RAMORAN, PAMELA GRACE L.

HEMATOLOGY I
B MebLabSci III

March 9, 2015

1. What is leukemia?
Leukemia is cancer of the body's blood-forming tissues, including
the bone marrow and the lymphatic system, and causes large numbers of
abnormal blood cells to be produced and enter the bloodstream.
Leukemia is a malignant disease characterized by unregulated
proliferation of one cell type. It may involve any of the cell lines or a
stem cell common to several cell lines.

2. What are the causes of leukemia?

The exact cause is frequently not known, but predisposing
factors are known:
A. Host Factors
Some individuals have an inherited increased predisposition to
develop leukemia.
There is an increased incidence in those with an inherited
tendency for chromosome fragility or abnormality or those
with increased numbers of chromosomes (such as Downs
syndrome).
Many of these diseases are characterized by
chromosomal translocations.
There is an increased incidence in those with hereditary
immunodeficiency.
There is an increased incidence in those with chronic marrow
dysfunction such as those with myeloproliferative diseases,
myelodysplastic syndromes, aplastic anemia, or paroxsymal
nocturnal hemoglobinuria.
B. Environmental Factors
Exposure to ionizing radiation
Exposure to mutagenic chemicals and drugs
Viral infections

3. What is leukemoid reaction?

A leukemoid reaction is a reactive increase in the white blood cell
count, which can mimic leukemia. The reaction is actually due to an
infection or another disease and is not a sign of cancer. Blood counts
usually return to normal when the underlying condition is treated.

A leukemoid reaction occurs when there is extremely high leukocyte

counts seen in a non- leukemic state and may be lymphoid or granulocytic
in nature.
Causes
Severe infections
Extensive burns
Malignancies with bone marrow infiltration
Severe hemorrhage
Lymphoid reactions seen usually in children in response to viral
infections

4. Give the classification of leukemia according to

duration.
A. Acute Leukemia
Acute Leukemias are associated with excessive proliferation of a
developing cell (blast) that has failed to mature. The immature cells
proliferate and gradually replace the normal cells in the bone marrow, and
then spill out into the circulation and other tissues.
Acute leukemia usually develops quickly. The number of leukemia
cells increases rapidly, and these abnormal cells dont do the work of
normal white blood cells. A bone marrow test may show a high level of
leukemia cells and low levels of normal blood cells. People with acute
leukemia may feel very tired, bruise easily, and get infections often.
B. Chronic Leukemia
Chronic leukemia differs from acute leukemia in that, in the early
course of the disease, the malignant cell is a mature cell. As well, the
patient is unwell for months and survival predictions in terms of years.
Chronic leukemia usually develops slowly. The leukemia cells work
almost as well as normal white blood cells. People may not feel sick at
first, and the first sign of illness may be abnormal results on a routine
blood test. For example, a blood test may show a high level of leukemia
cells. If not treated, the leukemia cells may later crowd out normal blood
cells.

5. Give the classification of leukemia according to

type of cell involved.
Leukemia also is classified according to the type of white blood cell
that is multiplyingthat is, lymphocytes (immune system cells),
granulocytes (bacteria-destroying cells), or monocytes (macrophageforming cells).
A. Myeloid Leukemia

If the abnormal white blood cells are primarily granulocytes or

monocytes, the leukemia is categorized as myelogenous, or myeloid
leukemia.
B. Lymphocytic Leukemia
On the other hand, if the abnormal blood cells arise from bone
marrow lymphocytes, the cancer is called lymphocytic leukemia.

6. Give the classification of leukemia according to

age.
A. Acute Lymphocytic Leukemia (ALL)
This is the most common type of leukemia in young children. ALL
can also occur in adults.
B. Acute Myelogenous Leukemia (AML)
AML is a common type of leukemia. It occurs in children and adults.
AML is the most common type of acute leukemia in adults.
C. Chronic Lymphocytic Leukemia (CLL)
With CLL, the most common chronic adult leukemia, you may feel
well for years without needing treatment.
D. Chronic Myelogenous Leukemia (CML)
This type of leukemia mainly affects adults. A person with CML may
have few or no symptoms for months or years before entering a phase in
which the leukemia cells grow more quickly.

7. Give the procedure and test to differentiate

leukemia from leukemoid reaction.
Leukocyte Alkaline Phosphatase (LAP) Test
This is a semi quantitative assessment of the level of functional
alkaline phosphatase in the cytoplasm of neutrophils.
Method: Film is made from freshly collected blood, and immediately
fixed.
Incubate in a phosphate solution, then rinse and
counterstain.
Interpretation:
Assess the number and intensity of blue cytoplasmic granules
in 100 cells.
For each cell score 0-4. Maximum score is 400. Normal 35 -100
0: No stained granules
1: few granules

2: moderate staining
3: Numerous granules, strongly positive
4: Numerous intensely stained granules