Haematological Malignancies

Question 1

What are the two types of haematological malignancies?

Answer 1

Lymphoid malignancies

Myeloid Malignancies

Question 2

What % of T cells are in blood?

Answer 2

70-85%

Question 3

What % of B cells are in blood?

Answer 3

15-30%

Question 4

What is contained in the Lymph node structure?

Answer 4

1 and 2 follicles

Germinal centres

Mantle zone

Interfollicular zone

Question 5

What is the WHO classification of Lymphoid Neoplasms?

Answer 5

Precurser Lymphoid Neoplasms
Mature B-cell neoplasms (85% of cases)
        - Chronic B cell leukaemia
        - Non-hodgkin lymphoma
        - Plasma cell neoplasms
Mature T- and natural killer cell neoplasms
         - Chronic T cell and NK cell leukaemias
         - Non-Hodgkin lymphoma
          - Hodgkin Lymphoma

Question 6

Name a type of lymphoblast malignancy?

Answer 6

Lymphoblastic leukaemia

Question 7

Name a type of Mature B-cell malignancy?

Answer 7

Chronic lymphocytic leukaemia

Question 8

What is a type of lymphoma?

Answer 8

Follicular Lymphoma
Burkitt lymphoma
Diffuse large B cell
Hodgkin lymphoma

Question 9

What is a type of End-stage B-cell malignancy?

Answer 9

Multiple myeloma

Question 10

Broadly, what is precurser lymphoid Leukaemia?

Answer 10

Neoplastic proliferation of precurser cells committed to B or T lymphoid lineage

Question 11

What sort of cell does precurser lymphoid leukaemia occur in?

Answer 11

Somatic mutation in progenitor cell

Question 12

What are the symptoms of precurser lymphoid leukaemia?

Answer 12

Bone Marrow failure - anaemia, infection, bleed

Organ infiltration: lymph nodes, spleen, liver, thymus

Question 13

How is precurser lymphoid leumaemia diagnosed?

Answer 13

Blood and bone marrow examination

Question 14

What is prognosis for adults and children with PLL?

Answer 14

Child = good
Adult = poor

Question 15

What is the primary example of precurser lymphoid leukaemia?

Answer 15

Lymphoblastic Leukaemia

Question 16

What is the morphology for LL?

Answer 16

Immature cells
Fine chromatin
Nucleolus, variable amounts of cytoplasm

Question 17

What cell type does LL effect?

Answer 17

B and T

Question 18

What is the B phenotype for LL cells?

Answer 18

CD10, CD19, cCD79a, TdT

Question 19

What is the T phenotype for LL cells?

Answer 19

CD2, 3, 7, (CD4/8), TdT

Question 20

What is the cytogenetics for lymphoblastic leukaemia?

Answer 20

Hyperdiploidy; t(9, 22); t(12;21); t(1;19); t(4;11)

Can involve Ig or TCR genes

Question 21

What cytogenetic make up is most common in babies?

Answer 21

t(4;11)

Question 22

What is the most common cytogenetic makeup in adults?

Answer 22

t(9;22)

Question 23

What is greatest survival chance cytogenetic makeup?

Answer 23

t(12;21) hyperdiploidy good prognosis, frequent in children

Question 24

What is worst survival prognosis?

Answer 24

t(9,22)

Question 25

What are some examples of Mature B celll neoplasms?

Answer 25

``` Chronic lymphocytic leukaemia Non hodgkin lymphoma - Follicular lymphoma - Burkitt lymphoma - Diffuse large B cell lymphoma Hodgkin Lymphoma End Stage B cell: Multiple myeloma ```

Question 26

What is chronic lymphocytic leukaemia?

Answer 26

Mature B cell neoplasm | Neoplastic proliferation of mature B lymphoid cells

Question 27

What is chronic lymphocytic leukaemias symptoms?

Answer 27

Lymphadenopathy | Infections

Question 28

What age group is effected by CLL?

Answer 28

Adults and elderly

Question 29

What is morphology of CLL?

Answer 29

Small, mautre lymphocytosis with smear cells Minimal cytoplasm Condensed chromatin

Question 30

What is CLL immunophenotype?

Answer 30

CD19, CD23, kfk, CD5