Sign InSign Up
All Posts

Hematology Of Leukemia

Discover the fascinating intricacies of leukemia's hematology, unraveling its mysterious nature and shedding light on its impact on the human body.
2023-03-16

USMLE Guide: Hematology of Leukemia

Introduction

Leukemia is a group of malignant disorders characterized by the uncontrolled proliferation of white blood cells in the bone marrow. This USMLE guide aims to provide a comprehensive overview of the hematology of leukemia, including its classification, clinical features, diagnostic tests, and treatment options.

Classification

  1. Acute Leukemias:
    • Acute Lymphoblastic Leukemia (ALL)
    • Acute Myeloid Leukemia (AML)
  2. Chronic Leukemias:
    • Chronic Lymphocytic Leukemia (CLL)
    • Chronic Myeloid Leukemia (CML)

Clinical Features

  1. Acute Leukemias:
    • Fatigue, pallor, and weakness due to anemia
    • Bone pain and tenderness
    • Increased susceptibility to infections
    • Bleeding tendencies (e.g., petechiae, ecchymoses)
  2. Chronic Leukemias:
    • Often asymptomatic initially
    • Fatigue, weight loss, and night sweats
    • Splenomegaly and hepatomegaly
    • Lymphadenopathy

Diagnostic Tests

  1. Complete Blood Count (CBC):
    • Leukocytosis with immature cells (blasts) in acute leukemias
    • Leukocytosis or lymphocytosis in chronic leukemias
    • Anemia and thrombocytopenia may be present
  2. Peripheral Blood Smear:
    • Presence of blasts in acute leukemias
    • Smudge cells in chronic lymphocytic leukemia (CLL)
    • Basophilia and increased granulocyte precursors in chronic myeloid leukemia (CML)
  3. Bone Marrow Aspiration and Biopsy:
    • Gold standard for diagnosis and classification
    • Increased blast cells in acute leukemias
    • Lymphocytic infiltration in CLL
    • Philadelphia chromosome (BCR-ABL fusion gene) in CML
  4. Flow Cytometry:
    • Immunophenotyping to determine the lineage of leukemic cells
    • Helps in distinguishing between ALL and AML

Treatment Options

  1. Chemotherapy:
    • Induction therapy to achieve remission
    • Consolidation therapy to eliminate residual leukemic cells
    • Maintenance therapy to prevent relapse
  2. Stem Cell Transplantation:
    • Allogeneic transplantation for younger patients with high-risk disease
    • Autologous transplantation for eligible patients in remission
  3. Targeted Therapy:
    • Tyrosine kinase inhibitors (e.g., imatinib) for CML patients with the Philadelphia chromosome
    • Monoclonal antibodies (e.g., rituximab) for CLL patients
  4. Supportive Care:
    • Blood transfusions and growth factors to manage anemia and thrombocytopenia
    • Prophylactic antibiotics to prevent infections

Conclusion

Leukemia is a heterogeneous group of malignant disorders affecting the white blood cells. Understanding the classification, clinical features, diagnostic tests, and treatment options is essential for medical students preparing for the USMLE.

USMLE Test Prep
a StudyNova service

Support

GuidesStep 1 Sample QuestionsStep 2 Sample QuestionsStep 3 Sample QuestionsPricing

Install App coming soon

© 2024 StudyNova, Inc. All rights reserved.

TwitterYouTube