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Flashcards in Lymphoma and Leukemia Deck (27):
1

What is Lymphoma?

Lymphomas represent a diversity of lymphoid malignancies often associated with peripheral lymphoid tissue, specifically the lymph nodes, where they are most likely to originate

2

Common classifications of lymphoma?

Separated in Hodgkin and Non Hodgkin

Otherwise, lymphomas are often classified by the make up of lymphoid cells involved and level of aggression of the malignancy

3

Cardinal Signs of Lymphoma

fever, fatigue and weight loss.

4

Common characteristics of Hodgkin Lymphoma>

Hodgkin lymphoma is characterized by large, atypical cells within the neoplasm know as Reed-Sternberg cells. This type of lymphoma originates in a single node or chain of nodes and will often spread to nodes nearest to its anatomical borders

5

Common characteristics of Non Hodgkin Lymphoma?

Non-Hodgkin Lymphomas, which do not include any Reed-Sternberg cells, are much more unpredictable in identifying their site of origin and pattern of spread. While they often begin in lymph nodes, they have the potential to originate in any lymphoid tissue and spread to any location in the body with relative unpredictability

6

Etiology of Hodgkin?

Risk Factors?

Largely idiopathic, viral etiology suspected

Incidence is bimodal, associated with early adulthood (15-40yrs) and elderly (55yrs+)

autoimmune disease, immunosuppressive drug therapies, herbecides, and close blood relative with disease increase risk

7

Pathology of Hodgkin

Hodgkin Lymphoma is unicentric in origin, beginning in a single lymph node. Subsequent spread is generally to contiguous areas within the lymphatic system. Though rare, the malignancy could potentially spread to anywhere in the body. The spleen is a common site of concern for spread. The disease is characterized by the presence of Reed- Sternberg cells within the neoplasm, though these cells can make up a proportionally smalll number of total make up of the tumor. The morphologically distinct cell is large and has a multinucleated or bilobed nucleus that allows them to be easily identified to provide diagnosis. The disease is typically divided into five subgroups with the most common being “nodular sclerosis” and “mixed cellularity.” The specific subgroup type will affect the pathology, risks and prognosis of the disease.

8

Classic early presentation of Hodgkin Lymphoma

Hodgkin lymphoma tends to first present with painless enlarged nodes, often in the cervical, supraclavicular and mediastinal nodes

9

What are B symptoms?

What do they indicate?

“B symptoms” are indicative of a more advanced form of the disease, often signaling a negative prognosis. These symptoms include weight loss greater then 10%, fever without chills, and drenching night sweats. These symptoms suggest systemic, rather then localized, neoplastic growth.

10

DX and Tx of Hodgkin Lymphoma

Diagnosis requires Reed-Sternberg cells to be present in a biopsy.

Treatment choice is based more on the stage of the disease then on the specific subgroup classification. Radiation is a common treatment for dealing with specific area of malignancy. Chemotherapy for to suppress growth

11

Etiology of Non Hodgkin Lymphoma?

Risk factors?

Largely Idiopathic

Incidence is highest in the elderly population over 50 years. Immune deficiencies and autoimmune diseases increase the risk of developing the disease, as do regular immunosuppressive drug therapies. Chronic infections, and associated high replication of lymphocytes, also increase risk of developing the disease.

12

Where does Non hodgkin lymphoma often originate and how does it spread

Non-Hodgkin Lymphomas often show multicentric origin and are rarely limited to a single location. The most common site of origin is still the lymph nodes, but development in any lymph tissue is possible, and spread in extra nodal tissue is not uncommon

13

What type of lymphocytes does non hodgkin involve?

B lymphocytes

14

What can be predicted with non hodgkin spread?

unpredictable in relation to location of secondary sites and often occurs before major symptom development and diagnosis. The liver, bone marrow, and spleen are locations of concern for spread

15

MNFTS of Non Hodgkin

constitutional symptoms of fever, excess sweating and weight loss. These systemic systems are referred to as “B symptoms” and are present in about 1/3 of cases, signaling a more negative prognosis. Poor humeral antibody response is common as well as an increased susceptibility to infections

16

Dx and TX of Non hodgkin Lymphomas

Diagnosis often comes through a lymph node biopsy. Histology type, stage of the malignancy, and clinical status of patient is important to treatment options.

Radiation and chemotherapy common

Total remission 60-80% of the time

17

What is Hematopoiesis

Process of creating new blood cells

leukocytosis and Erythrocytosis

18

• Pluripotent stem cell gives rise to what two sub groups

o Lymphoid stem cell *(lymphocytic) –T, B, NK
o Myeloid stem cell (myologenous)- RBC, Monocyte, Granulocyte

19

Which cells can develop a malignancy in leukaemia?

Any of these cells- mature or primitive

20

What is the difference between the chronic and acute types?

• Chronic: less aggressive: mature cells
• Acute: Aggressive: immature (blast) cells

21

Other classification ?

(beside chronic and acute)

lymphocytic (lymphocytes)

or

myelogenous (monocytes, granulocyte) leukemieas

22

What is leukaemia and where is it common?

Leukemia (malignancy of blood)
• Proliferation of malignant WBC
• measurable in circulation
• may infiltrate tissues
• most common CA in children and young adults

23

Etiology

Risk Factors

idiopathic

Risk factors
• Genetic predisposition
• Inc in radiation exposure, multiple exposures
• Immunodeficiency, T cell leukemia virus

24

Does it affect normal blood cells

YEs, do to competition for space and resources. Non malignant blood cell production also affected
• Impaired IR
• Dec 02 Supply

25

MNFTS of Leukemia

• Anemia, thrombocytopenia, leukopenia
• Bleeding gums, fever, generalized pain (WHY FEVER LOOK UP)
• Fatigue, weakness, bruising,
• recurrent infection

26

Common Tx for leukemia

Tx
• Radiation
• Chemotherapy
• Induction, intensification, maintenance
• Transfusions
• Antimicrobials
• Colony stimulating (CS) factors
• Marrow transplant

27

Three tx stages of leukemia

induction- give dose to see remission (chemo/radiation)

intensification- increase dose

maintenance- maintain for 2 yrs