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Hematologic neoplasms (multiple myeloma: malignant disease of plasma cells…

- - - - control of risk factors r/t too many cells
        stop smoking
        lose weight
        control HTN and DM
        avoid high dose aspirin
        avoid iron supplementatoin
        cool baths help pruritis
- - - - variable r/t diverse NHLs
        lymphadenopathy
        b symptoms in 1/3
        comorbidities r/t lymph enlargement
        CNS involvement
    - - histology of affected cells
        staging dependent on CT/PET scans
    - - stage/type dependent
        interferon
        chemo
        radiation
  - - - painless lymphadenopathy
        pruritus
        fever
        sweats
        weight loss
    - - stage dependent
        chemo and/or radiation
    - - rule out infection
        lymph node biopsy
        Reed Sternberg cells present
        stage
        assess for B symptoms
        CBC
        platelets
        ESR
        liver/renal function
- - - - signs
        symptoms
        
        CNS involvement common:
        cranial nerve palsies
        headache &
        vomiting r/t meningeal involvement
        
        pain r/t hepato or splenomegaly
        bone pain
      - treatment
        
        chemo
        imatinib mesylate (philly +)
        BMT
        monoclonal antibody therapy
      - bloodwork
        
        reduced: granulocytes, erythrocytes, plateles
        leukocytes: high or low, with high proportion of immature cells
      - young children
        boys > girls
        responsive to therapy
    - - signs
        symptoms
        
        lymphadenopathy (can be painful)
        hepatomegaly
        splenomegaly
        anemia/thrombocytopenia
        autoimmune destruction of RBCs/platelets by RES
        "B symptoms:: fever, sweats, weight loss
      - bloodwork
        
        lymphocytosis (increased lymphocytes)
        early: normal erythrocyte & platelet
        later: decreased erythrocyte & platelet
      - treatment
        
        chemo
        monoclonal antibody
      - most common leukemia
        more common in older adults
        men > women
        survival 2-14 years (r/t stage)
  - - - signs/
        symptoms
        
        fever/infection
        weakness
        bleeding
      - bloodwork
        
        blasts increase by 20%
      - treatment
        
        aggresive chemo
        induction therapy
      - most common non-lymphocytic anemia
        average age 60 yo
    - - signs/
        symptoms
        
        asymptomatic
        
        malaise
        
        anorixia
        
        weight loss
        
        confusion, sob r/t leukostasis
        
        enlarged, tender spleen
        
        enlarged liver
      - bloodwork
        
        increased leukocyte count (>2000,000/mm3)
      - treatment
        
        chemo
        imatinib mesylate (block BCR-ABL protein expression
        BMT
      - mutation of myeloid stem cell r/t philadelphia chromosom
        results in uncontrolled cell proliferation
        3 stages" chronic, transformational, blast crisis
        55-60 average age
        3-5 years to live