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Lab Results for Haematological Disorders
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Iron Deficiency Anaemia Megaloblastic Anaemias and Vitamin B12 Deficiency Folic Acid Anaemia of Chronic Disease
Anaemia of Chronic Renal Insufficiency Anaemia of Hypometabolism Hereditary Spherocytosis Glucose-6-Phosphate
Pyruvate Kinase deficiency The Thallasemias Sickle Cell Disease Haemoglobin C Disease
Autoimmune Haemolytic Anaemia Drug Induced Immune Haemolysis Haemolytic-Uraemic Syndrome Paroxysmal Nocturnal Haematuria
Haemolytic Disease of the Newborn Aplastic Anaemia Sideroblastic Anaemia Anaemia of Marrow Infiltration
Haemophilia A Von Willebrands Disease Haemophilia B Disseminated Intravascular Coagulation
Ideopathetic Thrombocytopenic Purpura Chronic Granulomatous Disease Myelofibrosis With Myeloid Metaplasia Polycythaemia Vera
Essential Thrombocytopenia Acute Leukaemia Chronic Myelocytic Leukaemia Chronic Lymphocytic Leukaemia
Malignant/Non-Hodgkin's Lymphomas Hodgkins Disease Immunoproliferative Disorders Leukaemic Reticuloendotheliosis
Multiple Myelomas Macroglobulinaemia Heavy Chain Disease .

LEUKAEMIAS

ACUTE LEUKAEMIAS
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LABORATORY FINDINGS

Peripheral Blood
 

Bone Marrow Other Laboratory Findings Terminal deoxynucleotidyl transferase (TdT) Immunologic Characteristics Cytogenetic Studies
CHRONIC MYELOCYTIC LEUKAEMIA
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LABORATORY FINDINGS

Peripheral Blood

Bone Marrow Other Laboratory Findings

CHRONIC LYMPHOCYTIC LEUKAEMIA
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CLL is the most common form of leukemia in the Western Hemisphere. It accounts for approximately 25 to 30 percent of all leukemias. CLL occurs more frequently in older individuals but is increasingly seen in younger patients as well. Although the etiology of CLL is unknown, recent laboratory investigations have improved our knowledge of this disorder. CLL is a growth of malignant B lymphocytes that grow slowly but have an extended life span. The result is an ever increasing number of leukemia cells. Because of this accumulation of leukemia cells, production of normal bone marrow and blood cells is diminished. Patients can experience severe anemia as well as low platelet counts which can put patients at risk of life-threatening bleeding. Patients with CLL may develop serious infections because of reduced numbers of infection-fighting cells known as neutrophils.

LABORATORY FINDINGS

Peripheral Blood

Bone Marrow Other Laboratory Findings

Peripheral Blood

Click on image for link to source

LEUKAEMIC RETICULOENDOTHELIOSIS
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LABORATORY FINDINGS

Peripheral Blood

Bone Marrow
MALIGNANT LYMPHOMAS
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NON-HODGKIN'S LYMPHOMAS

LABORATORY FINDINGS


HODGKIN'S DISEASE
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Hodgkin's Disease is a cancer of the lymph nodes. It develops when normal lymph cells mutate and grow uncontrollably. The lymphatic system comprises of many vessels that are networked throughout the body. The primary function of the lymphatic system is to help fight infection and the lymph nodes, which are located throughout the body, act as a kind of filter, removing debris that has been destroyed by the immune system.
Click on image for Link to Image source:

LABORATORY FINDINGS

Lymph Node Biopsy

  • Required for definitive diagnosis.
Peripheral Blood
  • Normocytic or microcytic anaemia, moderate; worsens as disease progresses
  • Haemolytic anaemia occasionally occurs in advanced disease;  the Coombs' test is usually negative.
  • Leukocytosis, which is characterised by increased granulocytes and decreased lymphocytes
  • Pancytopenia reflects extensive bone marrow involvement, the effect of therapy, or hypersplenism.
Bone Marrow
  • Requires biopsy to demonstrate involvement, which occurs in approximately 11% of cases
Other Laboratory Findings
  • Increased sedimentation rate reflects disease activity.
  • Increased leukocyte alkaline phosphatase during the active phase of disease;  not increased during remission
  • Protein electrophoresis - decreased albumin,  increased globulins; reflects active disease
  • Decreased serum iron and increased ferritin reflect chronic disease anaemia.
Hodgkin's Disease differs from Non-Hodgkins Lymphomas in 2 primary ways

The cause of HD is unknown. Some researchers are examining the relationship with the Epstein-Barr virus which is found in approx 50% of all HD patients. This remains contentious. Whatever the cause, the NCI reports about 7000 new cases in the US each year. There is a slight bias of 1.5:1 men to women.


IMMUNOPROLIFERATIVE DISORDERS
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MULTIPLE MYELOMA

LABORATORY FINDINGS

Peripheral Blood

Bone Marrow Protein Abnormalities Other Laboratory Findings
Multiple Myeloma

Myeloma in pneumonia

This slide shows a bone marrow smear from a patient presenting with hypercalcaemia and bone pain. The large cells are plasma cells and the diagnosis is multiple myeloma. Myeloma is a monoclonal proliferation of bone marrow plasma cells. Its associated with a plasma paraproteinaemia and Bence Jones (BJ) proteinuria. About 15% of patients have BJ protein in their urine without a paraproteinaemia. BJ proteinuria results from free IgG light chains. The median survival for patients with myeloma is two years.

MACROGLOBULINEMIA
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LABORATORY FINDINGS

Peripheral Blood

Bone Marrow Other Laboratory Findings

Click on image for link to source

Waldenstrom's Macroglobulinaemia

HEAVY-CHAIN DISEASE
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LABORATORY FINDINGS

All Heavy-Chain Diseases

Gamma Heavy-Chain Disease Alpha Heavy-Chain Disease Mu Heavy-Chain Disease Immunodeficiency Disorders
 
SYNDROME CLINICAL FEATURES LABORATORY FINDINGS
.Predominant Humoral Abnormality . .
X-linked agamaglobulinemia Increased bacterial sinus and pulmonary infections;
rheumatoid arthritis:
affects males
All Ig decreased or absent;
absence of plasma cells in all sites
IgA deficiency Steatorrhea and nontropical sprue Absence of serum and secretory IgA, may have IgA antibodies
Ig deficiencies with hyper-IgM Increased bacterial respiratory infections;
increased autoimmune diseases
Increased IgM and decreased IgA and IgG
. . .
Predominant Cell-Mediated Abnormality . .
Thymic dysplasia
Nezelof's syndrome)

Increased fungal and viral infections
Decreased granulocytes;
50% of patients have decreased IgA or IgG
. . .
Congenital thymic aplasia (DiGeorge's syndrome) Increased fungal and viral infections:  absent parathyroids, thymus; cardiovascular, tracheal, and esophageal malformations Normal serum Ig levels;
decreased calcium;
diminished cell-mediated immunity
Combined Immunologic Abnormalities . .
Wiskott-Aldrich syndrome Thrombocytopenia and eczema;  increased
bacterial and viral infections; bleeding
Decreased IgM, increased IgA:  decreased
lymphocytes and cellular immunity
Ataxia-telangiectasia Cerebellar ataxia;
telangiectasia in skin and eyes; ovarian dysgenesis; sinus and pulmonary infections
Decreased serum and secretory IgA and IgE;
impaired cellular immunity
Severe combined immunodeficiency Overwhelming widespread bacterial and viral infections;  failure to thrive; malabsorption Marked decrease in all Ig;  decreased to absent lymphocytes and plasma cells;  impaired cellular immunity
 
Common variable hypo-gammaglobulinemia Recurrent bacterial respiratory infections and GI disorders including malabsorption;  frequent occurrence of autoimmune diseases Absence of plasma cells; variable decrease in immunoglobulins, especially IgG

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