EXAM #2: CANCER & HEMATOLOGICAL MALIGNANCY Flashcards Preview

Hematology and Oncology > EXAM #2: CANCER & HEMATOLOGICAL MALIGNANCY > Flashcards

Flashcards in EXAM #2: CANCER & HEMATOLOGICAL MALIGNANCY Deck (48):
1

What is the definition of a Leukemia?

- Unregulated growth of WBCs (leukocytes) in the bone marrow

Note that this can leads to either increases or decreases of WBCs in the peripheral blood AND bone marrow failure i.e. pancytopenia.

2

What is the broad definition of a Lymphoma?

Discrete tumor masses in the lymph nodes

3

What is the difference between a Leukemia and Lymphoma?

Leukemia= neoplasm of the bone marrow

Lymphoma= neoplasm of the lymph nodes

4

What is the general difference between an acute and chronic leukemia?

Acute= will kill within weeks without treatment

Chronic= patient may survive for years without treatment

5

What do the terms myeloid, myelogenous, and myeloproliferative refer to?

Tumors involving the:
- Granulocytes
- RBCs
- Platelets

****And their progenitors*****

6

What do the terms lymphoid, lymphocytic, lymphoblastic, and lymphoproliferative refer to?

Tumors involving the:
- B-cells
- T-cells
- NK-cells

*****And their progenitors*****

7

What are the two types of acute leukemia?

Acute myeloblastic (AML)
Acute lymphoblastic (ALL)

8

What is the root of symptoms for patients with ALL and AML?

Pancytopenia

9

What is the difference between ALL-B and ALL-T?

Cell of origin is B vs. T cell in "Acute Lymphoblastic Leukemia"

10

What is the general feature of all AMLs?

Undifferentiated myeloblasts accumulating in the bone marrow

11

What is the most common acute leukemia in adults?

AML

12

What is the basis for the FAB categorization of AML?

Appearance of cells under microscope

13

What is the basis of the WHO categorization of AML?

Pathology, cytogenetics, and molecular characteristics

14

What are the two types of ALL? Which is more common?

B-ALL* (B-cell)
T-ALL (T-cell)

*****This is the most common type of all ALL cases*****

15

What is the most common acute leukemia in children?

ALL

16

What is the difference between a myeloproliferative neoplasm and AML?

Myloeproliferative neoplasm can lead to AML

17

List the major myeloproliferative neoplasms.

1) Polycythemia vera
2) Essential thrombocytpoenia
3) Primary myelofibrosis

18

What is polycythemia vera?

RBC overproduction i.e. Hct >55%

19

What is the mutation associated with polycythemia vera?

JAK2 mutation

20

What is Essential Thrombocythemia?

Overproduction of megakaryocytes/ abnormal platelets

21

What mutations are associated with Essential Thrombocythemia?

JAK2 or MPL

22

What is Primary Myelofibrosis?

Fibrosis that obliterates the bone marrow and produces atypical megakaryocytes

23

What is the genetic mutation associated with Primary Myelofibrosis?

JAK2 or MPL

24

What is CML?

Overgrowth of granulocytic and megakaryocytic precursors in bone marrow due to BCR-ABL fusion gene

*****Can convert to AML*****

25

What is myelodysplastic syndrome?

Class of stem cell disorders that result in ineffective hematopoiesis; causes defects in cell maturation of all non-lymphoid lineages

*****Can convert to AML*****

26

What viral infection causes the predominance of B-cell Lymphoid malignancies?

EBV

27

What cells is ALL typically derived from?

Immature B-cells

28

In CLL and lymphoma, what is the malignant cell population?

Mature B-cells

29

What is the difference between the locations of malignant cells in CLL and lymphoma?

CLL= blood

Lymphoma= lymph node or other tissues

30

What cells are malignant in myeloma?

Plasma cells

31

What do malignant plasma cells in myeloma produce?

Monoclonal immunoglobulin

32

What is the difference between Hodgkin and Non-Hodgkin Lymphoma?

Presence of absence of Reed-Sternberg cell

33

What are Reed-Sternberg cells, and what are the characteristics of Reed-Sternberg cells?

These are tumor giant cells seen in Hodgkin's Disease. Characteristics include:
- Large size
- 2+ nuclei (bilobed) that give an "OWL EYE" appearance
- Eosinophilic nucleolus
- CD15 and CD30+

34

Describe the progression of Hodgkin Lymphoma.

- Hodgkin Lymphoma is localized to a single group of lymph nodes
- Spread is contiguous and predictable

35

What is the prognosis for Hodgkin Lymphoma?

60-90% cure rate with radiation and chemotherapy i.e. GOOD PROGNOSIS

36

What are the three categories of Non-Hodgkin Lymphoma?

Indolent
Aggressive
V. aggressive

37

What are the characteristics of CLL?

- Increased small round lymphocytes
- Smudge cells

****Smudge cells are fragile cells that break on PBS--causing a smudge*****

38

What the major plasma cell disorders.

- Multiple myeloma
- Plasmacytoma
- Primary Amyloidosis
- MGUS
- POEMS Syndrome
- Waldenstrom Macroglobinemia

39

What is Multiple Myeloma?

Mature B-cell (plasma cell) cancer

40

What PBS features is characteristic of Multiple Myeloma?

Rouleaux formation, which is RBCs stacked like poker chips on PBS

41

What lab features are characteristic of Multiple Myeloma?

Increased immunoglobulin (IgG or IgA) in serum or urine

42

What is a Solitary Plasmacytoma? What lab feature is characteristic of this disease?

This is a plasma cell tumor characterized by a single plasma cell tumor in the bone marrow.

- NO or low immunoglobulin in the blood

43

What is Primary Amyloidosis?

Plasma cells secrete monoclonal light chains

- These are misfolded and form fibril deposits in tissue
- Disrupts organ function

44

What is MGUS?

"Monoclonal Gammopathy of Undetermined Significance"

- This is the ASYMPTOMATIC PRECURSOR of mutiple myeloma see with production of immunoglobulin detected in serum or urine

****Only 1-2% of patients with MGUS progress to Multiple Myeloma per year; hence the "undetermined significance"

45

What lab value is associated with Waldenstrom Macroglobulinemia?

IgM

****Associated with hyperviscosity syndrome*****

46

How is Leukemia diagnosed?

PBS
Bone marrow biopsy

47

What is lymphoma diagnosed?

Lymph node biopsy

48

How are plasma cell neoplasms diagnosed?

Bone marrow biopsy