1. leukocytosis- which cell-line is increased?
    • pmn, lymph, mono, eo, baso
    • mature vs immature
  2. increased count due to
    primary marrow abnormality or secondary (infection)
  3. leukemia
    • proliferation of leukocyte series in bone marrow. eventually abnormal cells go to blood;
    • prolierfation of multipotent progenitors
  4. leukemia disease course
    • chronic
    • acute

    cell lineage(lymph vs myelo)
  5. CML bld smear
    • philadephia chromosome, active tyrosine kinase 
    • peak age (40-60)
    • leukocytosis
    • bld smear- basophillia, eosinophailla, rbc nl, giant plts, all stages of maturation
  6. symptoms of CML
    malaise, fatigue, wt loss, spenomegally, palor
  7. philadelphia chromosome
    abnormal chr 22
  8. BCR-ABL
    BCR from chr 22 is translocated onto chr 9 next to ABL. Creates fusion protein with tyrosine kinase activity
  9. CML treatment
    • targeted therapes
    • chemo
    • marrow transplants
  10. acute leukemias
    viruses, toxins, diseases with immunodeficiencues, genetic disorders
  11. AML bld smear
    • myeloblastic whereas CML is myelogenous
    • show myeloblasts or other immature nonlymphoid cells
  12. AML symptoms
    • maliise, fever, infections, bleeding, petiache, heptpspenmegaly, 
    • hypercellular bone marrow with monotonous pattern of blast cells

    gum hyperlasia
  13. AML bone marrow failure due to
    • anemia, thrombocytopenia, enutropenia, 
    • also leukemic infiltration of tissues
  14. AML cytogenetic risk
  15. APL-acute promyelocytic leukemia
    M3 variant, cytogenetic translocation retinoic acid receptor PML-RARalpha.

    DIC present
  16. ALL-acute lymphoblstic leukemia
    neoplasm in children
    • marrow and bld show lymphoblasts.
    • CNS involvement, high cure rate with chemo
  17. ALL symptoms
    anemia, bleeding, neutropenia, bone pain, the Megalys, neurologic
  18. lymphoma
    • B-cell and T-cells
    • B-cells have CD19 markers
  19. Non-Hogkins lymphoma
    • B-cells mostly
    • 20% T-cells
  20. non-Hogkins lymphoma
    • follicle vs diffuse
    • (t-cells are always diffuse)
    • follicles are only int he lymph nodes.
  21. immature wbc in leukemia are know as
    • "blasts"
    • bone pain because pressure on bones, and decrease in all other bld cells, rbc, paltellets, hemotocrit b/c too many wbc
  22. AML vs 
    overproduction of myeloid stem cells
  23. ALL vs
    acute has immature in blood whereas chronic has mature usage
  24. oral complications of acute leukemia
    • gum hyperlasia
    • mucositis
    • infections
    • bleeding
    • graft vs host disease
  25. leukemia vs lymphoma
    leukemia in the bone marrow (lymphoblasts) to high grade lymphomas.
  26. lymphocytosis
    absolute lymphocytes>4000

    • acute, chronic infecions
    • neoplasm
  27. CLL
    B-cell chronic lymph leukemia
    • lymphadenopathy
    • malaise, weakness,
    • night sweats
    • heptospleomegaly, infections, bleeding
  28. CLL treatment
    treat only symptomaic, not cured, med surival 5-10 yrs
  29. multiple myeloma
    • proliferation of plasma cells
    • cells are clonal and produce antobody.
    • High levels of antibody in bld and urine.
  30. MM leads to skeletal destruction
    osteolytic lesions, osteopenia,
  31. monoclonal antibody production in myeloma
    • elevated serum protein
    • hyperglobulinemia
    • rouleaux formation of rbc
    • coat coagulation facotrs
    • xs light chain
  32. myeloma has
    • crowding out of normal cells
    • bone lesions
    • increased cell turnover in uric acid and calcium phosphate deposits
  33. hematopoietuc stem cell transplant
    • replace defectuve hematopoitic stem cells
    • allows for high dose chemo
  34. cd34 positive cells
    1% of mononuclear cells use as source of hematopoietic stem cells after GF pre-treatment of donor
  35. histocompatibility
    donor needs to have the same antigen class markers
  36. chance of survival after HLA identical transplant for AML
    high via autologous peripheral bld stem cell
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