ch 11

leukemia

circulating tumors that involve blood and bone marrow

lymphoma

localized in lymph tissues

plasma cell myeloma

malignant transformation of b cell plasma cells, localized tumors in bony structures

what cells belong to lymphoid lineage?

NK cell, B cell, T cell

what cells belong to myeloid lineage?

RBC, platelets, monocytes, granulocytes

what are the typical signs and symptoms of malignant WBC disorders?

weakness, weight loss, hepatomegaly, splenomegaly, recurrent infections, enlarged nontender lymph nodes, high WBC count

what are the typical clinical manifestations of malignant WBC disorders?

anemia, thrombocytopenia, leukopenia, neutropenia

what are the principles of treatment for malignant WBC disorders?

chemotherapy, stem cell transplant, radiation therapy

complete remission (CR)

return to normal hematopoiesis

chemotherapy

induce long term remission and apoptosis in cycles

what are the phases of chemotherapy

remission induction, post-remission/consolidation, remission maintenance

remission induction

eliminate all detectable neoplastic cells to achieve CR

post-remission/consolidation

after CR attainted, eliminate undetectable cells that escaped first phase

remission maintenance

manage neoplasms to prolong remission

bone marrow transplantation (BMT)

used on leukemias, stem cells introduced IV

why do some ppl receive BMT

intense chemotherapy caused bone marrow failure

what is a possible complication of BMT

graft vs host disease

peripheral stem cell transplantation

stem cells harvested from circulating bloodstream

allogeneic

donor from someone else

autologous

uses patient’s own stem cells

CML

chronic myeloid leukemia

chronic myeloid leukemia

malignant granulocytes that carry philadelphia chromosome

philadelphia chromosome

translocation of chromosome 9 and 22, create new fusion gene bcr/abl

what is the effect of bcr/abl mutation

increase cell proliferation and reduce apoptosis

clinical presentation of cml

high granulocyte count and splenomegaly

treatment for cml

anti-bcr/abl therapy reduce leukemic cells with bcr/abl

AML

acute myeloid leukemia

acute myeloid leukemia

buildup of immature blast cells in bone marrow

CLL

chronic lymphoid leukemia

chronic lymphoid leukemia

asymptomatic malignant B cell that invade lymphoid tissues and marrow

who is affected by ALL

kids

ALL

acute lymphoblastic leukemia/lymphoma

ALL symptoms

bone pain, bruising, infection, refusal to walk bc hematothrosis, enlarged spleen liver lymph nodes

plasma cell myeloma/multiple myeloma

malignant plasma cells produce excessive identical monoclonal antibodies that accumulate in blood

how is plasma cell myeloma detected

serum protein electrophoresis, Bence Jones protein, hypercalcemia, bone lesions

bence jones protein

produced by malignant plasma cells, light-chain antibody fragments that accumulate in blood and urine, can damage kidneys

how does multiple myeloma cause hypercalcemia

malignant plasma cells occupy bone, cause destruction, release calcium

hodgkin disease

malignant disorder of lymph nodes, originating in B cells and spread along lymphatic pathway

how is hodgkin disease diagnosed

evidence of Reed-Sternberg cells

risk factor of hodgkin disease

epstein-barr virus

non-hodgkin lymphoma

malignant B/T/NK cells with unpredictable spread

risk factors for non-hodgkin disease

burkitt lymphoma, epstein-barr virus, HIV

serious complications of non-hodgkin disease

superior vena cava obstruction and spinal cord compression

polycythemia vera (PV)

overproduction of RBC

essential thrombocytopenia (ET)

overproduction of platelets