White Blood Cell Disorders

Myelogenous

neoplastic changes in myeloid cell line

Lymphocytic

neoplastic changes in lymphoid cell line

acute

blocks in precursor hematopoeitic cells

Chronic

block in later stages of maturation and difffernation of hematopoietic cells

hematologic cancers

arise from abnormal cells in hematopoeitic system, vary according to specfic cell line of orgin

Hematopoiesis

formation of blood cellular components

leukemia

malignacies orginating in bone marrow or blood

lymphoma

malgnacies orginin in lympathic tissue

white

Concepts related to disorders of ___ blood cells
Unregulated proliferation

causes

• environmental influence

• genetics

proliferation of malignant cells disrupts production of erythrocytes, neutrophils, thrombocytes

Acute Myelogenous Leukemia (AML)

results from series of genetic mutations in hematoppoietic precursor cells

• proto-oncogenes

• oncogenes

30% of all new cases of leukemia

increased incidence in people 60yrs and older

serious, life threating disease

appears to be associated with damage to DNA

Risk factors

• chemo

• ionizing radiation

• long term exposure to toxins

• smoking

abnormal and immature hematopoietic cells

• accumulate in bone marrow and peripheral blood

• crowd out other hematopoietic cells

pancytopenia

• anemia

• infections

• bleeding

• infilatration of other tissues

Proto-oncogenes

normal genes that stimulate cellular division and proliferation

oncogenes

mutated normal genes that allow cells to proliferate unregulated

pancytopenia

condition charcterized by a decrease in all 3 types of blood cells: RBC, WBC, and platelets

Acute Lymphocytic Leukema (ALL)

12% of all new cases of leukemia

male kids aged 1-10 best prognosis; children have better prognosis than adults

5yr survival rate for kids if 90% and adults is 40%

nongenetic risk factors

• prenatal exposure to x-rays

• postnatal exposure to high doses of radiation

Pahtogenesis

• clonal disease

  • ineffective lymphoid cells

  • overcrowding of bone marrow

  • infiltration of leukemic cells into other organs

often nonspecific early

• fever

• bleeding

• bone pain

• lymphadenopathy (enlarge lymph nodes)

enlarged lymph nodes, CNS involvment (uncommon)

Chronic Myelogenous Leukemia (CML)

primary affects adults (median age at dignosis is 64)

Classifications

• Chronic phase: blast cells <10%

• Accelerated phase: blast cells 10-19%

• Blastic phase: blast cells >20%

causes

• 9;22 translocation (Philadephia chromosome)

Clinical manifesations

• asymtomatic at dignosis

• depend on degree of overproduction of myeloid cell s

  • infection related to neutropenia

  • weakness and fatigue related to anemia

  • bleeding related to thrombocytopenia

  • others: excessive sweating or night sweats, splenomegaly, gouty arthritis

Dignosis

• identificaiton of ___ phase

• poor prognostic indicators

  • older age

  • symptoms present at dignosis

  • signficant weight loss

  • hepatomegaly, splenomegaly

Chronic Lymphocytic Leukemia (CLL)

most common type of leukemia

primarily disease of older adults

• increased incidence in people over 50

Rai system of classification

• Rai stage 0-IV

Clinical Manifesations

• acculmulation of lymphocytes in lymphatic tissue

• lymphadenopathy, splenomegaly, and/or hepatomegaly

Other Sytmpoms

• fever, night sweats, unintional weight loss, fatique, other findings

Multiple Myeoloma

proliferation of malignant plasma cells

occurs primarly in people over 60 and 2x more in blacks

risk factors

• toxin and hazardous chem exposure

• obesity

• genetics

Clinical Manifesations

• anemia, pain, patholgic fracturs, hypercalcemia, renal insufficency or failure

OFTEN attack bone matrix so you see bone fractures a lot in people with this disease

Leukocytosis

Medical term for having a higher-than-normal number of white blood cells in your blood

types of blood cancer can change WBC counts

Non-Hodgkin Lymphoma (NHL)

heterogenous group of malignacies

origante in lymphatic system

common in US

• 5th most common cancer in M and 5th in F

exact cause is unknown

Risk factors

• weakend immune system

• viral infections

• Helicobacter Pylori (common stomach infection caused by germ called Helicobacter pylori, H.Pylori)

• environmental factors

Pathogenesis

• genetic mutations and solid tumors

T cells associated with them

Hodgkin Lymphoma (HL)

specialized form of lymphoma

high cure rate

Classification System

• Cotswolds modifcation of ANn Arbor Stafing System

• HL subtypes

  • Differentiated by morphology and phenotypic anaylsis of Hodgkind Reed- Sternberg (HRS) cells (HRS cells are usually large and have 2 or more nuclei or single large nucleus)

stage I-IV

cause is unknonw

Risk factos

• familial facotrs, viral exposure, immune suppression

Pathogenesis

• neoplastic process associated most commonly with B lymphocytes

  • specific cell is Reed sternberg cell

clinical manifesations

• enlarged lymph nodes (typically in neck)

• spenomegaly

• hepatomegaly

• fevers, night sweats, fatigue, weight loss, alcool induced pain, pruritus (irrating senseatin on skin)