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hematology oncology differential algorithm causes hemolytic leukemia summary chronic hemolysis hemophagocytic hlh lymphocytic lymphohistiocytosis mds myelodysplastic pulmonary syndromes testing thrombocytopenia
Chronic Lymphocytic Leukemia - Summary Cancer affecting lymphocytes/Mature B cell neoplasm • Lymphocytes accumulate in large numbers
weeks without infection ... Lymphocytosis on CBC ... cells can indicate disease ... • Neutropenia, anemia ... #workup #oncology
Diagnostic Framework for Hemolysis - Intravascular vs Extravascular Causes Intravascular Hemolysis: • Mechanical Trauma (Microangiopathic hemolytic anemia):
Diagnostic Framework ... ) - HELLP syndrome ... ) (e.g. lupus, CLL ... • Intrinsic RBC ... #hematology #anemia
Bandemia Overview Normal: < 1% Clinically significant: > 10% Band neutrophils are slightly less mature than segmented neutrophils and
on the left Myeloblast ... Differential Diagnosis ... • Autoimmune diseases ... #differential #diagnosis ... #CBC #hematology
Leukemias Overview: ALL, CML, AML, APML, CLL Acute leukemias > 20% blasts in the peripheral blood smear
extramedullary disease ... Neutrophils • Immature/Myeloblasts ... - infiltrates (anemia ... • Tumor lysis syndrome ... #Oncology #Diagnosis
Causes of Thrombocytosis - Differential Diagnosis Algorithm Spurious: • Artifact (redo CBC) Autonomous: • Essential thrombocytosis • Polycythemia
Artifact (redo CBC ... Myelofibrosis Infectious ... disorders • Celiac disease ... effect following treatment ... Iron deficiency anemia
Approach to Thrombocytosis - Elevated Platelet Count - Differential Diagnosis Algorithm Peripheral Smear concerning for malignancy?
for workup, including ... hemolysis, deficiency anemia ... Rebound effect from treatment ... Vasculitides, IBD, Celiac disease ... Kawasaki, Nephrotic syndrome
Hemolytic Anemia - Differential Diagnosis Algorithm • Sickle cells - Consider sickle cell disease (diverse genotypes):
Hemolytic Anemia ... - Differential Diagnosis ... Consider sickle cell ... inclusions - If infection ... #Algorithm #workup
Myelodysplastic Syndrome (MD) - Diagnosis and Management Summary myelo (marrow) -dys- (abnormal) -plastic (shape) = funny-shaped cells
Myelodysplastic Syndrome ... cytopenias (usually anemia ... risk-stratification • Risks: infection ... Allogeneic stem cell ... #Management #treatment
Chronic Lymphocytic Leukemia (CLL) - Summary Overview: • Most common leukemia in adults • Disorder of
Vmphocytosis on routine CBC ... 5) Symptoms of anemia ... Complications: 1) Infection ... chemotherapy for low-risk disease ... #management
Hemolysis - Differential Diagnosis Framework 1) Environment - Fragmentation - MAHA: TTP, HUS, DIC, HELLP
Drug-associated, PCH, Evans Syndrome ... ) - Infections ... Defects: Sickle cell ... anemia, Thalassemias ... #hematology
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