Hematopoietic and lymphoid systems - White cell disorders - Neoplastic proliferations of white cells

12 important questions on Hematopoietic and lymphoid systems - White cell disorders - Neoplastic proliferations of white cells

What is the difference between leukemias and lymphomas

leukemias involve the bone marrow and the peripheral blood and  lymphomas produce masses in lymph nodes or other tissues

Acute Leukemia is a fast progressive disease with lots of proliferation. What are the symptoms of bone marrow failure and organ infiltration?

◦ Infections (granulocytic function!)
◦ Bleeding
◦ Anemia (fatigue, dyspneu)
◦ Hepatosplenomegaly
◦ CNS dysfunction, headache

From which cells can Acute Lymfoblastic Leukaemia (ALL) originate from?

B or T cell precursor (most often “pre-Bcells”)
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In what age group does ALL occur the most and is considered a favorable prognostic marker?

2-10 years

What is characteristic for AML?

incidence of AML increases with age and can arise in another bone marrow disease (MPN or MDS)

Associated with mutations that lead to expression of abnormal transcription factors, which interfere with myeloid differentiation

WHat is characteristic for CLL?

• Mature B cell tumor that usually manifests with bone marrow and lymph node involvement
• Indolent course (=causing little or no pain), commonly associated with immune abnormalities, including increased susceptibility to infection and autoimmune disorders

The 2 main groups of acute lymphoma are ALL and AML. Why is this distinction been made?

Because of differences in therapy and different prognosis

There are 2 types of Chronic leukemias. Which are these?

  • CML (= myeloproliferative disease)
  • CLL (= NHL)

What are characteristics for CML?

  • Myeloproliferative disease t(9;22)
  • Stamcel disease
  • Bone marrow with myelopoiesis and often megakaryocytes, normal maturation
  • In PB leukocytosis with mature and immature myeloid cells
  • Huge splenomegaly
  • In chronic phase few complaints
  • Progression to AML (blasts crisis)

What is characteristic for follicular lymphomas

a (14;18) translocation that fuses the BCL2 gene which causes overexpression of BCL2

What is characteristic for Burkitt lymphoma

Burkitt lymphoma is highly associated with translocations involving the MYC gene, which causes overexpression of this gene. MYC is associated with rapid cell growth, and therefore it is said that Burkitt lymphoma is the fastest-growing human tumor.

Aggressive mature B tumor. Often latently infected by EBV

What are the most common lymphomas in adults?

non-Hodgkin lymphomas derived from germinal center B cells

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