Sandbox:Hannan: Difference between revisions
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! rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Myeloproliferative neoplasms (MPN) | ! rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Myeloproliferative neoplasms (MPN) | ||
! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Clinical manifestations | ! colspan="2" style="background:#4479BA; color: #FFFFFF;" align="center" + |Clinical manifestations | ||
! colspan=" | ! colspan="12" style="background:#4479BA; color: #FFFFFF;" align="center" + |Diagnosis | ||
! rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features | ! rowspan="4" style="background:#4479BA; color: #FFFFFF;" align="center" + |Other features | ||
|- | |- | ||
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Symptoms | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Symptoms | ||
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical examination | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Physical examination | ||
! colspan=" | ! colspan="9" style="background:#4479BA; color: #FFFFFF;" align="center" + |Lab findings | ||
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Bone marrow biopsy | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Bone marrow biopsy | ||
! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Gold standard | ! rowspan="3" style="background:#4479BA; color: #FFFFFF;" align="center" + |Gold standard | ||
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! colspan="7" |WBCs | ! colspan="7" |WBCs | ||
! rowspan="2" |RBCs | ! rowspan="2" |RBCs | ||
! | ! rowspan="2" |Platelets | ||
|- | |- | ||
!<small>Leukocytosis</small> | !<small>Leukocytosis</small> | ||
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(CML), BCR-ABL1+ | (CML), BCR-ABL1+ | ||
|<small>Asymptomatic</small> | | | ||
* <small>Asymptomatic</small> | |||
<small>Non-specific</small> | * <small>Non-specific</small> | ||
* <small>Hyperviscosity related</small> | |||
<small> | * <small>Anemia related</small> | ||
* <small>Bleeding</small> | |||
* <small>Infection</small> | |||
* | * | ||
| | | | ||
* <small> | * <small>Splenomegaly (46–76%)</small> | ||
* <small>Purpura</small> | * <small>Purpura</small> | ||
* <small> | * <small>Anemia related</small> | ||
* <small> | * <small>Priapism</small> | ||
|<small> | |<small>Absolute leukocytosis</small> <small>(median of 100,000/µL)</small> | ||
|<small> | |<small>Blasts usually <2%</small> | ||
| | |<small>Left shift with</small> <small>classic myelocyte bulge (myelocytes > metamyelocytes on the blood smear</small><small>)</small> | ||
* | * | ||
|<small> | |<small>Absolute basophilia is almost always present</small> | ||
|<small> | |<small>Absolute eosinophilia in 90% of patients</small> | ||
|<small> | |<small>Often present</small> | ||
| | | | ||
|<small>Anemia</small> | |<small>Anemia</small> | ||
| | |<small>Platelet count is usually normal or elevated but t</small><small>hrombocytopenia indicates advanced stage or an alternative diagnosis</small> | ||
| | | | ||
|<small>Bone marrow aspirate and unilateral biopsy with conventional cytogenetics and flow cytometry</small> | |<small>Bone marrow aspirate and unilateral biopsy with conventional cytogenetics and flow cytometry</small> | ||
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|- | |- | ||
|Chronic neutrophilic leukemia (CNL) | |Chronic neutrophilic leukemia (CNL) | ||
| | | | ||
| | | | ||
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|- | |- | ||
|Polycythemia vera (PV) | |Polycythemia vera (PV) | ||
| | | | ||
| | | | ||
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* <small>prefibrotic/early stage</small> | * <small>prefibrotic/early stage</small> | ||
* <small>overt fibrotic stage</small> | * <small>overt fibrotic stage</small> | ||
| | | | ||
| | | | ||
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|- | |- | ||
|Essential thrombocythemia (ET) | |Essential thrombocythemia (ET) | ||
| | | | ||
| | | | ||
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|- | |- | ||
|Chronic eosinophilic leukemia, not otherwise specified (NOS) | |Chronic eosinophilic leukemia, not otherwise specified (NOS) | ||
| | | | ||
| | | | ||
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|- | |- | ||
|MPN, unclassifiable | |MPN, unclassifiable | ||
| | | | ||
| | | | ||
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|- | |- | ||
|Mastocytosis | |Mastocytosis | ||
| | | | ||
| | | |
Revision as of 18:54, 15 January 2019
Myeloproliferative neoplasms (MPN) | Clinical manifestations | Diagnosis | Other features | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical examination | Lab findings | Bone marrow biopsy | Gold standard | Other investigations | ||||||||||
WBCs | RBCs | Platelets | |||||||||||||
Leukocytosis | Blasts | Left shift | Basophilia | Eosinophilia | Monocytosis | Others | |||||||||
Chronic myeloid leukemia
(CML), BCR-ABL1+ |
|
|
Absolute leukocytosis (median of 100,000/µL) | Blasts usually <2% | Left shift with classic myelocyte bulge (myelocytes > metamyelocytes on the blood smear)
|
Absolute basophilia is almost always present | Absolute eosinophilia in 90% of patients | Often present | Anemia | Platelet count is usually normal or elevated but thrombocytopenia indicates advanced stage or an alternative diagnosis | Bone marrow aspirate and unilateral biopsy with conventional cytogenetics and flow cytometry | ||||
Chronic neutrophilic leukemia (CNL) | |||||||||||||||
Polycythemia vera (PV) | |||||||||||||||
Primary myelofibrosis (PMF)
|
|||||||||||||||
Essential thrombocythemia (ET) | |||||||||||||||
Chronic eosinophilic leukemia, not otherwise specified (NOS) | |||||||||||||||
MPN, unclassifiable | |||||||||||||||
Mastocytosis |
Other myeloid neoplasm and acute leukemia | Clinical manifestations | Diagnosis | Other features | ||||
---|---|---|---|---|---|---|---|
Symptoms | Physical examination | Lab findings | Bone marrow biopsy | Gold standard | Other investigations | ||
Myeloid/lymphoid neoplasms with eosinophilia and rearrangement of
PDGFRA, PDGFRB, or FGFR1, or with PCM1-JAK2
|
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Myelodysplastic/myeloproliferative neoplasms (MDS/MPN)
|
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Myelodysplastic syndromes (MDS)
|
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Acute myeloid leukemia (AML) and related neoplasms
|
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Blastic plasmacytoid dendritic cell neoplasm | |||||||
Acute leukemias of ambiguous lineage
|
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B-lymphoblastic leukemia/lymphoma
|
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T-lymphoblastic leukemia/lymphoma
|
- 50% of patients are asymptomatic
- Clinical features are generally nonspecific such as left upper quadrant pain, early satiety, fatigue & lethargy (most common presenting symptom), weight loss, and night sweats.
- symptoms of anemia
- bleeding
- priapism
- bone pain
- Abdominal mass or fullness
- Infection
- Headache
- Dyspnoea
- Visual disturbances
- Weakness
- Arthralgia
- Cough
- Malaise
- Dizziness
- Nausea/vomiting
- Ankle oedema
- Mental change