...Bone marrow examination | A Wright's stained bone marrow aspirate smear from a patient with leukemia. | Bone marrow examination refers to the pathologic analysis of samples of bone marrow obtained by bone marrow biopsy (often called a trephine biopsy) and bone marrow aspiration. A bone marrow aspiration should be performed as part of the same procedure. For patient safety and convenience, biopsies are usually performed on the posterior iliac crest. The biopsy specimen should measure at least 1.6 cm and, if it does not, consideration should be given to repeating the procedure, possibly on the contralateral iliac crest. Bone marrow examination is used in the diagnosis of a number of conditions, including leukemia, multiple myeloma, lymphoma, anemia, and pancytopenia. The bone marrow produces the cellular elements of the blood, including platelets, red blood cells and white blood cells. While much information can be gleaned by testing the blood itself (drawn from a vein by phlebotomy), it is sometimes necessary to examine the source of the blood cells in the bone marrow to obtain more information on hematopoiesis; this is the role of bone marrow aspiration and biopsy. { A trephine (/trɨˈfaɪn/; from Latin trypan, meaning to bore) is a surgical instrument with a cylindrical blade. It can be of one of several dimensions and designs depending on what it is going to be used for. They may be specially designed for obtaining a cylindrically shaped core of bone that can be used for...
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...Multiple Myeloma Practical Apllication of dsdsd Nikolitsa Vagenas Azusa Pacific University Case Study: Multiple Myeloma What is Multiple Myeloma? What is it Yiayia are you going to be okay? I remember saying these exact words after finding out that my grandmother had been diagnosed with cancer, this was about seven years ago. When she was first diagnosed with cancer, she made sure that the whole family knew right away and this took a toll on my family. Before this had all happened, my Yiayia, Greek for grandmother, knew she had multiple myeloma she complained about having back pain. We just assumed it was from her osteoporosis, which causes bones to become fragile (Osteoporosis Mayo Clinic Staff, 2014)....
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... Aplastic anemia is a condition where bone marrow does not produce sufficient new cells to replenish blood cells. The condition, per its name, involves both aplasia and anemia. Typically, anemia refers to low red blood cell counts, but aplastic anemia patients have lower counts of all three blood cell types: red blood cells, white blood cells, and platelets, termed pancytopenia. Causes Congenital or inherited causes Congenital or inherited causes of aplastic anemia (20%) include the following: • Patients usually have dysmorphic features or physical stigmata; on occasion, marrow failure may be the initial presenting feature. • Fanconi anemia • Dyskeratosis congenita • Cartilage-hair hypoplasia • Pearson syndrome • Amegakaryocytic thrombocytopenia (thrombocytopenia-absent radius [TAR] syndrome) • Shwachman-Diamond syndrome • Dubowitz syndrome • Diamond-Blackfan syndrome • Familial aplastic anemia Acquired causes Acquired causes of aplastic anemia (80%) include the following: • Idiopathic factors • Infectious causes, such as hepatitis viruses, Epstein-Barr virus (EBV), human immunodeficiency virus (HIV), parvovirus, and mycobacteria • Toxic exposure to radiation and chemicals, such as benzene • Transfusional GVHD • Orthotopic liver transplantation for fulminant hepatitis • Pregnancy • Eosinophilic fasciitis Drugs and elements, such as chloramphenicol, phenylbutazone, and gold, may cause aplasia of the marrow. Staging Staging of aplastic anemia...
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...malignant plasma cells. Normal plasma cells are found in the bone marrow and are an important part of the immune system. Plasma cells become cancerous and grow out of control they can produce a tumor called a plasmacytoma. Theses tumors can develop in a bone but are also rarely found in other tissues. If there is only a single plasma cell tumor, it is called an isolated or solitary plasmacytoma. When there is more than one plasma cell tumor, it is called multiple myeloma. In the United States , the risk of getting multiple myeloma is 1 in 149% (0.67%). The American Cancer Society estimates in 2013: About 22,350 new cases will be diagnosed (12,440 men and 9,910 women). About 10,710 deaths will occur (6,070 men and 4,640 women). (https://www.cancer.org/cancer/multiplemyeloma/detailsguide/multiple-myeloma-key-statistics.) Most people who develop multiple myeloma have no clear risk factors: However some risk factors have been identified. Risk factors concerning multiple myeloma included: age, gender, race, obesity, employment in the petroleum industry and exposure to radiation. Most first diagnosis is usually seen in patient’s in the early to mid 60’s, men are diagnosed much more frequently than women, African American’s are diagnosed twice as often as white Americans, a study by the American Cancer Society shows that obesity increases the risk of multiple myeloma, exposure to radiation accounts for a small number of cases diagnosed and petroleum workers have shown a slight increase...
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...cells are formed and how they act. Most blood cells develop from stem cells, which can be found in bone marrow (soft material inside our bones – the “filling”). Stem cells mature into white blood cells, red blood cells, or platelets.2 The purpose of white blood cells is to fight off infection, while red blood cells carry oxygen and platelets aid in blood clotting, which controls bleeding. Plasma cells make antibodies, which are parts of the immune system and help the body protect itself from germs and other harmful substances (Exhibit 1).2 Myeloma begins when a plasma cell begins dividing uncontrollably, which sets off a chain reaction of abnormal cell divisions. These abnormal plasma cells are called myeloma cells. Eventually, there is a large buildup of myeloma cells in the bone marrow, potentially damaging the outer, solid part of the bone. The reason the disease is called multiple myeloma because it usually affects several bones in any given infected person. The myeloma cells, instead of creating the normal antibodies, create M proteins, which can collect in the urine, blood, or even in organs as blood spreads it throughout the body (Exhibit 2).2 Whether or not Multiple Myeloma has genetics roots which are traceable is still up for debate, but there isn’t much evidence to suggest that there is a genetic component in multiple myeloma diagnoses. A research study done by the Centre for Haematological Oncology at...
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...analogs of inorganic pyrophosphate that has an affinity for calcium.1 They are used in the treatment of various malignant and benign metabolic conditions, such as hypercalcemia of malignancy; Paget’s disease of bone; multiple myeloma; and metastases from distant sites such as breast, thyroid, prostate glands, and lung. The oral form of BPs is indicated in the management of osteoporosis, fibrous dysplasia, and most recently, osteogenesis imperfecta in the pediatric population.2,3 Currently, there are 5 bisphosphonates in clinical use: alendronate (Fosamax; Merck, Whitehouse Station, NJ), risedronate (Actonel; Proctor & Gamble Pharmaceuticals, Cincinnati, OH), ibandronate (Boniva; Roche Pharmaceuticals, Nutley, NY), zoledronate (Zometa; Novartis Pharmaceuticals, East Hanover, NJ), and pamidronate (Aredia; Novartis Pharmaceuticals). All 5 medications differ in their binding affinity to bone, potency, and duration.2–5 B Osteonecrosis of the jaws (ONJ) is a condition characterized by necrotic exposed bone in the jaws of patients receiving intravenous or oral bisphosphonate therapy. A review of the medical and dental literature reveals that the pathoetiology of ONJ remains unknown and there is no established link that bisphosphonates are the primary cause of this bone pathology. However, there is clinical evidence that Actinomyces may play a critical role in the pathogenesis of bisphosphonate-associated ONJ. Identification and a prolonged course of oral antimicrobial therapy...
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...SUBMITTED TO: ROMANA SIDDIQUE LECTURER MNS DEPARTMENT OF MATHEMATICS AND NATURAL SCIENCES Introduction Leukemia is a type of cancer that results in the body making too many abnormal white blood cells. This uncontrolled production results in an excessive amount of white blood cells that may be immature (acute leukemia) or mature (chronic leukemia). The leukemic cells may not function well to fight infection and may interfere with the production of red blood cells (which carry oxygen) and platelets (which control bleeding). Normally, white blood cells play an important role in the body's natural defence system. They target and destroy foreign invaders like viruses and bacteria. White blood cells are made in the marrow (the spongy core) of your bones. Without healthy and functioning white blood cells, the body is at risk of developing severe and sometimes fatal infections. Different types of leukemia Acute leukemia develops within days to weeks, and large numbers of immature cells called "blasts" build up. These cells can't function as well as normal white blood cells, so people with acute leukemia are at a higher risk of infection. Because the body is so busy producing "blasts," it can't make as many red blood cells or platelets, which can cause anemia and bleeding disorders. Chronic leukemia, which progresses over the course of months to years, involves overproduction of mature white blood cells that cannot function like normal white blood cells. There are 4 types...
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...the gene: ⇒ 25 % chance getting two mutated duplicates would result in the disease ⇒ 50 % chance of receiving only one mutated copy would end in the child being a carrier of the mutation but would not result in obtaining the disease itself ⇒ 25% chance of inheriting two ordinary copies of the gene • There has also been a usually high incidence of 6 cases...
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...other organs involved in the formation or storage of blood, the hematologic system allows the human body to maintain adequate oxygenation and tissue perfusion (Ignatavicius & Workman, 2010, p. 876). Because every cell, tissue, organ, and system is dependent on blood circulation for survival, hematologic problems involving impaired production, impaired function, or abnormal destruction of blood cells are likely to have wide-reaching effects on the patient's health and wellness (Ignatavicius & Workman, 2010, p. 876). This is especially clear when examining cancers of the hematologic system, including multiple myeloma. A cancer of certain white blood cells in the bone marrow known as plasma cells, “myeloma” refers to a tumor of the bone marrow, and “multiple” refers to more than one area of the bone marrow being affected (Mangan, 2006, p. 64hn1). Because the disease is incurable, and because only 30 percent of patients survive longer than five years after diagnosis, living with multiple myeloma can be difficult for patients and their families (Mangan, 2006, p. 64hn1). As health care providers on the front lines of patient care, nurses must be aware of the multi-system manifestations of multiple myeloma, be able to make the assessments needed to identify and prevent complications related to the disease and its treatment regimen, and be ready to provide patients and their families with knowledge and support. In this paper, the author will first provide a full description...
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...tumors are the cancerous tumors of the two different types of tumors. Can cause pain and interfere with normal function, but they can also cause other systems in the body to act abnormally. Malignant tumors can invade nearby groups of cells or tissues, crowding out and destroying normal cells. Sometimes cancer cells can break away from the tumor and travel to other parts of the body. Body fluids that carry cancer cells from the tumor to other parts of the body are called lymph’s. Lymph is a fluid that drains waste from cells and filters unwanted substances such as cancer cells. Isolated or disseminated tumor cells are single or small groups of tumor cells that have been separated from the tumor and can be found in the blood, lymph, or bone marrow. Men have slightly less than 1 in 2 chances that they will develop some type of cancer during their lifetime. Approximately 77% of all cancers are diagnosed in persons aged 55 and older. The most frequently diagnosed cancer in men in the US is prostate cancer. ( (Disease)) Symptoms of prostate cancer are as follows, Weak or interrupted flow of urine, Frequent urination (especially at night).Trouble urinating, Pain or burning during urination, Blood in the urine or semen, A pain in the back, hips or pelvis that doesn't go away and Painful ejaculation. Medical attention is required if any of these symptoms occur. Even though the causes of prostate cancer are unknown it is known that the growth of cancer cells in the prostate are stimulated...
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...tumors are the cancerous tumors of the two different types of tumors. Can cause pain and interfere with normal function, but they can also cause other systems in the body to act abnormally. Malignant tumors can invade nearby groups of cells or tissues, crowding out and destroying normal cells. Sometimes cancer cells can break away from the tumor and travel to other parts of the body. Body fluids that carry cancer cells from the tumor to other parts of the body are called lymph’s. Lymph is a fluid that drains waste from cells and filters unwanted substances such as cancer cells. Isolated or disseminated tumor cells are single or small groups of tumor cells that have been separated from the tumor and can be found in the blood, lymph, or bone marrow. Men have slightly less than 1 in 2 chances that they will develop some type of cancer during their lifetime. Approximately 77% of all cancers are diagnosed in persons aged 55 and older. The most frequently diagnosed cancer in men in the US is prostate cancer. ( (Disease)) Symptoms of prostate cancer are as follows, Weak or interrupted flow of urine, Frequent urination (especially at night).Trouble urinating, Pain or burning during urination, Blood in the urine or semen, A pain in the back, hips or pelvis that doesn't go away and Painful ejaculation. Medical attention is required if any of these symptoms occur. Even though the causes of prostate cancer are unknown it is known that the growth of cancer cells in the prostate are stimulated...
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...Causes and risk factors, including environmental risks * According to the American Cancer Society (2013) states, “A risk factor is anything that affects your chance of getting a disease such as cancer” (American Cancer Society, 2013). “There are a few known risk factors for childhood leukemia” (American Cancer Society, 2013). According to the American Cancer Society (2013) states, “Genetic risk factors are those that are part of our DNA (the substance that makes up our genes)” (American Cancer Society, 2013). The genetic risk factor is what we get from our parents that is most of the time inherited (American Cancer Society, 2013). “Most cases of leukemia are not linked to any known genetic causes” (American Cancer Society, 2013). * Other risk factors of leukemia would be “inherited disorders, this can increase a child’s risk of developing leukemia” (American Cancer Society, 2013). Here is a listed of syndromes: “Down syndrome (trisomy 21), Klinefelter syndrome, and Li-Fraumeni syndrome” (American Cancer Society, 2013). According to the American Cancer Society (2013) states, “Certain inherited diseases cause children to be born with immune system problems” (American Cancer Society, 2013). “These include: Ataxia telangiectasia, Wiskott-Aldrich syndrome, and Bloom syndrome” (American Cancer Society, 2013). * According to the American Cancer Society (2013) states, “Lifestyle-related risk factors are important in many adult cancers, but they are unlikely to play a role...
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...Neuroblastomas are cancers that start in early nerve cells of the sympathetic nervous system (sympathetic neuroblasts), so they can be found anywhere along this system. The sympathetic nervous system controls body functions, such as heart rate and blood pressure, digestion, and levels of certain hormones. According to www.americancancersociety.org 1 out of 3 neuroblastomas start in the adrenal glands, 1 out of 3 begins in sympathetic nerve ganglia in the abdomen, and most of the rest start in sympathetic ganglia near the spine in the chest or neck or in the pelvis. There is a wide spectrum of how neuroblastomas can behave. Sometimes, in very young children, the cancer cells die without any cause and the tumor goes away on its own. In other cases, the cells sometimes mature on their own into normal ganglion cells and stop dividing. Normal body cells grow, divide, and die in an orderly fashion. During the early years of a person's life, normal cells divide faster to allow the person to grow. After the person becomes an adult, most cells divide only to replace worn-out or dying cells or to repair injuries. Cancer begins when cells in a part of the body start to grow out of control. Cancer cells can invade other tissues, something that normal cells cannot do. Growing out of control and invading other tissues are what makes a cell a cancer cell. Cells become cancer cells because of damage to DNA. DNA is in every cell and directs all its actions. In a normal cell, when DNA gets damaged...
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...From www.bloodjournal.org by guest on March 10, 2015. For personal use only. How I treat How I treat enteropathy-associated T-cell lymphoma Antonio Di Sabatino,1 Federico Biagi,1 Paolo G. Gobbi,1 and Gino R. Corazza1 1First Department of Medicine, Centro per lo Studio e la Cura della Malattia Celiaca, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Policlinico S. Matteo, University of Pavia, Pavia, Italy Enteropathy-associated T-cell lymphoma (EATL) is a complication of celiac disease (CD). This tumor derives from the neoplastic transformation of aberrant intraepithelial T lymphocytes emerging in celiac patients unresponsive to a gluten-free diet. Poor adherence to a gluten-free diet, HLA-DQ2 homozygosity, and late diagnosis of CD are recognized as risk factors for malignant evolution of CD. Recurrence of diarrhea, unexplained weight loss, abdominal pain, fever, and night sweating should alert physicians to this complication. The suspicion of EATL should lead to an extensive diagnostic workup in which magnetic resonance enteroclysis, positron emission tomography scan, and histologic identification of lesions represent the best options. Treatment includes high-dose chemotherapy preceded by surgical resection and followed by autologous stem cell transplantation, although biologic therapies seem to be promising. Strict adherence to a gluten-free diet remains the only way to prevent EATL. (Blood. 2012;119(11): 2458-2468) Introduction Celiac disease (CD) is a chronic...
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...common ones include Aspergillus fumigatus, Aspergillus flavus, Aspergillus terreus, Aspergillus nidulans and Aspergillus niger. For healthy people, this does not cause harm, the immune system is able to get rid of the spores. But for people with weakened immune systems, breathing in these spores can lead to infection. Studies have shown that Invasive Aspergillosis can occur during building renovation or construction. Outbreaks of Aspergillus skin infections have been traced to contaminated biomedical devices. Aspergillosis cannot be spread from person to person or between people and animals, and because it is not a reportable infection, the exact incidence is difficult to determine. Aspergillus mostly targets the respiratory system. Allergic bronchopulmonary aspergillosis (ABPA), is a condition where the fungus causes respiratory symptoms, such as wheezing and coughing, but does not actually invade and destroy tissues. It can affect people who are otherwise healthy, but it is most common in people with asthma or cystic fibrosis. Invasive aspergillosis generally affects people who have weakened immune systems, such as those who have had a bone marrow transplant or solid organ transplant, are on high doses of corticosteroids, those on chemotherapy, or those with HIV. It most commonly affects the lungs, but can also cause infection in many other organs and can spread throughout the body. In this condition, the fungus invades and damages tissues in the body causing...
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