Chapter 105. Malignancies of Lymphoid Cells (Part 5)

Table 105-5 Diseases or Exposures Associated with Increased Risk of Development of Malignant LymphomaInherited immunodeficiency diseaseKlinefelters syndromeChédiak-Higashi syndromeAtaxia telangiectasia syndromeWiscott-Aldrich syndromeCommon variable immunodeficiency diseaseAcquired immunodeficiency diseasesIatrogenic immunosuppressionHIV-1 infectionAcquired hypogammaglobulinemiaAutoimmune diseaseSjögrens syndromeCeliac sprueRheumatoid arthritis and systemic lupus erythematosusChemical or drug exposuresPhenytoinDioxin, phenoxyherbicidesRadiationPrior chemotherapy and radiation therapyImmunologyAll lymphoid cells are derived from a common hematopoietic progenitor that gives rise to lymphoid, myeloid, erythroid, monocyte, and megakaryocyte lineages. ...
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Chapter 105. Malignancies of Lymphoid Cells (Part 5) Chapter 105. Malignancies of Lymphoid Cells (Part 5) Table 105-5 Diseases or Exposures Associated with Increased Risk ofDevelopment of Malignant Lymphoma Inherited immunodeficiency disease Klinefelters syndrome Chédiak-Higashi syndrome Ataxia telangiectasia syndrome Wiscott-Aldrich syndrome Common variable immunodeficiency diseaseAcquired immunodeficiency diseases Iatrogenic immunosuppression HIV-1 infection Acquired hypogammaglobulinemiaAutoimmune disease Sjögrens syndrome Celiac sprue Rheumatoid arthritis and systemic lupus erythematosus Chemical or drug exposures Phenytoin Dioxin, phenoxyherbicides Radiation Prior chemotherapy and radiation therapy Immunology All lymphoid cells are derived from a common hematopoietic progenitorthat gives rise to lymphoid, myeloid, erythroid, monocyte, and megakaryocytelineages. Through the ordered and sequential activation of a series of transcriptionfactors, the cell first becomes committed to the lymphoid lineage and then givesrise to B and T cells. About 75% of all lymphoid leukemias and 90% of alllymphomas are of B cell origin. A cell becomes committed to B cell developmentwhen it begins to rearrange its immunoglobulin genes. The sequence of cellularchanges, including changes in cell-surface phenotype, that characterizes normal Bcell development is shown in Fig. 105-2. A cell becomes committed to T celldifferentiation upon migration to the thymus and rearrangement of T cell antigenreceptor genes. The sequence of the events that characterize T cell development isdepicted in Fig. 105-3. Figure 105-2 Pathway of normal B cell differentiation and relationship to B celllymphomas. HLA-DR, CD10, CD19, CD20, CD21, CD22, CD5, and CD38 arecell markers used to distinguish stages of development. Terminal transferase(TdT) is a cellular enzyme. Immunoglobulin heavy chain gene rearrangement(HCR) and light chain gene rearrangement or deletion (κR or D, λR or D) occurearly in B cell development. The approximate normal stage of differentiationassociated with particular lymphomas is shown. ALL, acute lymphoid leukemia;CLL, chronic lymphoid leukemia; SL, small lymphocytic lymphoma.