WBC disorders Flashcards
(32 cards)
Which leukemia is the most common cancer in children?
ALL (ages 3-7)
What are the features of all acute leukemias (ALL, AML)?
Sx of platelet problems (gingival bleeding, epistaxis, menorrhagia)
Sx of neutropenia (predisposed to infection)
Sx of anemia, thrombocytopenia, CN palsies, rash
What are the sx specific to younger patients (childhood to young adult) with acute leukemias?
fatigue, fever, lethargy, HA
bone/joint pain specific to sternum, tibia, femur
How do older patients present with acute leukemias?
Slow and progressive onset
lethargy, anorexia, dyspnea
With which acute leukemia do you find lymphadenopathy and hepatosplenomegaly?
ALL
What is a characteristic diagnostic finding of AML and ALL?
Increased WBCs; panycytopenia w/ blast cells
Bone marrow bx has blast cells
ALL: terminal deoxynucleotidyl
AML: Auer rods
How do you treat acute leukemias?
induction chemo with consolidation therapy (destroys leukemic cells)
2nd line: allogeneic bone marrow transplant
Which leukemia is the most prevalent?
CLL - malignancy of b lymphocytes
more common in males
What are the symptoms of CML?
Triphasic; gradual
Chronic: asymptomatic, may develop fatigue, anorexia, wt loss, fever, excess sweating
Accelerated: splenomegaly causes abd fullness, sx progress w/ bone pain and bruising
Acute “blast crisis”: very pronounced sx
Rarely may get blurred vision, resp distress, priapism
What is a pathognomonic dx of CML?
CBC shows leukocytosis
Also, 95% have Philadelphia chromosome mutation
Bone marrow bx shows left shift
How will you treat CML?
Allogeneic bone marrow transplant is curative!
Imatinib mesylate (Gleevec) for chronic phase
What is the outcome of CML?
80% survive
What are the symptoms of CLL?
indolent (painless)
peripheral lymphocytosis w/ invasion of bone marrow, liver, spleen, and lymph
recurrent infections, splenomegaly, lymphadenopathy
What is diagnostic of CLL?
CBC shows isolated lymphocytosis, leukocytosis
Periph smear shows smudge cells
Bone marrow bx has left shift
How do you treat CLL?
Mostly palliative care; resistant to tx
Can give chlorambucil PO or fludarabine IV
What is the outcome of CLL?
Median survival is 6 years :(
In what population will you find Hodgkin lymphoma?
Ages 15-45 or over age 50
History of EBV (1/2 of cases)
What are the symptoms of Hodgkin lymphoma?
painless cervical, supraclavic, and mediastinal lymphadenopathy
possible pain in node after ETOH
A sx: no constitutional sx
B sx: fever, wt loss, night sweats, pruritis, fatigue
How are you going to dx Hodgkin lymphoma?
- r/o other reasons for lymphadenopathy
- lymph node bx
What will you see in the lymph node bx for Hodgkin’s lymphoma?
Reed-Sternberg cells (look like owl eyes)
How do you treat Hodgkin lymphoma?
Combination chemo
initial tx: radiation therapy
ABVD chemo
Who gets Non-Hodgkin lymphoma?
Ages 20-40y
Risk with HIV, immudeficiency
What are the 2 types of Non-Hodgkins lymphomas?
indolent (usually progress to…)
agressive
What are the sx of non-hodgkins lymphoma?
isolated, painless lymphadenopathy, bone marrow may be involved
may migrate to extralymphatic sites
Burkitt lymphoma comes w/ abd fullness
less likely to have “B” sx
