Hematologic Malignancies

Question 1

Spongy tissue where development of all types of blood cells takes place

Answer 1

bone marrow

Question 2

Bones that have active marrow in adults

Answer 2

vertebrae, hip, shoulders, ribs, breast and skull

Question 3

Cancer of white blood cells. characterized by increased and unregulated growth of myeloid cells in the bone marrow.

Answer 3

Chronic myelogenous leukemia (granulocytic)

Question 4

Clonal bone marrow stem cell disorder

Associated with characteristic chromosomal translocation- Philadelphia (Ph) chromosome

Answer 4

Chronic myelogenous leukemia (granulocytic)

Question 5

the result of a reciprocal translocation between chromosome 9 and 22

Answer 5

philadelphia chromosome

Question 6

result of the translocation is the oncogenic BCR-ABL gene fusion

Answer 6

the mutant tyrosine kinase encoded by the BCR-Abl transcript results in a protein that is “always on” (ie cancer)

Question 7

Therapeutic options for CML that limits growth of tumor cells and decreases risk of blast crisis. Used to induce remission.

Answer 7

Imatinib mesylate (Gleevec)

Question 8

Only known cure for CML

Answer 8

allogenic stem cell transplantation

Question 9

Malignant plasma cell tumor

Answer 9

Plasmacytoma

Question 10

Where are extramedullary plasmacytomas usually found?

Answer 10

upper respiratory trat

Question 11

Main signs and symptoms of multiple myeloma

Answer 11

bone lesions, bone pain, anemia

Question 12

What is the cause of renal dysfunction in late stage multiple myeloma?

Answer 12

amyloid, light chain, or Bence Jones protein deposition in the kidneys

Question 13

Types of multiple myeloma with no anemia, bone lesions, normal calcium and kidney fxns

Answer 13

MGUS and smoldering MM

Question 14

Type of multiple myeloma with anemia, bone lesions, high calcium, or abnormal kidney fxn

Answer 14

active MM

Question 15

What causes bone pain associated with multiple myeloma?

Answer 15

distention of the periosteum by rapidly growing lesion

Question 16

found in serum or urine or both at time of diagnosis in 97% of patients with MM

Answer 16

M protein

Question 17

Cancers with the highest prevalence of metastatic bone disease

Answer 17

breast and prostate cancers

Question 18

primary diagnostic test to detect destructive bony lesions in multiple myeloma

Answer 18

skeletal radiography

Question 19

Clinical features include: fatigue, infection, organomegaly, extranodal infiltrates

Answer 19

CLL

Question 20

Overall median survival of patients with CLL

Answer 20

10 yrs

Question 21

Rai staging of CLL

Answer 21

0- lymphocytosis. 1- lymphocytosis w/lymphadenopathy. 2- lymphocytosis w/hepatomegaly or splenomegaly. 3- lymphocytosis w/anemia. 4- lymphocytosis w/thrombocytopenia

Question 22

What predicts rapid disease progression of early stage disease?

Answer 22

short lymphocyte doubling time

Question 23

Prognosis based on bone marrow histology patterns

Answer 23

diffuse marrow infiltration-poor. nodular pattern-good

Question 24

Intravenous infusion of autologous or allogeneic stem cells. Collected from bone marrow, peripheral blood or umbilical cord blood

Answer 24

Hematopoietic stem cell transplantation

Question 25

Term that describes a graft source from an identical twin

Answer 25

syngeneic

Question 26

CI to autologous transplant

Answer 26

disease of blood or bone marrow

Question 27

From parent, child or sibling. Must have many stem cells to overcome risk of graft rejection. Increased risk of GVHD

Answer 27

Haploidentical Donors

Question 28

Cryopreserved | Small number of stem cells. Higher incidence of engraftment failure. Degree of matching not as stringent

Answer 28

Umbilical cord blood

Question 29

clonal stem cell disorder characterised by increased red cell production

Answer 29

Polycythaemia vera

Question 30

Associated with JAK2 protein mutation

Answer 30

Polycythaemia vera

Question 31

Presentation includes 55-60yrs, vascular complications, hepatosplenomegaly, erythromyalgia

Answer 31

Polycythaemia vera

Question 32

Term for increase skin temp, burning sensation, and redness

Answer 32

erythromyalgia

Question 33

Treatment of Polycythaemia vera

Answer 33

venesection/chemo, low dose aspirin, antihistamines