Myeloproliferative & Lymphoproliferative Disorders

Blast cells Rare in children - incidence increases with age Increased WBC -> infiltrate bone marrow = anemia, thrombocytopenia, neutropenia

Philadelphia Chromosome (translocation between 9 and 22) Overproduction of neutrophils 5th - 6th decade Chronic phase = anaemia, anorexia, splenomegaly Accelerated phase = 20 - 30% blast cells, anaemia, thrombocytopenia Blast Crisis = >30% blast cells in blood and bone marrow, fatal acute leukaemic phase

Malignant B precursos cells (80% cases) Peak incidence = childhood May infiltrate CNS = anaemia, infection, haemorrhage

Increased immature B lymphocytes = immune suppression Smudge cells in blood smear Elderly Diagnosis = increased blood lymphocyte numbers Anaemia, recurrent infections, weight loss, hepatomegaly and splenomegaly

REED-STERNBERG cells Bi-modal occurance = 20 - 30yrs and >50yrs 2x more common in men Symptoms = fever, sweating, weight loss, fatigue Lymphadenopathy - assymetrical, commonly cervical region, painless

Any age Heterogenous group Wide range - relatively benign to aggressive Subsequent clinical signs depend on other body systems affected Painless lymphadenopathy

Elderly Increased Ig's of Ig fragments (BENCE-JONES PROTEINS) - damages and blocks renal tubules Uncontrolled proliferation of plasma cells in bone marrow Increased plasma cells causes - lysis of bone (bone pain), anaemia, lethargy

Group of conditions characterised by clonal proliferation of 1 or more haematopoietic components in the bone marrow: Increased RBC precursor = Polycthemia Vera Increased Megakaryocytes = Essential Thrombocythemia Granulocyte precursor = Chronic and Acute myeloid leukaemia

Elderly BONE MARROW FAILURE - abnormalities of all 3 myeloid cell lines (granulocytes, RBC, megakaryocytes) = neutropenia, thrombopenia, anaemia Often leads to AML Diagnosis: haemorrhage, infections, abnormal rbc and wbc, chromosomal abnormalities - Monosomy 7, Monosomy 5, Trisomy 5