Acute lymphocytic leukemia (ALL) - aggressive, fast-growing leukemia with too many
lymphoblasts or immature WBC found in blood and marrow (lymphocytes are B cells
and T cells)
-MAINLY B CELL
Acute myelogenous leukemia (AML) - aggressive, fast-growing leukemia with too many
myeloblasts (i.e. immature WBC that are not lymphoblasts such as RBC, granulocytes-
monocytes, macrophage, basoph, eosinoph, platelets)
Increase risk for ALL linked to - -prenatal exposure to xray
-exposure to ionizing radiation
-past tx with chemo
-certain genetic conditions
-exposure to cigarette smoke
-low-dose radiation
-HIV or Hep C infx
-infx with human T-cell leukemia/lymphoma virus
AML most common secondary ca - after high doses of chemo for HL, non-HL, MM,
ovarian ca and breast ca
Acute leukemia may develop secondary to - -chronic myelogenous leukemia
-chronic lymphocytic leukemia
-hodgkin lymphoma
ALL more common in - children
-more deadly in adults
AML most common - adult leukemia
AML displacement in marrow and blood may cause - bleeding, anemia, infx
Clinical manifestations of leukemia (more pronounced onset in ALL) - -fatigue
-bleeding (thrombocytopenia)
-fever (infx)
-anorexia (wt loss), diminished taste, dysphagia
-pain in bones
-neurologic from bleeding or lymphocyte infiltration
Liver, spleen, and lymph enlargement more common in - ALL than in AML
-abd pain and tenderness
Other tx for leukemia - -radiation
-chemo with stem cell transplant
-other drug therapy
Supportive tx for leukemia - -blood transfusion
-antibiotics
-antifungals
-antivirals
Presence of philadelphia chromosome - poor prognosis
Chronic lymphocytic leukemia (CLL) and Small lymphocytic lymphoma (SLL) differ only
in the amount of proliferation of peripheral blood lymphocytes - differ only in the amount
of proliferation of peripheral blood lymphocytes
Chronic leukemia cells are - well differentiated and can be readily identified (acute
leukemia cells are not)
CML is clonal - and arises from a hematopoietic stem cell
-philadelphia chromosome present in 95% of CML pts
-BCR-ABL 1 protein initiates CML
CLL involves - malignant transformation of B cells (rarely T cells)
CLL cells - that accumulate in the marrow do not interfere with normal blood cell
production to extent of acute leukemias
*MAJOR deficit - failure of B cells to mature into plasma cells that synthesize
immunoglobulins
Most common symptom in chronic leukemia - lymphadenopathy
Most significant effect of CLL - suppression of humoral immunity and increased infection
with encapsulated bacteria
-infiltration occurs in lymph nodes, spleen, liver, salivary glands
-not usu in organs or CNS
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