Hematologic Malignancy Notes

Neoplasm of lymphoid origin.
Usually starts in lymph nodes but can involve lymphoid tissue in the spleen, GI tract, liver, or bone marrow.
Classified according to degree of cell differentiation and origin of predominant malignant cell.
Two major categories:
- Hodgkin lymphoma
- Non-Hodgkin lymphoma

Relatively rare malignancy with a high cure rate.
Suspected viral etiology, familial pattern, incidence in early 20s and again after the age of 50 years; more common in men.
Unicentric; initiates in a single node.
Reed-Sternberg cell is a characteristic feature.
Manifestations:
- Painless lymph node enlargement
- Pruritus
- B symptoms: fever, sweats, weight loss
Treatment is determined by stage of the disease and may include chemotherapy, radiation therapy, or both, and HSCT for advanced disease.

Lymphoid tissues become infiltrated with malignant cells; spread is unpredictable and localized disease is rare.
Increases with age, with average age being 66 years.
Increased in autoimmune disorders, prior treatment for cancer, organ transplant, viral infections, exposure to pesticides
Manifestation:
- Lymphadenopathy
- B symptoms
- Symptoms associated with lymphomatous masses
Treatment is determined by type and stage of disease and may include interferon, chemotherapy, radiation therapy, and HSCT

Malignant disease of the most mature form of B lymphocyte- the plasma cell
Incidence increases with age; median age is 70 years old. 5-year survival rate (no cure).
Manifestations:
- Bone pain reported in 80%, mostly back and ribs
- Osteoporosis and fractures related to bone destruction
- Hypercalcemia
- Renal impairment and failure
- Anemia
Treatment may include HSCT, chemotherapy, corticosteroids, radiation therapy.
New drugs being used: immunomodulatory drugs, thalidomide analogs, monoclonal antibody