WBC disorders Flashcards by Kwihyun Cho

Lymphomas are ______ proliferations of cells native to lymphoid tissue - Lymphocytes and their precursors and derivatives.

Malignant

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Lymphomas arise in ____ and can spread to ________

Lymphoid tissue

solid tissue, marrow, and blood

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2 Types of Lymphomas are:

Hodgkin

2. Non-Hodgkin

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Leukemias are malignant proliferations of cells native to the ______, which often spillover into the blood

Bone marrow (myeloid and lymphoid)

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Leukemia may spread to _______

Solid tissues (Typically liver and spleen)

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Leukemia can be _____ and ______

Acute, Chronic

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Hodgkin lymphoma has a _____

Distinctive cell type (Reed-sternberg cell)

Contiguous (근접) spread within lymph node group

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Hodgkin lymphoma is often accompanied by ______

Fever, and arises in a SINGLE lymph node or chain of nodes

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Hodgkin lymphoma is more common in ______

young adults (20-30 yrs) and over 50 yrs old

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Hodgkin lymphoma is highly curable in most cases with _______ and ______

Chemotherapy

Radiotherapy

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The cause of HL is unkown, but ______ has been implicated in playing a role

EBV (Epstein-Barr Virus), is seen 70% of the cases

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Reed-Sternberg (RS) cell is a large cell with ______ and _______

Large cell with mirror-image nuclei and prominent nucleoli

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RS cell is the malignant cell of HL, but comprises only ___% of cells in the involved lymph node.

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Origin of RS cell

Germinal center B lymphocyte but remains uncertain

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Staging refers to….

the assessment of the amount of tumor burden and its distribution in the body

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HL staging is..

Predictable (lymph nodes, spleen, liver, and bone marrow)

Staging used to determine treatment and prognosis

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Low Stage of HL denotes….

localized lymph node involvement, with No systemic signs (fever, weight loss) and has a better prognosis

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High stage of HL indicates….

Widespread disease, often with bone marrow involvement, and has a worse prognosis

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Choice of therapy and prognosis are based on ________

STAGE

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Treatment consists of a combination of _______ and _______

Chemotherapy (used more than radio)

Radiotherapy

@ Low stage both are used

@ High stage CHEMOTHERAPY!!

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HL Stage 1

Tumor in one region or 2 contiguous anatomic regions on the SAME side of the diaphragm

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HL stage 2

Tumor in more than 2 anatomic regions or 2 Non-contiguous regions on the same side of the diaphragm

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HL stage 3

Tumor on both sides of the diaphragm not extending beyond lymph nodes, spleen or Waldeyer’s ring (so still within the lymph node)

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HL stage 4

Tumor in bone marrow, lung, etc. Any organ site OUTSIDE of the lymph nodes, spleen or Waldeyer’s ring

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"B" signs/symptoms of HL include:

Fever, night sweats, and significant weight loss

Patients without B sings/symptoms have better | _______

prognosis

Stage 3 and 4 disease more likely to have ______

B symptoms

5 yr survival almost 100% at ___ and ___

Stage 1 and Stage 2A

5 yr survival rate in stage 4 is ____

50%

Non-Hodgkin Lymphomas (NHL) aries in lymphoid tissue - either in ____ or _____

Lymph nodes or lymphoid tissue of solid organs

NHLs have to capcity to spread into ______, _____, _____, and ______

Other nodes, solid organs, bone marrow, and blood.

Over ____ types are currently recognized but only ______ of these subtypes comprise over 90% of the NHLs in the US.

Two dozens, 8 subtypes

Most _____ are of _____ origin and most remainder are _____

85%, B cell T cell

NHL incidence rises steadily after age of ____ and roughly ______ in 2015

40 yrs old, 71,000 cases But it does affect all ages

Unlike HL, NHLs tend to have ________ involvement, more frequent extranodal spread and peripheral blood involvement

Multiple node

A lymphoma develops when there is a _____ expansion of lymphocytes that have been arrested (or have acquired a genetic rearrangement that alters growth regulation)

Monoclonal

In NHLs, ________ occur frequently.

Immune abnormalities

NHLs may involve ______

GI tract, bones, CNS

NHLs are classified on the basis of their _____, _______, ________, and _______

Morphology Cell of origin Clinical features Genotype

_____ disease is better than diffuse | _____ cell disease better than large

Nodular | Small

Low stage of NHL

localized disease

High stage of NHL include ______

Numerous sites of involvement or bone marrow involvement

Stage 1 of NHL

single lymph node region or extralymphatic organ or site

Stage 2 of NHL

2 or more lymph node regions on same side of diaphragm alone or with involvement of contiguous extralymphatic organ or tissue

Stage 3 of NHL

Involves lymph node regions on both sides of diaphragm which may include spleen

Stage 4 of NHL

Multiple or disseminated (퍼진) foci of involvement of one or more extralymphatic organs or tissues with or without lymphatic involvement

Clinical Features and course of NHLs

Usually painless enlarged lymph nodes, or evidence of extranodal spread (enlarged liver or spleen) More common bone marrow involvement than HL Lymphoma cells may circulate in peripheral blood = Leukemic phase

NHLs have complications with....

Infections, anemia, and thrombocytopenia

Leukemias are malignant neoplasms of hematopoietic tissue that arise in the ______

bone marrow

The malignant cells proliferate in the bone marrow, commonly producing a pattern of ________. Often ______ of the proliferating cells into the blood and other organs

diffuse infiltration Spill over

Acute leukemia:

Rapid onset with blasts in the blood Myeloid lymphoid cells affected

Chronic leukemia:

Indolent onset and tends to involve more mature cells Myeloid lymphoid cells affected

Acute Lymphoblastic Leukemia (ALL) has the proliferating cell which is a ________

Primitive lymphoid cell

ALL accounts for about ____% of the acute leukemias

40%

ALL is the most frequent type in children _____ old

under 15 years old

ALL is the principal cause of cancer deaths in childhood, with a peak incidence at age of ______, but it can affect persons of all ages

4 yrs old

ALL has ____ subtypes immunologically

5 (early b pre, pre-B, mature B, and T cell)

________ being the subtype with best prognosis in ALL

Hyperdiploidy (>50 chromosomes per leukemic cell)

In ALL enlargement of _____, _____, and _____ is more common than AML

lymph nodes, liver, spleen

The best prognosis group for ALL is children aged _______ with ______

2-10 with pre-B cell type

Acute myelogenous leukemia (AML) has the proliferating cell which is a...

Primitive myeloid cell

AML has a cytoplasmic inclusions called _______

Auer rods

Out of all subtypes of AML _____ is most predictive of prognosis

The karyotype

AML usually affects an _____ population, with a median age of ____ years

older adult, 50 yrs old

AML can also proliferate in soft tissue including _____, producing ______

gingivae, Granulocytic sarcoma

_______ is the undergoing evaluation and treatment for AML

Bone marrow treatment

The proliferating cell of Chronic Lymphocytic Leukemia (CLL)?

Mature-appearing, but immunologically incompetent, lymphocyte These cells are Monoclonal (derived from same precursor cell)

CLL has more than ___% are B-cell type, and commonly express ______ kappa surface immunoglobulin

95%, IgM

CLL accounts for _____ of chronic leukemias and most common in adults over ____ yrs

2/3 60 yrs old

CLL has a male:female ratio of.....

2:1

CLL can have involvement of...

spleen, liver, and lymph nodes

_______ develops in most patients

hypogammaglobulinemia

Median survival of CLL is ____ yrs

4-6 yrs

Chronic Myelogenous leukemia (CML) has a proliferating cell called

immature hematopoietic cell

with CML, stem cell pool is increased ______

10-20 times normal

CML has all myeloid cell types present esp. ____, ____, and _____

myelocytes, eosinophils, and basophils

CML has a specific chromosomal abnormality called ______

philadelphia chromosome [t(9;22)], occurs in all the proliferating cells

CML has the chromosomal abnormality results in fusion of ______, which mimic the _____

BCR-ABL genes mimic the effects of growth factor activation, driving the proliferation

The fusion gene is not ____ to CML

unique

CML accounts for ____ of chronic leukemias

1/3

CML usually occurs in adults from ______ yrs of age

25-60

The terminal phase of the disease marked by a relative increase in peripheral blood and bone marrow, and decreased response to treatment is known as ______

blast crisis

CML has the stage equivalent to an ____, and is of myeloid lineage in _____ and lymphoid lineage in _____

acute leukemia 2/3 1/3

Initial therapy of CML is with targeted inhibitors of the _______ tyrosine kinase, which induce complete remission in a high % of patients.

BCR-ABL

_____ maybe performed in CML patients, but risky in older patients

Bone marrow transplant

Plasma cell disorders result from...

clonal expansion of immunoglobulin-secreting cells

The secreted immunoglobulin results in increases in _______ and may have adverse effects on ___ and _____ function

serum monoclonal protein (M component) renal, neurologic

Multiple myeloma has a proliferating cell which is a _____

plasma cell that produces immunoglobulin

Only one immunoglobulin type is produce by the neoplastic cells. ____ is IgG, ____ IgA, and remainder it is only ____ or ____ light chain

60% 20-25% kappa or lambda

When only light chains are produced, patients can excrete the low MW light chains in the urine is called....

Bence Jones Proteinuria

______ is often present in multiple myeloma, and _____ may form from the monoclonal protein

Hypercalcemia | Amyloid

Average age of _____ are suffering from multiple myeloma

70 years old

Patients with multiple myeloma often present with _____, ______ and _____

Bone pain, hypercalcemia, and renal disease

As tumor cells proliferate in multiple myeloma, complications with _____, _____, and _____ develop due to destruction of normal marrow by the tumor

recurrent infections, anemia, and thrombocytopenia

WBC disorders Flashcards

(94 cards)