Class notes
PHYA418 Hematology and Oncology Notes
- Course
- PHYA 418
- Institution
- Duquesne University
This is a comprehensive and detailed note on Hematology and oncology for PHYA 418. *Essential Study Material!!
[Show more]
Content preview
Pediatric Hematology and Oncology:Childhood Cancers:
● Leukemia
○ Acute: ALL, AML
○ Chronic: CML, CLL
● Lymphoma
○ Hodgkins (HL), Non-Hodgkins (NHL)
● Malignant Bone Tumors
○ Osteosarcoma, Ewing Sarcoma
● Neuroblastoma
● Wilm’s Tumor
Hematopoiesis:
Acute Leukemias:
● Acute leukemias represent a clonal expansion and arrest at a specific stage of
normal myeloid or lymphoid hematopoiesis.
● ACUTE leukemias constitute 97% of all childhood leukemias.
, ● ALL (Acute Lymphoblastic Leukemia)
○ 75%
○ 2,500-3,000 children diagnosed per year in US
● AML (Acute Myelogenous Leukemia)
○ 20%
○ 500 children diagnosed per year in US
Acute Lymphoblastic Leukemia:
● Etiology- unknown
● Clinical Symptoms:
○ Fever
○ Fatigue
○ Pallor
○ Organomegaly
○ Bleeding (bruising, petechiae, or purpura)
○ Lymphadenopathy
○ Bone pain
● Hematologic Effects (Bone Marrow Invasion)
○ Anemia
○ Neutropenia / Leukopenia
○ Thrombocytopenia
● Clinical Findings (Lymphoid System Infiltration)
○ Lymphadenopathy
○ Organomegaly
● Clinical Manifestations of Extramedullary Invasion
○ CNS Involvement
○ Painless enlargement of testis
● Diagnostic Studies:
○ CBC
■ Hgb – moderate to large reduction
● Normocytic, normochromic morphology
■ WBC – low, normal or elevated
■ Blood smear – Lymphoblasts* presents on blood smear
■ Platelets – low in 92% of patients
○ Blood chemistries
○ Bone Marrow Biopsy – must be done for diagnosis
■ BM usually replaced by blasts
■ Megakaryocytes usually absent
■ Blast cell is the hallmark for diagnosis
○ Chest Xray – looking for mediastinal mass
○ Lumbar Puncture – looking for CNS disease
, ● Classifications:
○ Pre-B cell ALL accounts for 80% of cases → Good prognosis
○ T- Cell ALL accounts for 15-20% of cases → Poorer prognosis
■ Older age at presentation
○ High initial WBC
○ Presence of extramedullary disease (thymus)
● Favorable Prognostic Factors:
○ Age 1-9 years
○ WBC <50,000
○ Precursor B cell
○ Genetic factors
○ No CNS difficulties
○ Early Response to therapy
○ Minimal residual disease (MRD) at end of induction
● Treatment
○ Supportive care measures before chemotherapy
■ Patients may be:
● Dehydrated, infected, bleeding, anemic
● Impaired renal and hepatic function
○ All regimens include the following elements:
■ Induction (aim for remission)
■ Consolidation (intensification of remission)
■ Prevention of CNS leukemia
■ Maintenance therapy
Acute Myeloid Leukemia:
● Age of incidence is constant except:
○ Peak in the neonatal period
○ Peak during adolescence
● Clinical Symptoms:
○ Mirrors ALL – fever, petechiae, N/N anemia, thrombocytopenia
● Morphology
○ Auer Rods are diagnostic
○ Myeloblasts
■ Must have 20% blasts on bone marrow biopsy for diagnosis
● Poor Prognostic Factors:
○ WBC > 100K
○ Monosomy 7
○ Secondary AML
○ FLT-3 ITD mutation (16.5% of peds AML)
The benefits of buying summaries with Stuvia:
Guaranteed quality through customer reviews
Stuvia customers have reviewed more than 700,000 summaries. This how you know that you are buying the best documents.
Quick and easy check-out
You can quickly pay through credit card or Stuvia-credit for the summaries. There is no membership needed.
Focus on what matters
Your fellow students write the study notes themselves, which is why the documents are always reliable and up-to-date. This ensures you quickly get to the core!
Frequently asked questions
What do I get when I buy this document?
You get a PDF, available immediately after your purchase. The purchased document is accessible anytime, anywhere and indefinitely through your profile.
Satisfaction guarantee: how does it work?
Our satisfaction guarantee ensures that you always find a study document that suits you well. You fill out a form, and our customer service team takes care of the rest.
Who am I buying these notes from?
Stuvia is a marketplace, so you are not buying this document from us, but from seller anyiamgeorge19. Stuvia facilitates payment to the seller.
Will I be stuck with a subscription?
No, you only buy these notes for $10.99. You're not tied to anything after your purchase.
Can Stuvia be trusted?
4.6 stars on Google & Trustpilot (+1000 reviews)
78998 documents were sold in the last 30 days
Founded in 2010, the go-to place to buy study notes for 14 years now