CH6 - 3) Chronic Leukemia Flashcards

1
Q

What is chronic leukemia?

A

Neoplastic proliferation of mature circulating lymphocytes

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2
Q

What is chronic leukemia characterized by?

A

a high WBC count

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3
Q

Describe the onset of chronic leukemia?

A

Usually insidious in onset and seen in older adults

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4
Q

What is chronic lymphocytic leukemia?

A

Neoplastic proliferation of naive B cells that co-express CD5 and CD20;

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5
Q

What is the most common leukemia overall?

A

Chronic lymphocytic leukemia (CLL)

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6
Q

In CLL what is seen on the blood smear?

A

Increased lymphocytes and smudge cells are seen on blood smear

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7
Q

small lymphocytic lymphoma

A

In CLL, with involvement of lymph nodes leads to generalized lymphadenopathy

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8
Q

What are the complications of CLL?

A

1) Hypogammaglobulinemia, 2) autoimmune hemolytic anemia, 3) Richter transformation

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9
Q

What is the most common of death in CLL?

A

infection

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10
Q

What is Richter transformation?

A

transformation to diffuse large B-cell lymphoma

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11
Q

What is Richter transformation marked clinically by?

A

an enlarging lymph node or spleen

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12
Q

What is Hairy cell leukemia?

A

Neoplastic proliferation of mature B cells

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13
Q

What characterizes hairy cell leukemia?

A

hairy cytoplasmic processes

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14
Q

What are hairy cell leukemia cells positive for?

A

tartrate-resistant acid phosphatase (TRAP).

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15
Q

What are the clinical features for hairy cell leukemia?

A

Splenomegaly, dry tap on bone marrow aspiration

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16
Q

Why is there splenomegaly in hairy cell leukemia?

A

Due to accumulation of hairy cells in red pulp

17
Q

Why is there a dry tap on bone marrow aspiration in hairy cell leukemia?

A

due to marrow fibrosis

18
Q

How is lymphadenopathy related to hair cell leukemia?

A

Lymphadenopathy is usually absent

19
Q

What drug is used in the treatment of hairy cell leukemia?

A

2-CDA (cladribine)

20
Q

How does hair cell leukemia respond to cladribine?

A

excellent response

21
Q

How does cladribine work?

A

Its an adenosine deaminase inhibitor, adenosine accumulates to toxic levels in neoplastic B cells.

22
Q

What is adult T cell leukemia?

A

Neoplastic proliferation of mature CD4+ T cells (ATLL)

23
Q

What is adult T cell leukemia associated with?

A

Associated with HTLV-I (human T cell lymphotrophic virus -1)

24
Q

Where is ATLL associated with HTLV-1 most commonly seen in?

A

Japan and the Caribbean

25
Q

What are the clinical features for ATLL?

A

include rash (skin infiltration), generalized lymphadenopathy with hepatosplenomegaly, and lytic (punched-out) bone lesions with hypercalcemia

26
Q

What is mycosis fungoides?

A

Neoplastic proliferation of mature CD44 T cells that infiltrate the skin, producing localized skin rash, plaques, and nodules

27
Q

What are Patitrier microabscesses?

A

Aggregates of neoplastic cells in the epidermis

28
Q

Sezary syndrome

A

cells can spread to involve the blood, producing Sezary syndrome.

29
Q

What are Sezary cells?

A

Characteristic lymphocytes with cerebri form nuclei

30
Q

What would you see on blood smear in mycosis fungoides?

A

Sezary cells