Leukemia and Lymphoma Notes

Lymphoma Types

  • Hodgkin's Lymphoma:
    • Spreads in a contiguous manner, following the lymphatic system's map or roadway.
    • Predictable spread: if found in one lymph node, it will likely spread to the next in the lymphatic chain.
  • Non-Hodgkin's Lymphoma:
    • Spreads haphazardly and can go anywhere, making it harder to treat.
    • Metastasizes more easily than Hodgkin's lymphoma.
  • Age of Diagnosis:
    • Hodgkin's lymphoma is often diagnosed in younger people, such as teenagers.

Bone Marrow and Cell Proliferation

  • Normal Bone Marrow Function:
    • The bone marrow continuously produces red blood cells, white blood cells, and platelets.
  • Impact of Myeloproliferative/Myelodysplastic Cells or Lymphoma:
    • These cells can take over the bone marrow, hindering the proper proliferation of normal blood cells.
    • This takeover reduces the production of red blood cells, white blood cells, and platelets.
  • Consequences of Bone Marrow Takeover:
    • Anemia: Insufficient red blood cells lead to reduced oxygen-carrying capacity.
    • Infections: Low white blood cell count or non-functional white blood cells impair the body's ability to fight infections.
    • Bleeding/Bruising: Lack of platelets leads to easy bleeding or bruising.

"Penia" Suffix

  • Definition: Indicates a deficiency of a specific type of blood cell in the blood.
    • Leukopenia: Deficiency of leukocytes (white blood cells).
    • Anemia: Deficiency of red blood cells or, more accurately, insufficient oxygen-carrying capacity in the blood.
    • Thrombocytopenia: Deficiency of thrombocytes (platelets).
    • Neutropenia: Deficiency of neutrophils; low absolute neutrophil count.
  • Kidney and Bone Marrow Interaction:
    • Low cell count triggers the kidneys to excrete erythropoietin (EPO).
    • EPO stimulates the bone marrow to proliferate red blood cells.
    • In cases of severe anemia, patients may be given EPO to stimulate red blood cell production.

Chronic Myeloid Leukemia (CML)

  • Cell Lineage:
    • The cells proliferating in CML are of myeloid lineage.
  • Onset:
    • Typically occurs in older individuals due to its chronic, slow-growing nature. Rare in children.
  • Mutation:
    • CML is unique because it is caused by a single mutation, a translocation between chromosome 9 and chromosome 22.
  • Philadelphia Chromosome:
    • The translocation results in the formation of the Philadelphia chromosome.
    • This chromosome produces a functional protein that causes cells to proliferate excessively.
  • Treatment:
    • Because CML is caused by a single mutation, drugs can be developed to target the Philadelphia chromosome, offering effective treatment.

Acute Myeloid Leukemia (AML)

  • Cell Appearance:
    • AML cells are dysplastic (abnormal in appearance).
    • Most cells are blasts (immature cells) that serve no functional purpose.
  • Blast Count:
    • Normal bone marrow aspirates contain only 1-2% blasts.
    • In AML, blasts do not mature into sites and are released in excessive numbers.
    • A high blast count is indicative of AML.

Acute Lymphoblastic Leukemia (ALL)

  • Prevalence:
    • Most common leukemia in children.
  • Cell Types:
    • Involves pre-B cells and pre-T cells, which are responsible for producing antibodies.

Multiple Myeloma

  • Cell Type:
    • A B-cell malignancy involving plasma cells, which produce antibodies.
    • Requires a specific type of antibody.
  • Survival Rate:
    • Survival rate is low, often because it primarily affects older men.
    • Treatment decisions (e.g., chemotherapy, bone marrow transplantation) must consider the patient's age and overall health.
  • Treatment Considerations:
    • Aggressive treatments like chemotherapy may not be suitable for older patients due to potential side effects and reduced quality of life.

Test-Taking Tips

  • Acronyms:
    • The test will likely use acronyms (CML, AML, CLL, ALL, multiple myeloma) as answer choices.
    • Be sure to study and differentiate between these acronyms to avoid confusion.
  • Study Strategies:
    • Pay attention to details to avoid mixing up similar acronyms (e.g., CML vs. CLL).
    • Associate each acronym with key characteristics (e.g., ALL = kids, CLL = basket smudge).
  • Chapter 11:
    • Students often neglect to study Chapter 11 thoroughly, which can negatively impact their test scores.
    • Allocate sufficient time to study all chapters, including Chapter 11.
    • Consider studying from the back to the front to ensure Chapter 11 receives adequate attention.
  • Time Management:
    • Organize your study time effectively.
    • Utilize guided notes.
  • Asking Questions:
    • Don't hesitate to ask questions during the test if something is unclear.
  • Positive Mindset:
    • Maintain a positive attitude and take deep breaths to manage test anxiety.
    • Remember that achieving a perfect score is possible with thorough preparation.