Chronic Myelogenous Leukemia (Ch. 9) Flashcards
(22 cards)
What is Leukemia?
cancer in blood cells produced in the bone marrow
What is Chronic myelogenous leukemia (CML)?
proliferation of the granulocytic cell line w/o losing their capacity to differentiate but are NOT functional
What are the 3 other myeloproliferative disorders?
- polycythemia vera
- myelofibrosis
- thrombocytopenia
What is polycythemia vera? What can it cause?
increase in RBC numbers
- Can affect BP, can cause blockages = stroke or MI
- Can cause splenomegaly
What is idiopathic myelofibrosis? What can it cause?
marrow replaced w/ scar tissue, extramedullary hematopoiesis, anemia, splenomegaly
- Can lead to less cells of the blood circulating
What is thrombocythemia? What can it cause?
overproduction of platelets
- high risk of clotting
What are the symptoms of blast crisis?
- fatigue
- fever
- splenomegaly
What is a risk factor for CML?
radiation exposure
Signs and Symptoms of CML?
- fevers
- unexplained weight loss
- night sweats
- fatigue
- LUQ pain/discomfort
- abdominal fullness (related to enlarged spleen)
- sternal tenderness (marrow overexpansion)
What is the Philadelphia chromosome?
translocation from chr9 to chr22 = fusion gene BCR-ABL1
What is the pathology of the Philadelphia chromosome?
unregulated tyrosine kinase activity = unregulated cell division
What are the 3 disease phases of CML?
chronic (<10% blast cells) | accelerated (10-19% blast cells) | blast crisis (<20% blast cells)
What is the pathophysiology of CML?
overproduction of blast granulocytes in BM = no room for healthy blood cells in BM = decrease in circulating healthy blood cells
What are the 7 diagnostic tools used to determine CML?
- physical exam
- CBC
- blood smear
- BM biopsy
- FISH
- karyotype
- PCR
What are the X treatment options for CML?
- Gleevec
- allogenic transplant
- CRISPR
- hydroxyurea
What is Gleevec and its mechanism
tyrosine kinase inhibitor = Gleevec binds to ATP site = inhibits tyrosine kinase from being activated
What causes tyrosine kinase inhibitor resistance?
GDPD3 (plays a role in lipid biogenesis)
How does hydroxyurea help relieve CML?
disrupting growth of cancer cells
What is the median survival time of affected CML individuals from onset of sxs?
4 years
Which disease phase presents similarly to acute leukemia?
blast crisis
What are MNPs?
myeloproliferative neoplasms = myelocytes tumor cells receiving their own signal to replicate
What are 2 issues with MNPs?
- Stealing resources and energy
- Can cause blockage or structural issue depending on site of neoplasm
