A condition where there are fewer WBCs than
normal Causes: Neutropenia Lymphopenia:
Neutrophil count less than 2,000/mm3 Causes: Decrease production of neutrophils Increased destruction of neutrophils.
Sequelae: Increase risk for infection Increased duration of neutropenia leads to increased risk of infection.
There is no definite symptoms of neutropenia
until the patient becomes infected.
LEUKOCYTOSIS Increased level of WBCs in the circulation. Causes: Increase need (e.g. In acute infection) Malignancy
LEUKEMIA A neoplastic proliferation of one particular cell
type (granulocytes, monocytes, lymphocytes, or the megakaryocytes) There is an unregulated proliferation of WBCs in the bone marrow
ACUTE MYELOID LEUKEMIA results from a defect in the hematopoietic stem
cell that differentiates into all myeloid cells: monocytes, granulocytes (neutrophils, basophils, eosinophils), erythrocytes, and platelets. Resistant to treatment, resulting in a much shorter duration of remision. With treatment, the patient survive an average of less than 1 year, with death usually a result of infection or hemorrhage.
Clinical Manifestations: evolve from
insufficient production of normal blood cells. Fever and infection because of neutropenia Weakness and fatigue because of anemia Bleeding tendencies because of
thrombocytopenia Ecchymosis and petechia
Enlarged liver or spleen Hyperplasia of the gums Bone pain from expansion of marrow
Complications: bleeding Correlates with the level of thrombocytopenia Major hemorrhage occurs when the platelet counts
drops to less than 10,000/mm3 Common sites of bleeding: Gastrointestinal Pulmonary intracrania
Infection Because of the lack of mature and normal granulocytes
CHRONIC MYELOID LEUKEMIA arises from the mutation in the myeloid stem
cell. Normal myeloid cells continue to be produced but there is a preference for immature (blast) forms. A section of DNA is missing from chromosome 22 (Philadelphia chromosome) translocated in chromosome 9 causes the WBC to divide rapidly Patients have overall median life expectancy of 3 – 5 years.
Clinical Manifestations: Majority are asymptomatic WBC count exceeds 100,000/mm3 SOB and Slightly confused due to decreased capillary perfusion to the lungs and brain from leukostatis Enlarged tender spleen Enlarged liver
ACUTE LYMPHOCYTIC LEUKEMIA Results from uncontrolled proliferation of
immautre cells (lymphoblast) derived from the lymphoid stem cells. Most common in young children Clinical manifestations: Reduced number of erythrocytes, leukocytes,
and platelets. Pain from enlarged spleen or liver Bone pain headache and vomiting
CHRONIC LYMPHOCYTIC LEUKEMIA Common malignancy of older adults Derives from a malignant clone of B
lymphocytes Most of the cells are fully mautre. Clinical Manifestations: Aysmptomatic in early stages Elevated lymphocyte count (>100,000/mm3) Lymphadenopathy Hepatomegaly Splenomegaly Anemia Thrombocytopenia Anergy
absent or decreased reaction to skin sensitivity test infection
NEOPLASMS OF CELSS OF LYMPHOID ORIGIN
A relatively rare malignancy that has an
impressive cure rate. Reed-Sternberg cells Malignant cells of Hodgkin’s disease Gigantic tumor cell that is morphologically
unique and is thought to be of immature lymphoid origin. Pathologic hallmark and essential diagnostic criterion for Hodgkin’s Disease
Clinical Manifestations: Painless enlargement of one or more
lymph nodes on one side of the neck. Cervical lymph nodes Supraclavicular lymph nodes Mediastinal lymph nodes
Mediastinal mass dyspnea Pruritus Brief but severe pain after drinking
alcohol Cough and pulmonary effusion Jaundice Abdominal pain Bone pain Anergy
Malignant disease of the most mature form of
B lymphocytes, the plasma cells Malignant plasma cells produced an increased amount of a specific immunoglobulin that is non-functional monoclonal protein (M protein) Serves as a useful marker to monitor the extent
of the disease and the patient’s response to therapy.
Clinical manifestatons: Bone pain (usually in the back or ribs)
classic presenting symptoms Lytic lesions in the bone Osteoporosis Increase risk for fractures
Hypercalcemia Excessive thirst, dehydration, constipation, altered
mental status, confusion, coma Renal failure Anemia Reduced WBC and platelets