Introduction to Haematological Malignancies Flashcards
(45 cards)
What is a malignancy?
- presence of cancerous cells or tumors that have the potential to spread to other parts of the body.
What causes Haemopoiesis
Rapidly dividing cells more prone to cytogenetic abnormalities (mutations) during division.
Ionising radiation
Chemicals/drugs
Genetics
Viruses
Consequences of acquired mutations
- Abnormal Maturations
- Uncontrolled proliferation and abnormal maturation
- Uncontrolled proliferation: Increased cellular division and reduced cell death
Consequences of uncontrolled proliferation
- Malignant cells crowd out the bone marrow
- Normal cells cant compete for space of nutrients
- Reduction in production of normal cells
- Malignant cells spill out into the peripheral circulation but they are functionally incompetent.
Common features of Anemia
Lethargy
Pallor
Common features of Leucopenia
Infections
Common features of thrombocytopenia
- Easy bruising
- Bleeding
Secondary symptoms of hematological malignancies
Splenomegaly
Bone pain (myeloma)
Weight loss
Extramedullary haemopoiesis
Night sweats
What kind of proliferation causes acute leukemia?
Haemopoietic stem cell with abnormal clones causes proliferation with minimal or no differentiation.
What kind of proliferation causes Myelodysplastic Syndromes?
Haemopoietic stem cell with abnormal clones causes proliferation with abnormal differentiation
What kind of proliferation causes Myeloproliferative Disorder?
Haemopoietic stem cell with abnormal clones causes proliferation with differentiation
Myeloproliferative Neoplasms
Caused by clonal proliferation of haemopoietic cells leading to excess production of one or more cell lines.
Examples of Myleoproliferative Neoplasms (MPs)
Polycythaemia vera (PV)
Essential thrombocythemia (ET)
Primary myelofibrosis
What can MPs turn into
these disroders are closely related to each other sharing clinical/ morphological/ ,olecular features
can transform into each other - e,g JAK2 mutations or can transform into acute myeloid leukemia
Myelodysplasia / Myelodysplastic Syndrome (MDS)
Clonal disorder of haemopoetic stem cells characterised by production of abnormal cells (dysplasia)
Low incidence ( 2-12 cases per 100000) each year
patients are usually > 60 years old at diagnosis
Numerous subtypes
Myelodysplasia / Myelodysplastic Syndrome (MDS) - clinical pathogenesis
Bone marrow is hypercellular
- blood shows pancytopenia due to disturbed maturation and inability to replace the cells
- Retarded maturation and cell death in bone marrow causes ineffective cell production
What is panytopenia
reduction in the number of all three major types of blood cells (RBC, WBC, Platelets)
Myelodysplasia / Myelodysplastic Syndrome (MDS) - Diagnosis
Via microscopy and mrophology
Leukemia
characterised by the abnormal proliferation of haemopoeitic cells that progressively infiltrate the bone marrow and lymphatic tissues compromising the production of normal blood cells.
accounts for 4% of deaths from malignant disease
Initial classification of leukaemia - Difference between myeloid and lymphoid
Myeloid: originates in the myeloid cells (precursors to main blood cells) except lymphocytes
Lymphoid : originates in the lymphoid cells, which are precursors to lymphocytes. Affects lymphoblast’s and lymphocytes
Initial classification of leukaemia - Chronic or acute
Chronic Leukaemia - progress slowly over time (months to years) with the cells produced by the bone marrow being partially mature with improper function causing the accumulation of dysfunctional cells in the blood stream.
Acute Leukemia - rapid progression ( weeks to months) with immature abnormal cells (blasts) multiplying quickly and crowding out healthy cells in the bone marrow causing a rapid onset of symptoms.
acute leukaemia: AML
acute myeloid leukemia (AML).
More common in adults w- peak incidence at 60+ years
Causes majority of adult leukemia
Acute Leukaemia - ALL
More common in children
Peak incidence of 3 years of age for B-ALL
15-20 years of age for T-ALL
Chronic Leukemia - CML
Chronic Myeloid Leukaemia
Peak incidence of 50-60 years of age
Chronic phase -> accelerated phase -> Blast crisis
