White Blood Cell And Lymphoid Tissue Disorders

Front 1

What is the first line defense?

Back 1

T cells, cellular immunity

Front 2

What are T-lymphocytes cells?

Back 2

from thymus, marrow; kill foreign cells or secrete substances to increase activity of phagocytes, responsible for delayed allergic reactions, transplant rejection and destruction of tumor cells

*cellular immunity

Front 3

What are b-lymphocytes cells?

Back 3

produced in bone marrow

-differentiate into plasma cells which produce immunoglobulin (protein that destroys foreign matter)

*Humoral immunity = antibodies

Front 4

Role of neutrophil?

Back 4

-released into circulation within 6 hr

-phagocytosis

-first defense against bacterial infection

Front 5

Role of monocytes?

Back 5

-convert to macrophages in the tissue

-phagocytosis

-second line of defense

-pac man

Front 6

Role of eosinophils?

Back 6

-phagocytosis of parasites

-increase in allergic reactions

-neutralize histamine

Front 7

Role of basophils?

Back 7

Produce and store histamine (histamine provokes allergic reaction)

-manifestations of inflammation

Front 8

What is leukemia?

Back 8

-"white blood"

-ratio of RBCs to WBCs is reversed

-happens in childhood and adults

Front 9

What is the pathophysiology of leukemia?

Back 9

-Proliferation of one type of WBC

-malignant transformation of one stem cell (bad cell takes over and kills other good cells)

-Major feature: crowds out other cells, which results in anemia/thrombocytopenia

-WBCs are immature, do not function, high risk for infection

Front 10

Common S&S of leukemia?

Back 10

*Fatigue (common)

-LOA, wt loss, fever, infections

-swelling

-enlargement of spleen/liver

-night sweats, easy bleeding bruising, purplish patches

-pain/tenderness of joints/bones

-SOB

-Weakness

Front 11

What is the survival rate?

Back 11

w/ out tx= dead

46% 5 year

Front 12

What is acute myeloid?

Back 12

uncontrolled proliferation of myeloblasts (granulocytes)

Front 13

How does AML develop?

Back 13

-DNA change of bone marrow and multiplies, huge explosion of unhealthy cells (leukemic blasts) = don't function normally and flushes all good out

Front 14

What are some causes and risk factors with AML?

Back 14

Benzene

down's syndrome

radiation/chemo

-cannot catch

Front 15

What are S&S of AML?

Back 15

-Fatigue

-SOB

-pale skin

-bruises with no cause

-swollen gums

-frequent minor infections (peri anal sores)

Front 16

Tx of AML?

Back 16

Chemotherapy

anti-tumor antibiotics

-antimetabolics

-DNA repair enzyme inhibitor

ect.

-stem cell transplant

Front 17

What is chronic myeloid leukemia?

Back 17

unregulated growth of myeloid cells typically has 3 phases

-chronic (may/may not have S&S)

-Accelerated phase (Showing classic S&S, increase blasts cells, swollen spleen)

-Blast crisis phase (lots of blasts, treated very aggressively)

Front 18

What is the incidence of CML? Risk factors?

Back 18

-effects mainly adults >65

-5000 diagnosed/yr

-RF: increased doses of radiation and other chemo

-RF: Philedelphia chromosome: stuff that should be on chromosome 22 are on 9

Front 19

CML treatment?

Back 19

TX phase: return blood levels back to normal

Chronic phase

-imatinib mesylate

-dasatinib

-nilotinib

Accelerated/blast crisis

-interferon

-busulfan

-cytabine

-hydroxyurea

STEM cell transplant

Front 20

What is acute lymphoctyic leukemia?

Back 20

characterized by excess lymphoblasts

-most common type of cancer age 1-7

-most common leukemia for kids infancy- 19

Front 21

Risk factors for ALL?

Back 21

Unknown

maybe X-rays or certain medications

Front 22

ALL subtypes?

Back 22

BCell ALL

T Cell ALL

Humoral or cellular can be affected

Front 23

ALL tx?

Back 23

stem cell transplant

intrathecal therapy

spinal tap cerebral spinal fluids

Front 24

What is chronic lyphocytic leukemia?

Back 24

-Affects bcell lymphocytes

-most common type of leukemia

-almost all over the age of 50

-RAPIDly progresses

Front 25

CLL causes?

Back 25

No known

Potentially vietnam agent orange

Front 26

Forms of CLL?

Back 26

slow-growing (no need for immediate tx, no s&S)

Faster growing (needs immediate tx)

Front 27

Staging systems consider certain factors such as:

Back 27

-the elevation of your blood and marrow leukemic lymphocyte counts

-your lymph nodes size and distribution

-your spleen's size

-the extent of your decreased blood platelet counts

-the degree of anemia

Front 28

CLL Tx?

Back 28

-watch and wait

-drug therapy (chemotherapy and monoclonal antibody therapy)

-white cell (neutrophil) growth factors

-Radiation therapy

-splenectomy

Front 29

Diagnostics w/ leukemia?

Back 29

CBC w/ diff

-low RBCs, platelets, hub, hct, clotting factos

-elevated PTT, WBC w/ immature cells

Front 30

Why do a bone marrow biopsy?

Back 30

-identification of blast cells and proteins

-chromosome analysis: aids in identification of the type and prognosis

Front 31

Induction stage (stage 1) of chemotherapy

Back 31

-supportive care: transfusion, treat infections, use G-CSF and Gm-CSF (stimulate the bone marrow to help produce normal blood cells), granulocytic growth factor of colony stimulating factors

-intense phase

Front 32

Consolidation (stage 2) of chemotherapy

Back 32

-eliminate residual leukemic cells

-multiple cycles, lower dosages

Front 33

What is radiation?

Back 33

-damages cellular DNA

-Responds quickly to radiation and prevents cells from dividing

-systemic radiation is hard on the body

Front 34

What are the types of bone marrow transplant/stem cell transplant?

Back 34

Autologous: receive own stem cells (not common)

Allogeneic: receive cells from closely matched sibling or unknown donor

Syngeneic: cells from identical twin

Front 35

Stage 1 of bone marrow transplant: stem cell obtainment

Back 35

-find best match

-Three sources: bone marrow harvest, peripheral blood (stem cell pheresis), umbilical cord blood

Front 36

Stage 2 of bone marrow transplant: conditioning regimen

Back 36

-lasts 5-10 days

-same side effects as with chemo/radiation (nausea, vomiting, stomatitis, capillary leak syndrome, diarrhea, severe bone marrow suppression)

Front 37

Stage 3 of bone marrow transplant: transplantation

Back 37

-2 days after conditioning stopped, allows chemo drugs to get out of system so they won't kill transplanted cells

-WBC close to 0

-infusion like blood transfusion (over about 30 min)

Front 38

Stage 4 of bone marrow transplant: engraftment

Back 38

"wait and see what happens"

=8-12 days for peripheral blood

-12-28 days for bone marrow

-when engraftment occurs, know that it worked, rise in blood cell counts

-GCSF and GMCSF given to stimulate production

Front 39

Stage 5 of bone marrow transplant: post transplantation recovery

Back 39

-waiting period to see level of success

-at extreme risk for bleeding and infection

Front 40

Complications of bone marrow transplant

Back 40

-failure to engraft

-graft versus host disease (bone marrow that is transplanted doesn't recognize host) autoimmune disease

Front 41

*Presence of what indicates engraftment?

Back 41

GVHD