Lower ph than Cellulose acetate.

Run depending on aas composition. Hgb C is separated from A2

Valine substituted for glutamate -->non conservative substitution (hydrophobic to philic)

Beta is affected not alpha

• chronic hemolytic anemia
• vascular obstruction by sickled cells
• splenatomegaly

What are test results of Hgb S disease?

• Inc Hgb F
• Blood Transfusion
• BM transplant with gene therapy

• target cells
• ****crystals poke out of cell
• less anemia than Hgb SS

--Anopheles Mosquitoes in tropical regions

• banana shaped gametocytes
• Rings form everywhere

• Massive Hemolysis
• Cerebral Malaria--->causes death
• fevers

• dots
• enter through Duffy antigen
• chronic bc they stay in liver
• in US not Africa

Babesiosis

• to immunocompromised
• can be with Lyme disease
• or spread through transfusion

1:1 or 2:1

Hypercellular is >4:1

Hypocellular is <1:4

• old age (bm is less active)
• Aplastic anemia
• Reticular fibrosis

What is the difference bw a myelocyte and a metamyelocyte?

Leukocyte alkaline phosphatase score

infection: high score

leukemia: low score

Distinguishes Gaucher's from Neiman Pick (lymphoid).

Erythroid Leukemia

Giant fused granules in Neutrophils and lymphs

• Cells engulf but do not kill microbes
• die as child
• skin hypopigmentation

when Cell cycle checkpoints don't work

• Chronic Myeloid Leukemia
• Chronic Idiopathic Myelofibrosis
• **Polycythemia Vera
• Essential Thrombocythemia

• Middle Aged
• elevated WBC
• fever, weakness, bleeding,splenomegaly
• tender lower sternum
• no lymphadenophathy
• bruises

looks strange bc cells are make in the worng places

• Dacrocytes (tear drop)
• Aniso/poikilo, Basophilic Stipping
• <5% blasts
• Elevated LAP

Panmyelosis in BM (100% cellularity)

Splenomegaly

• cells are very sensitive to EPO

• Bloodletting to dec Hct
• stable
• BM fibrosis, splenomegaly, teardrop

• long after diagnosis
• Plts can clog vessels
• txt: suppress plt production through radiation and drugs --->increases risk of leukemic transformation

• Older adults
• ***Oval macrocytes (norm B12)
• Dimorphic RBC
• Poikilocytosis from irregular shape
• Basophilic Stippling, Howell-Jolly Bodies, Siderocytes
• abnormal plt

Since Hematopoetic SCs are messed up:

• RBC with multiple nuclei and abnormal shapes (lobes)
• Nuclear Bridging from trying to divide
• Megaloblastoid changes
• Basophilia, 2nd granules absent

Deletion of q arm of chromosome 5

• Women >50
• Refractory macrocytic anemia
• thrombocytosis
• erythroid hypoplasia

Lenalidomide-forces precursor cells to develop

Replace Hematopoetic progenitors:

• BM transplant, Cord blood, Low Intensity Transplant

What is the presentation and demographics of someone Acute promyelocytic leukemia?

• females, adults
• SUDDEN AND SEVERE progression
• bleeding; clot and fibrinolysis everywhere-

give Heparin to present coag cascade

+ Myeloperoxidase

+ Chloroacetate (specific for Neut)

- Nonspecific Esterase

• 5 yr after txt
• MDS-->all myeloid lines affected
• Ringed Sideroblasts
• >20%blasts
• poor prognosis

• 25% of AML cases
• myeloid and monocytic cells
• high WBC
• thrombocytopenia
• >30% blasts in BM: 20% non-rbc are monocytic
• ***elevated serum Muramidase

What is the AML kids get?

• kids
• weakness/bleeding
• skin rash
• high muramidase (from monocytes)
• gums overgrown
• DIC if monocytes lyse

• in Children
• proliferation of: lymphocytes, B-cells, eos, Reed-Sternberg cells (dinucleated/owl cells)
• 30% of lymphomas
• usually in one node; cells don't mature proper

• B-cell markers (CD--) > 10
• Weak surface Ig with light chain restriction

• lots of small lymphocytes
• smudge cells (from breaking of fragile lymphocytes)

• no fat
• no Erythroid progenators or Monocytes-->anemia and bleeding
• immature cells, huge lymphoblasts
• lypho with cleaved nucleus

What distinguishes Hairy Cell Leukemia; cells and tests?

• Splenomegaly
• dry tap
• + TRAP
• + for IG
• hairy cells
• mature lymph in BM

B-cell Neoplasm:

• IgM: plasma cells won't stop making antibody
• Small lymphs and plasma cells take over node
• not too bad, incurable
• not enough blasts to be leukemia
• Roullexing

• Malignant Proliferation of plasma cells
• takes Ca2+ out of bone causing fractures
• light chain Bence Jones protein in urine
• from tumor burken
• 63yoa

B-cell disease with high malignancy

• kids, AIDs PT, surpressed immune system
• large jaw
• EBV
• cells regrese to immature

T-cell disease from skin tumors

• CDs <10
• cleaved nucleus
• poor prognosis if other organs are involved

• lymphoblasts in CSF -need chemo that cross BBB
• fatigue (no RBC), fever, bleeding
• enlarged Lymph nodes
• Hepatosplenomegaly
• bone pain if stuffed
• Blasts in ovaries/testes

1. L1-small blasts: 2x cytes, flat round nucleus
2. L2-Larger than L1: irregularly shaped nucleus
3. L3-Large Blasts: Round/oval nuclei, lots of blue cytoplasm w/vacuoles

• most common
• immunoglobulin is ABSENT on surface and cyto
• Best prognosis bc cells aren't active

• Surface Ig with Lambda or Kappa Light Chain expressed
• worst prognosis

• CD<10 are expressed Tdt+
• Teenage boys
• mass in chest
• inc blood blasts
• cells in CSF
• infiltration of other sites
• Aggressive Therapy improves prognosis