Chronic Myelogenous Leukemia (CML)
- BCR-ABL
- 9;22 Translocation
- Philadelphia Chromosome
- Tyrosine Kinase
- Low Alkaline Phosphatase
- Splenomegaly
- Blast Crisis
- Age 30 to 90 Years
- Responds to Imatinib
Chronic Lymphocytic Leukemia (CLL)
- Age > 60 Years
- B Cell Neoplasm
- Smudge Cells
- Often Asymptomatic
- Cold IgM Autoimmune Hemolytic Anemia
- Warm IgG Autoimmune Hemolytic Anemia
- Richter's Transformation
Acute Lymphoblastic Leukemia (ALL)
- Ages < 15
- May Present with Bone Marrow Involvement in Children
- Mediastinal Mass in Adolescents
- TdT Positive
- CALLA Positive
- t(12;21) Better Prognosis
- Spread to CNS and Testes
- Most Responsive to Chemotherapy
Acute Myelogenous Leukemia (AML)
- Myeloblasts Increase on Peripheral Smear
- Median Onset 60 Years
- T 15;17 M3 Subtype
- Auer Rods
- Disseminated Intravascular Coagulation (DIC) is a Common Presentation
- M5 Gum Infiltration
- Responds to Vitamin A
Hairy Cell Leukemia
- Mature B Cell Tumor
- Splenomegaly
- Flow Cytometry
- Cells Have Filamentous Hair-Like Projections
- Stains TRAP Positive
- Dry Tap on Bone Marrow Aspiration
- Cladribine
- Pentostatin
Hodgkin Lymphoma Pathophysiology
- Reed-Sternberg Cells
- Binucleate
- Owl's Eyes Appearance
- CD 15 and CD 30
- B Cell Origin
- Bimodal Age Distribution
Hodgkin Lymphoma Signs & Symptoms
- Localized Single Group of Lymph Nodes
- Contiguous Spread
- Constitutional B Symptoms
- Low-Grade Fever
- Night Sweats
- Weight Loss
Hodgkin's Lymphoma Interventions
- Biopsy
- Staging
- Radiation
- Chemotherapy
- Treat Side Effects of Therapy
- Secondary Cancer Screening
Non-Hodgkin's Lymphoma Assessment
- Lymphatic Cancer
- Non-Contiguous Spread
- B or T Cells
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Mediastinal or Abdominal Mass
- Older Adults
- > 60 Subtypes
Adult T Cell Lymphoma
- Caused by HTLV 1
- Japan, West Africa, Caribbean
- Present with cutaneous lesions
- Aggressive
Mantle Cell Lymphoma
- Older Males
- Activation of Cyclin D Gene
- T 11;14
- CD5
- Poor Prognosis
Follicular Lymphoma
- Derives from Germinal Center
- Occurs in adults
- T14;18
- BCL 2 overexpression
- BCL 2 inhibits apoptosis
- Indolent
- Generalized lymphadenopathy
- Bone marrow involvement
Diffuse Large B Cell Lymphoma
- Most Common Non-Hodgkin’s Lymphoma
- Usually in Older Adults
- 20% in Children
- May be Mature T Cell in Origin
- Derives from Germinal Center
- GI Tract and Brain
Burkitt's Lymphoma
- Adolescents or young adults
- C-myc gene moves next to heavy chain Ig gene
- T 8;14
- Starry sky appearance
- Sheets of lymphocytes with interspersed macrophages
- Jaw lesion in endemic (African) form
- Pelvis or abdomen in non endemic form (American form)
- Associated with EBV
Mycosis Fungoides / Sézary Syndrome
- Neoplastic CD4+ Cells
- Adults 40 - 60 Years Old
- Neoplastic CD4+ Cells Infiltrate Skin
- Rashes Or Plaques
- Pautrier's Abscesses
- Neoplastic CD4+ Spread from Skin to Systemic Involvement
- Sézary Cells With "Cerebriform Nuclei"
Multiple Myeloma Pathophysiology
- Monoclonal Plasma Cell Cancer
- Clock Face Chromatin
- M Spike on Protein Electrophoresis
- Increased IgG and IgA
- Fried Egg Appearance (BM Biopsy)
- Rouleaux Formation
- Stacked RBC's
- Bence Jones Protein
Multiple Myeloma Signs and Symptoms
- Increased Susceptibility to Infection
- Back/Bone Pain
- Punched Out Lytic Bone Lesions
- Hypercalcemia
- Primary Amyloidosis
- Renal Insufficiency
- Anemia
Tumor Lysis Syndrome
- Leukemia/Lymphoma Treatment
- Oncologic Emergency
- GI Distress
- Fatigue
- Arrhythmias
- Acute Kidney Injury
- Hyperkalemia
- Hyperphosphatemia
- Hyperuricemia
- Hypocalcemia
- Aggressive Hydration
- Electrolyte Correction
- Allopurinol
- Rasburicase