Leukemias & Lymphomas

Flashcards covering key concepts, definitions, and distinctions relevant to leukemias and lymphomas as outlined in the lecture notes.

What is the translocation associated with Burkitt lymphoma?

t(8;14) which leads to c-myc activation.

What happens when genes are translocated next to the Ig heavy-chain genes in Burkitt lymphoma?

They become overexpressed.

What is the effect of the t(11;14) translocation?

It activates cyclin D1, driving the G1 to S phase transition.

What type of lymphoma is associated with t(11;18)?

Marginal zone lymphoma.

What is the significance of t(14;18)?

It causes BCL-2 activation, which inhibits apoptosis.

What gene is associated with acute promyelocytic leukemia (APL)?

PML-RARA fusion gene.

What chromosome abnormality is known as the Philadelphia chromosome?

t(9;22) associated with CML and ALL.

Which markers are indicative of the lymphoid lineage?

CD3, CD4, CD8, CD19, CD20, CD56, TdT.

What does TdT indicate in a lymphoblast?

It marks a TdT+ lymphoblast seen in B-ALL and T-ALL.

Which marker indicates a malignant T-cell?

CD3.

What is a Sézary cell?

Malignant Helper T-cell associated with MF/Sézary syndrome.

What does a malignant B-cell indicate in terms of disease?

Associated with ALL, CLL/SLL, FL, DLBCL, BL, MCL, MZL.

Which marker is present on mature B-cells?

CD20.

What cellular lineage is indicated by CD33?

Myeloblast lineage.

What type of leukemia is associated with the presence of Auer rods?

Acute Myeloid Leukemia (AML).

What abnormal cell types are involved in CML?

Myeloblasts and CD33⁺ blasts.

Which marker is indicative of a myeloblast?

MPO (myeloperoxidase) positive.

What is the difference between Chronic Lymphoblastic Leukemia (CLL) and Small Lymphocytic Lymphoma (SLL)?

CLL primarily involves the blood; SLL primarily involves the lymph nodes.

What is the most common adult leukemia?

Chronic Lymphoblastic Leukemia (CLL).

What age group is typically affected by CLL?

Patients over 60 years old.

What is a common presenting symptom of CLL?

Asymptomatic with lymphadenopathy.

What is the appearance of smudge cells in CLL related to?

Fragile cell structure in leukemic B-cells.

What kind of treatment is commonly used for CLL?

Rituximab, Ibrutinib, Venetoclax.

What are the 'B symptoms' of Hodgkin lymphoma?

Unexplained fever, drenching night sweats, unexplained weight loss.

What defines Reed-Sternberg cells in Hodgkin lymphoma?

They are CD15+ and CD30+.

What pattern of lymph node involvement is typical in Hodgkin lymphoma?

Contiguous spread from one group of nodes to the next.

Which viral infection is commonly associated with Hodgkin lymphoma?

Epstein-Barr Virus (EBV).

What kind of Hodgkin lymphoma involves Lacunar cells?

Nodular Sclerosis Hodgkin lymphoma.

What is the most common subtype of Hodgkin lymphoma?

Nodular Sclerosis.

What distinguishes Non-Hodgkin lymphoma (NHL) from Hodgkin lymphoma?

NHL typically involves extranodal spread and is non-contiguous.

What are the general presentations of low-grade non-Hodgkin lymphomas?

Painless lymphadenopathy and constitutional symptoms.

What age does Burkitt lymphoma typically affect?

Adolescents or young adults.

What is the characteristic histology seen in Burkitt lymphoma?

Starry sky appearance.

What translocation is associated with Burkitt lymphoma?

t(8;14), which disrupts c-myc regulation.

What type of multiple myeloma is characterized by bone pain and systemic symptoms?

Plasma cell neoplasm.

What acronym summarizes the common symptoms of multiple myeloma?

CRAB: hyperCalcemia, Renal failure, Anemia, and lytic Bone lesions.

What is the diagnostic criteria for multiple myeloma regarding plasma cells?

30% plasma cells in the bone marrow.

What characterizes the urine of patients with multiple myeloma?

Presence of Bence-Jones proteins.

What conditions can lead to secondary polycythemia?

Chronic lung disease, renal tumors, and high altitude.

What mutation is commonly seen in Polycythemia Vera?

JAK2 mutation.

What is the primary effect of the JAK2 mutation in Polycythemia Vera?

Increased erythropoiesis regardless of erythropoietin levels.

What distinguishes primary myelofibrosis from essential thrombocythemia?

Primary myelofibrosis is associated with significant marrow fibrosis.

What are typical findings in the blood smear of primary myelofibrosis?

Tear drop cells (dacrocytes).

What does a high platelet count in Essential Thrombocythemia lead to?

Thrombotic events such as Budd-Chiari syndrome.

Which hematological malignancy is characterized by 'flower cells'?

Adult T-cell leukemia/lymphoma.

In which population is adult T-cell leukemia/lymphoma most commonly found?

In areas endemic to HTLV-1, such as Southern Japan.

What are the key features of Mycosis Fungoides?

Progression from patches to plaques to tumors.

What laboratory finding indicates Sézary syndrome?

Involvement of peripheral blood with neoplastic T-cells.

What is the primary treatment modality for acute promyelocytic leukemia (APL)?

All-trans retinoic acid (ATRA).

What is the typical prognosis for patients with acute promyelocytic leukemia?

Very favorable when treated with ATRA.

What features distinguish acute lymphoblastic leukemia (ALL) in children?

Lymphoblasts infiltrate tissues, causing lymphadenopathy and hepatosplenomegaly.

What is the key diagnostic marker for Lymphoblasts in ALL?

TdT positive.

What is the significance of the CD10 marker in B-ALL?

It indicates pre-B cell differentiation.

What are the common genetic aberrations in acute lymphoblastic leukemia?

t(12;21) for good prognosis, t(9;22) for poor prognosis.

What are the constitutional symptoms of lymphoma?

B-symptoms: fever, night sweats, and weight loss.

What is the most common form of Non-Hodgkin lymphoma in adults?

Diffuse large B-cell lymphoma.

What differentiates the chronic phase of CML?

Characterized by massive leukocytosis (>100,000 WBCs).

What is the most common cytogenetic abnormality in Chronic Myelogenous Leukemia (CML)?

BCR-ABL fusion gene due to t(9;22).

What treatment is used for chronic myeloid leukemia targeting the BCR-ABL fusion?

Imatinib (Gleevec).

What distinguishes the accelerated phase of CML?

Basophilia ≥20% and blasts are 10-19%.

What is the risk associated with Myelodysplastic Syndromes (MDS)?

Increased risk for transformation to AML.

What laboratory finding is characteristic of acute myeloid leukemia?

Presence of >20% blasts in bone marrow or blood.

What are early symptoms of all leukemias?

Fatigue, frequent infections, and easy bruising.

What type of leukemia typically presents with leukemoid reactions?

CML, characterized by low LAP scores.

What might elevate the risk of chromosomal abnormalities leading to AML?

Previous genotoxic therapy or radiation exposure.

What condition is characterized by increased blood viscosity and hyperviscosity symptoms?

Polycythemia Vera (PCV).

What can be a presentable symptom after hot showers in PCV patients?

Pruritus due to basophil histamine release.

What is the role of Arsenic Trioxide in treating APL?

Degrades PML-RARα and kills residual leukemic cells.

What is the main evaluation method for B-cell neoplasms?

Flow cytometry with CD markers for lineage identification.

What cell type shows the 'starry sky' appearance in pathology?

Burkitt lymphoma.

Which leukemia is primarily seen in older adults and is often asymptomatic?

Chronic lymphocytic leukemia (CLL).

What is a key clinical finding in myelofibrosis?

Massive splenomegaly.

What type of staining is used to identify myeloblasts in acute myeloid leukemia?

MPO stain.

What is an important marker for B cells in flow cytometry?

CD19.

What defines the activation of NF-kB in Hodgkin lymphoma?

Episomal retention of the virus, often from EBV.

What medications are used as part of the treatment for multiple myeloma?

Proteasome inhibitors and immunomodulators.

What is the target serum M protein concentration in multiple myeloma?

Typically >3 gm/dl.

What distinguishes Hodgkin lymphoma from non-Hodgkin lymphoma in terms of age epidemiology?

Hodgkin lymphoma exhibits a bimodal distribution, affecting young adults and the elderly.

What causes splenomegaly in Chronic Myelogenous Leukemia?

Accumulation of mature and immature myeloid cells due to inhibited apoptosis.

What condition arises from the immune response to malignancies and hyperviscosity in multiple myeloma?

Increased susceptibility to infections.

Which leukemia has a prognosis significantly improved by targeted therapy?

Acute Promyelocytic Leukemia (APL) with ATRA.

What is the identification marker for myeloblasts via histology?

Presence of Auer rods.