliferative
disorders
iv. Essential
thrombocythemia

Patients

Adults & older adults

29

Chronic myeloproliferative
disorders
iv. Essential
thrombocythemia

Unique Features

Increased platelet production, most are asymptomatic,
splenomegaly, thrombosis or hemorrhage

30

Chronic myeloproliferative
disorders
iv. Essential
thrombocythemia

Prognosis

No impact on lifespan with medical management of thrombocytes