Alterations in Leukocytes.pdf

Alterations of Leukocytes and Pathophysiology of Leukemias 1. Define the following terms: leukopenia and leukocytosis. 2. Define neutrophilia and neutropenia. Define “shift-to-the-left” 3. Define granulocytopenia and give an example of causative condition. 4. Describe and define esoinop...

Alterations of Leukocytes and Pathophysiology of Leukemias 1. Define the following terms: leukopenia and leukocytosis. 2. Define neutrophilia and neutropenia. Define “shift-to-the-left” 3. Define granulocytopenia and give an example of causative condition. 4. Describe and define esoinophila including the main/most common cause. 5. Define basophilia and basopenia 6. Define monocytosis and monocytopenia 7. Define lymphocytosis and lymphocytopenia 8. Define and describe infectious mononucleosis including the most common cause, transmission, clinical manifestation and diagnostic testing. 9. Briefly define and describe leukemia. Indicate the predominant cells of origin. 10. Compare and contrast acute vs chronic leukemia 11. Describe the four types of leukemia: Acute lymphocytic leukemia (ALL), Acute myelogenous leukemia (AML), Chronic lymphocytic leukemia (CLL), Chronic myelogenous leukemia (CML) 12. In the above description include the demographic of highest prevalence (adults/children/men/women), survival rates, common genetic translocations, etc. 13. Briefly describe the clinical manifestation of acute leukemia vs chronic leukemia  Quantitative Leukocyte Disorders  Deficiencies in the quality and quantity of leukocytes  Qualitative Leukocyte Disorders  Disruption of leukocyte function  Many hematologic disorders are malignancies.  Many nonhematologic malignancies metastasize to the bone marrow, affecting leukocyte production.  Quantitative Disorders Qualitative Disorders  Increases or decreases in cell  Disruption of leukocyte numbers function  Bone marrow dysfunction or  Phagocytic cells may lose their premature destruction phagocytic capacity to function. of cells  Lymphocytes may lose their capacity to  Response to infectious respond to antigens. microorganism invasion  Leukocytosis  Counts are higher than normal  Can be a normal protective physiologic response to stressors or to the invasion of microorganisms  Can be pathological  Leukocytosis Leukopenia  Counts are higher than normal  Counts are lower than normal  Absolute blood cell count 50 years of age  Malignant transformation and progressive accumulation of monoclonal B lymphocytes (less than5% are T cell origin)  Lymphadenopathy is the most common finding.  Suppresses humoral immunity, and increases infection with encapsulated bacteria.  CML  Infections, fever, and weight loss  Effect of CML resemble those of acute leukemia, but with more prominent and painful splenomegaly  Chronic phase (2-5 yrs; symptoms my not be apparent)  Accelerated phase (6-8 months; splenomegaly)  Terminal blast phase  “Blast crisis”  Survival: Only 3 to 6 months https://www.sciencedirect.com/science/article/pii/S0301472X16307500  Tests  Blood smear  Treatment  Chlorambucil, administered with or without corticosteroids, on a daily or intermittent schedule  Chemotherapy  No cure for CML  Combined chemotherapy  Biologic response modifiers  Allogeneic stem cell transplantation  Characteristics ALL CLL AML CML Progression Rapid Slow Rapid Slow Adults versus Most common in Most common Most Found mostly in children children in adults common adults adult form Survival rate 91% 85% 24% No cure Primary cell Greater Monoclonal B Precursor Neutrophilic or than 30% myeloid eosinophilic or lymphoblasts cells clonal; arise from and B cells a hematopoietic stem cell