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82 Cards in this Set
- Front
- Back
WBC lineage?
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1. MYELOID CELL LINE
a. Granulocytes i. neutrophils ii. eosinophils iii. basophils b. Agranulocytes i. macrophages 2. LYMPHOID CELL LINE a. T cells b. B cells |
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What is the normal WBC count in circulation?
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about 5-10,000 cells/mcL)
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What is leukopenia?
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a WBC disorder
absolute decrease in WBC # -may affect any WBC, but most often PMNs |
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What are PMNs aka?
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polymorphin NEUTROPHILS (compromise about 60-70% of all WBCs)
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What is neutropenia?
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a WBC disorder
-decrease in PMN # -circulating PMN count reduced to less than 1500cells/mcL |
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What is agranulocytosis?
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severe neutropenia
-circulating PMN count of less than 200 cells/mcL |
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Describe the 2 general causes of neutropenia?
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either decreased production of wbcs...or increased removal of wbcs
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The lifespan of a neutrophil?
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1 day
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2 ways in which you can attain neutropenia?
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1. acquired
2. congenital |
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Describe acquired neutropenia and list 5 causes?
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-impaired granulopoiesis (formation of granulocytes) due to
1. chemotherapy 2. infection 3. radiation 4. CA 5. medications |
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Describe congenital neutropenia?
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inherited disorders (seen at birth), including:
1. cyclic neutropenia (waxes and wanes, sometimes normal) 2. Kostmann's syndrome (severe neutropenia but you have enough platelets, etc...just lack neutrophils) |
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General manifestations of leukopenia?
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1. decreased neutrophils so increased susceptibility to infection
2. also increased inflammation |
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Tx for leukopenia?
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1. antibiotics
2. stim. factors to produce neutrophils ("colony stimulating factors") |
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What kind of disease is infectious mononucleosis?
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viral, self-limiting proliferative disorder
-proliferation of certain cell types |
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Cause of infectious mononucleosis?
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epstein-barr virus (EBV)
-virus present in all human pop.s -transmission: oral (EBV contaminated saliva) |
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What is pathgenesis?
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the development and production of a disease?
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Describe the pathogenesis of infectious mononucleosis?
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1. invades B cells, viral genome incorporation
-produce heterophil abs (heterophil : reacts with humans and other species, ie, sheep) -detectable/diagnostic 2. T-cells proliferative -large atypical lymphocytes characterisic of disease |
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5 manifestations of infectious mononucleosis?
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1. fever, chills
2. sore throat (severe) 3. lymphadenopathy 4. anorexia 5. malaise |
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What is lymphadenopathy?
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manifestation of infectious mononucleosis (lymph nodes enlarge b/c churning out cells)
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2 presentations and diagnosis for mono?
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1. heterophil abs (appear 2nd to 3rd week)
2. atypical lymphocytes (greater than 20% of the total) |
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Which lymphocytes are atypical in mono?
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t cells
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Tx for mono?
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usually relieves on own...acute phase is 2-3 weeks
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Name 3 neoplastic disorders?
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1. lymphoma
2. leukemia 3. plasma cell dyscrasia |
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The 3 different types of neoplastic disorders are characterized according to what?
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lineage
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Two types of lymphomas?
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1. hodgkins
2. non-hodgkins |
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two types of leukemia?
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1. acute
2. chronic |
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What is multiple myeloma?
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a types of plasma cell dyscrasia
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Hodgkins disease and non-hodgkins disease are ? lymphomas.
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malignant...metastatic, uncontrolled growth
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Describe distribution of hodgkins disease?
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bimodal distribution...sharp rise after 10yo, peaks in early 20s, another increase in incidence after 50yo
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Etiology of hodgkins disease?
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unknown, perhaps viral
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Signs and symptoms of hodgkins disease?
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painless, progressive enlargement of single or group of lymph nodes (sometimes fevers)
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Diagnosis for malignant lymphomas?
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biopsy lymphnodes and examine for Reed-Greenberg Cell type
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Tx for hodgkins disease?
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it's cancer...so irradiation and chemotherapy
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Cure rate for hodkins disease?
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After 5 years there is an 85% survival rate
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Describe the appearance of a Reed-Sternberg cell?
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indicates hodgkins disease
-one cell with mirror-image nucleus (may look like 2 cells) -nuclei stains red |
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Cause of non-hodgkins lymphomas?
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unknown, perhaps viral
-disease of older people...typically over 50 and immunosuppressed, like transplant pts |
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Non-hodgkins lymphomas are heterogenous. Name 3 groups?
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1. low grade
2. intermediate grade 3. high grade |
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Describe low grade non-hodgkins lymphomas?
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least aggressive of dev. cancer
-mostly B cells and not rapid -may asymptomatic for a long time (10 yrs) -will eventually progress to high grade |
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Describe intermediate grade non-hodgkins lymphomas?
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T cells and B cells rapidly dividing
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Describe high grade non-hodgkins lymphomas?
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most aggresive, T and B cells rapidly dividing
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Signs and symptoms of non-hodgkins lymphomas?
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enlarged lymph nodes...fever...sweating....(these symptoms are assoc. with WBCs in general)
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diagnosis for non-hodkins lymphomas?
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have to visually examine cells...see B and T (atypical) and increased number of cells
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Tx for non-hodgkins lymphomas?
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depends which lymph nodes involved and which grade...but generally chemo and irradiation
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Survival rate for non-hodgkins?
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55% after 5 years
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What does the suffix "-emia" indicate?
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in blood
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What is leukemia characterized by?
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WBC disorders
-char. by unregulated, proliferating, immature neoplastic cells replacing bone marrow |
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In most cases of leukemia what occurs?
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leukemic cells enter blood and start to replace RBCs
-these neoplastic cells can infiltrate liver, spleen, lymph nodes (cause enlargement of organs) |
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Leukemia is the leading cause of death for who?
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1-14 yo.s
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Is the number of diagnosis of leukemia greater for adults or children?
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adults...but kids die from it more
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2 ways of classifying leukemias
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1. lymphocytic or myelocytic
2. acute or chronic |
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lymphocytic and myelocyte refer to what?
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whether the cells involved are from the lymphoid lineage or myeloid lineage
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Acute or Chronic leukemias are distinguished by what?
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acute= rapid = immature cells
chronic= slower= more mature ( so rapidity of onset, and cell maturity) |
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The myelocytic cells that may be involved in leukemia?
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1. macrophages
2. neutrophils 3. eosinophils 4. basophils |
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The lymocytic cells you may see in leukemia?
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1. t cells
2. b cells |
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Lymphocytic aka what?
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lymphoplasic
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Myelocytic aka what?
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myelogenous
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4 types of leukemias?
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1. acute lymphocytic leukemia (ALL)
2. acute myelocytic leukemia (AML) 3. Chronic lymphocytic leukemia (CLL) 4. Chronic myelocytic leukemia (CML) |
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Leukemic cells are almost always what?
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immature
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Etiology of leukemias?
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unknown
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4 things possibly associated with leukemia?
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1. radiation (high incidence)
2. benzene exposure (increased incidence) 3. antitumor drugs 4. congenital? (correlation b/n it and people with congenital disorders) |
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Molecular biology of leukemias?
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chromosomal changes associated with leukemia, may include:
a. deletions (missing genes on chromosomes) b. translocations (genes in wrong location) c. inversion (gene order flipped) |
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9 manifestations of leukemia?
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1. bone marrow depression (normal cells not produced bc your churning out abnormals)
2. malaise, fatigue 3. fever (WBCs assoc w fever) 4. bleeding (petechiae, eccysmosis, gingival) 5. bone pain/ tenderness 6. headache 7. abdominal discomfort 8. infections 9. anemia |
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What is ecchymosis?
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small hemorrhages in mucous membrane
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What is bone pain in leukemias caused by?
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increased cell production
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Why are infections associated with leukemias?
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b/c the cells produced are not mature enough to fight off infections
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Describe acute lymphocytic lymphoma (ALL)?
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-rapid, more immature lymphoid lineage
-see in children and young adults -most are B cell precursors cell type -prognosis: 80% of children cured, 30-40% of adults achieve long-term survival |
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Describe acute myelocytic leukemias (AML)?
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-predominantly adults
-strong toxin and congenital disorder correlation -heterogenous cell types -prognosis: 30-40% achieve 4-years disease free |
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5 warning signs of acute leukemias?
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1. fatigue
2. pallor 3. weight loss 4. repeated infections 5. bleeding |
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Diagnosis of acute leukemias?
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have to look at blood smear (increased counts)(anemic because decreased RBC and platelets)
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Tx for acute leukemias?
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chemo
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What is tumor lysis syndrome?
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associated with acute leukemias
-during tx normal cells dying and tumor cells are dying...these lysed cells release content and can be life threatening |
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Describe chronic lymphcytic leukemia (CLL)?
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-seen in older persons (less than 10% under 50 yo)
-2x more men than women -gradual (chronic) accum. of nearly mature B cells |
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Describe chronic myelocytic leukemia (CML)?
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-predom. 30-50yo
-slightly more men than women -malignant transformation of pluripotent hematopoietic stem cells (granulocytes) -assoc. with translocation of gene (the philadelphia chromosome from #9 to #22) |
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Chronic leukemias have a more ? onset than acute.
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insidious
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3 manifestations of CLL?
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1. fatigue
2. reduced exercise tolerance 3. enlarged superficial lymph nodes, splenomegaly |
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3 CML manifestations?
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1. chronic (asymptomatic) phase
2. accelerated phase 3. terminal blast phase |
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Describe chronic (asymptomatic) phase of CML?
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could be years before symptoms. Unfortunate because it holds off tx.
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Describe accelerated phase of CML?
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-start to see changes
-enlargement of spleen...feel full -increased #s of myelocytic cells...ex. basophils -low grade fever -lethargy -bone pain -bleeding..bc platelets needed for clogging |
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Describe terminal blast crisis of CML?
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"the end"
-an acute leukemia at this point -very immature cells -only survive about 3 months -increased spleen size -cells may go into lymph nodes |
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Diagnosis for Chronic leukemias?
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blood and bone marrow studies (may or may not see depending on stage for blood studies)
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Tx of CLL?
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survival is less than 2 years to about 10 depending on how quick you catch it
-variable, depending upon cell type involved, stage of disease, persons health and age -early: no tx or chemo -aggressive: in young pts, stem cell transplant |
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Tx of CML?
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survival is 3-4 years without transplant
-chemo -bone marrow/stem cell transplant |