spec heme KISS terms

CML

all WBC stages present; 50,000< WBC count; increased eos baso plts; hypercellular BM
normo/normo anemia
decreased LAP
Philadelphia chromosome

young adults/middle aged

BMT, blast crysis poor prognosis

CLL

prolif and accum of B cells unresponsive to antigenic stimuli

leukocytosis, lymphocytosis, smudge cells

elderly ~70yo, more men; slow chronicity

PNH

complement mediated hemolysis

dark urine in morning

aplastic anemia or AML

sugar water test screen, Ham’s acid serum test diag

multiple myeloma

increased plasma cells, IgG, ESR

rouleaux, BJ proteinuria

serum/urine protein electrophoresis

Dx BM study

Waldenstrom’s

plasma cell dyscrasia w secretion of monoclonal IgM

plasmacytoid lymphs clones

50 months survival

older men

ALL

30% < blasts, no auer rods

children 2-10yrs

+ TdT; flow cyto always

chemo, BMT, radiation

AML

30-100% blasts, ~50% auer rods

15-95% blasts (WHO 20%< acute)

middle aged

+ peroxidase + SBB + spec esterase

HUS

E. coli infection

bloody diarrhea, schistocytes, thrombocytopenia

children and elderly

Hodgkin’s lymphoma

Reed-Sternberg cell

starts in 1 lymph node then spreads in predicable pattern

young adults

increased mono and eos, peripheral eosinophilia

Dx by biopsy

leukemoid rxn

may resemble CML

caused by infection, inflamm, trauma, surgery, etc

leukocytosis, left shift, NO blasts, toxic gran/vac, dohle bodies

increased LAP, no Philadelphia gene

primary RBC aplasia

erythrocytopenia, thymoma

Fanconi’s anemia

congenital aplastic anemia

physical deformities, increased risk of AML

aplastic anemia

pancytopenia, hypocellular BM, idiopathic

caused by chloramphenicol and benzene

BMT

hemochromatosis

iron accumulation in tissues

liver damage, genetics, normal PBS

PCH

intravasc hemolysis when <15C

post virus, mostly children

+ Donath-Landsteiner test

Diamond Blackfan

congenital hypoplastic anemia/erythrocytopenia

NO erythroblasts in BM, WBC/plts normal

G6PD def

RBC hemolysis with oxidant stress

Heinz bodies, bite cells

x-linked, falciparum protection

pyruvate kinase def

small dense spiculated RBCs from water and K loss

mild to severe hemolysis by spleen culling

P5N def

RNA metabolite does not diffuse out of RBC

heavy basophilic stippling like in Pb poisoning

myelophthisic anemia leukoerythroblastosis

space occupying BM disorder

increased imm RBC/WBC, teardrops, bizarre platelets

cryoglobulin

protein that precipitates at 4C and redissolves at 37C in serum/plasma

auer rod

fused primary granules in acute leuk blasts

NEVER lymphoblasts

LAP score

sum of (# cells x rating)

increased in leuk rxn, decreased in CML

acute leuk cbc

variable WBC, decreased RBCs and plts

slow smear

false lymphocytosis bc WBCs pulled to feathered edge

LE cells

live neutrophils ingested free nucleus of cell homogenized by LE factor

not in PBS, seen in BM/body fluids/tissues

to diagnose lupus erythematosus

lupus erythematosus

autoimmune collagen disease

facial rash, glomerulonephritis, CNS symptoms

Dx antinuclear antibody test

essential thrombocythemia

spontaneous bleeding or thromboembolism (ineffective/defective plts)

giant, bizarre, abnormal platelets

plateletpheresis or antiplt aggreg drug

polycythemia vera

predominantly RBCs, panmyelosis
increased total blood vol
increased LAP, decreased or normal EPO

50-60yo, 20-30 yr duration

spent phase: myelofibrosis and myeloid metaplasia

primary myelofibrosis

leukoerythroblastic anemia (imm WBC, RBCs, teardrops, bizarre giant plts)
fibroblasts

dry tap bc of fibrosis

BMT only cure