Hematologic part 2 Flashcards
What is the difference between acute myeloid leukemia and chronic myeloid leukemia?
Instead of having a blast issue, there’s a Philadelphia chromosome section missing.
Explain the Philadelphia chromosome issue with Chronic Myeloid Leukemia or CML.
The section known as Philadelphia chromosome will be missing from #22 and put on #9 - and fused to crease rapid division of leukocytes or wbcs due to an abnormal protein that was formed.
What is the name of the protein that causes wbc division in Chronic myeloid leukemia?
tyrosine kinase protein
What portion of the #22 was taken?
Where was it put specifically?
BCR - breakpoint cluster
It was put on the ABL viral of #9.
Who does CML typically happen to?
Its uncommon in people younger than 20, so usually older. Like 67 old.
What are the phases of Chronic Myeloid Leukemia?
Chronic > Transformation > Acute form
What is chronic CML like?
Very few symptoms. Very subtle.
What is the transformation phase of CML?
What might they start to notice sypmtom wise?
It’s when the chronic form of the myeloid leukemia is transforming into the acute form.
Symptoms of bone pain, fevers, and weight loss.
What is the Acute phase of CML?
Since they are in this phase, what are they likely to die from?
Well at this point the CML is no longer chronic. It’s transformed into AML and they are at a blast crisis.
They can die from bleeding and infection due to the Pancytopenia.
When the CML is still in the chronic phase, what are the treatment options?
Gleevec
Add on another dose of the Gleevec
Add another inhibitor
Bone marrow transplant (BMT)
What does Gleevec do to stop the CML?
Inhibits the tyrosine kinase protein that started the leukocyte issue by blocking the signal to divide.
What do patients need to avoid when taking Gleevec so that they don’t ruin absorption?
Antacids
Grapefruit juice
What is treatment like for CML that phases into the AML?
Follow treatment for AML.
Induction > Consolidation, BMT.
You are giving your CML patient Gleevec PO. What do you need to before opening the medication?
Gloves to protect yourself.
How long does a patient have to be in remission for to be considered cured?
At least 5 years
During remission, what do patients need to do?
Continue to do check ups.
Does everyone qualify for BMT?
Nope.
Should probably be under the age of 65 and otherwise healthy. But, it’s not a hard rule.
What is Acute Lymphocytic Leukemia?
Proliferation or replication of immature lymphoid stem cells that we call lymphoblasts which causes the pancytopenia.
What age will we not see Acute Lymphocytic Leukemia in?
We won’t see ALL in middle aged adults. It is common in those under 15 and also common in those above 50.
When we say the Acute Lymphocytic Leukemia causes pancytopenia, what are we referring to?
The ALL impedes on the growth of our myeloid cells like rbcs, wbcs, and platelets.
What do patients with pancytopenia look like again?
Anemic, bruising, petechiae, cold. - remember they are at a bleeding risk fyi.
In Acute lymphocytic leukemia, where do we generally see it travel to?
Where else will it go?
Liver & Spleen
Bones
CNS
We generally don’t see infiltration of leukemia cells into other organs and areas of the body with Acute Lymphocytic Leukemia.
True or false?
False.
ALL infiltration into other organs is the most common.
When you assess a patient and are trying to discover if there’s any infiltration of the liver, spleen, bones, etc. What will you be looking for?
Liver/spleen infiltration may have tenderness and rebound pain
Bone pain which may be mistaken for just being old.
