Free Publications

Search for stem cell transplants returned 472 results

Glossary Results

Allogeneic Stem Cell Transplantation (Transplant)

A treatment that uses healthy donor stem cells to restore a patient’s marrow and blood cells. It uses high doses of chemotherapy and sometimes radiation to “turn off” a patient’s immune system so that the donor cells are not rejected. See the free LLS publication, Blood and Marrow Stem Cell Transplantation.

Stem Cell Transplantation

See Allogeneic Stem Cell Transplantation; Autologous Stem Cell Transplantation.

Nonmyeloablative Stem Cell Transplantation

See Reduced-Intensity Stem Cell Transplantation.

Reduced-Intensity Stem Cell Transplantation

A type of allogeneic transplantation. Patients receive lower doses of chemotherapy drugs and/or radiation to prepare for a reduced-intensity transplant. This protocol may be safer than an allogeneic stem cell transplant–especially for older patients. See the free LLS publication, Blood and Marrow Stem Cell Transplantation.

Autologous Stem Cell Transplantation

A treatment that uses a patient’s own stem cells to slow the growth of certain blood cancers. See the free LLS publication Blood and Marrow Stem Cell Transplantation.

Cord Blood Stem Cells

Stem cells that are present in blood drained from the placenta and umbilical cord (the link that attaches a mom to a new baby). These stem cells have the capability to repopulate the marrow of a compatible recipient and produce blood cells. Frozen cord blood is a source of donor stem cells for transplantation to HLA-matched recipients. Most cord-blood transplants are given by either matched or nearly matched unrelated donors.

Stem Cells

Primitive marrow cells that mature into red blood cells, white blood cells, and blood platelets. Stem cells are mostly found in the marrow, but some leave and circulate in the bloodstream. Stem cells can be collected, preserved, and used for stem cell therapy. See Hematopoiesis.

Bone Marrow Transplantation

See Allogeneic Stem Cell Transplantation; Autologous Stem Cell Transplantation

Transplantation

See Allogeneic Stem Cell Transplantation; Autologous Stem Cell Transplantation.

Autotransplant

See Autologous Stem Cell Transplantation

Somatic Cell Mutation

A change in the DNA that occurs in a specific tissue cell which may result in a tumor. Most cancers start after a somatic cell mutation.

Germ-Cell Mutation

A mutated cell in the egg or the sperm is passed from parent(s) to offspring. See Mutation.

Blast cells

A young (or immature) type of cell in the bone marrow. In healthy people, blast cells make up 5 percent or less of normally developing marrow cells.

Blood Cell Count

A lab test that measures the number and types of cells in the blood. Often called a “complete blood count” or “CBC.”

Biomarkers (cancer cell markers)

Chemicals or structures present either on the surface of or within cells or in the serum. They may aid physicians in determining when treatment (and which type of treatment) is needed by identifying disease that will progress more rapidly and/or have a better or worse response to certain treatments. Examples of biomarkers are gene expression, serum protein levels and chromosome abnormalities in cancer cells. No single feature can accurately predict disease progression in a patient; therefore, physicians use a combination of factors to make a diagnosis and a treatment plan.

Host

The recipient of the transplant who acts as "host" to the transplanted stem cells.

Graft versus cancer effect

With an allogeneic stem cell transplant, the donated stem cells make immune cells that are not totally "matched" with the patient's cells. For this reason, the donor immune cells may recognize the patient's cancer cells as foreign and kills them.

Haploidentical

A potential stem cell donor that has a 50 percent HLA antigen-match with a patient. Parents are haploidentical with children. Siblings have a 50 percent chance of being haploidentical. See HLA; Allogeneic Stem Cell Transplantation.

Matched donor

A person whose major tissue types are identical to those of a patient who is seeking a stem cell transplant. The patient can be given the donor's healthy matched stem cells, which can restore blood and immune cells after high-intensity cancer treatment.

Immune response

The reaction of the body to foreign material. Examples of foreign material are an infection-causing microorganism, a vaccine, or the cells of another person used for an allogeneic stem cell transplant.

Scavenger Cell

See Monocyte/Macrophage.

Conditioning Treatment

Intensive therapy of a patient with cytotoxic drugs or drugs and total body radiation just before receiving a stem cell transplant. The therapy serves three purposes. First, it severely depresses the lymphocytes that are the key cells in the recipient's immune system. This action helps prevent the rejection of the graft. Second, it markedly decreases the marrow cells, which may be important to open up the special niches where the transplanted stem cells must lodge to engraft. Third, if the patient is being transplanted for a malignancy, this intensive therapy greatly decreases the numbers of any remaining tumor cells.

Myeloma Cells

Malignant plasma cells that are the hallmark of myeloma. Their appearance may be similar to normal plasma cells, but they are present in increased numbers.

Blood Cells

There are three types of blood cells: red blood cells, which carry oxygen; white blood cells, which fight infections; and platelets, which help stop bleeding.

Red Blood Cells

Blood cells (erythrocytes) contain hemoglobin, which carries oxygen to the tissues of the body. Red blood cells make up about 40 to 45 percent of blood volume in healthy people

White Blood Cells

Also known as “leukocytes,” the five types of infectionfighting cells in the blood. These include neutrophils, eosinophils, basophils, monocytes and lymphocytes.

Engraftment

The process of transplanted stem cells homing to the recipient's marrow and producing blood cells of all types. This occurrence is first evident when new white cells, red cells, and platelets begin to appear in the recipient's blood following transplantation.

Myelogenous

A term used to describe a form of blood cancer that begins in a marrow stem cell or early marrow progenitor cell.

Chemokines

These are small molecules which may stimulate inflammation and which may play a role in stem cell mobilization.

Haplotype

The tissue type contributed by either the mother or father to his or her offspring. It is implied that it represents the genes on one parental chromosome. When a transplant procedure is between a donor and recipient that are haplotype identical, it means that the tissue type or HLA type of each is identical in respect to mother or father but not identical to the other. In some situations, if the discrepancy is not too great, the transplant may still be possible if the underlying disease makes the risk of partial compatibility warranted. Conditioning of the recipient and lymphocyte depletion of the donor stem cell suspension are steps taken to mitigate the risk of immune cell activation by the tissue type differences.

Differentiation

When stem cells develop and mature and take on a new function. Stem cells will either mature into red blood cells, platelets or white blood cells. See Hematopoiesis.

Tolerance

A very important event in the long-term success of transplantation. After a time, usually a year or so, the prior host and donor T lymphocytes die off and new lymphocytes are formed from the donor?s engrafted stem cells. These "adapt" to the new host and stop attacking the recipient's cells. If tolerance is present, the immune system is no longer distracted and can serve the patient by working efficiently to protect against microbes. Risk of infection diminishes and approaches that of a healthy person. Immunosuppressive therapy can be stopped.

FMS-like tyrosine kinase 3 gene (FLT3)

An abbreviation for the FMS-like tyrosine kinase 3 gene. FLT3 is expressed on blood forming stem cells and plays a role in cell development. FLT3 mutations can be detected in about one-third of AML patients. These mutations have been identified as part of the AML disease process and may become the basis for new targeted therapies.

Cryopreservation

A technique used to keep frozen cells intact and functional for many years. Blood or marrow cells, including stem cells, can be stored for very long periods and remain functional if they are suspended in a fluid that contains a chemical that prevents cellular injury during freezing or thawing. This chemical is referred to as a "cryoprotective" agent. Dimethyl sulfoxide (DMSO) is one of the most commonly used agents. The freezing temperature is much lower (colder) than that of a household freezer.

Promyelocyte

A cell that is formed during the transition from an immature cell to a mature cell during the development cycle for certain types of red blood cells.

Lymphoblast

The leukemic cell that replaces the normal marrow cell. Uncontrolled and exaggerated growth and accumulation of these leukemic cells means that they fail to function as normal blood cells.

Nucleus

A part of the cell containing the chromosomes and genes.

Tumor Suppressor Gene

A gene that works to stop cell growth.

DNA

Deoxyribonucleic acid. The genetic matter found in all cells. DNA is passed to new cells during the process of cell division. A change or mutation in the DNA can lead to cell death, changes in the cell function, and in some cases, cancer.

Donor lymphocyte infusion (DLI)

A therapy often used for patients after an allogeneic bone marrow transplant. In this procedure, patients are given lymphocytes (white blood cells) that come from the original transplant donor to help attack remaining cancer cells.

Granulocyte

A type of white blood cell with many particles (granules) in the cell body. Neutrophils, eosinophils and basophils are types of granulocytes.

Hematologic response (hematologic remission)

A treatment response where the leukemia, lymphoma or myeloma cell numbers are decreased in the blood; and, red cell count, white cell count, and platelet count are either at or near normal values.

Graft-Versus-Tumor Effect (Graft-Versus-Leukemia Effect)

The potential immune reaction of transplanted (donor) T lymphocytes causing them to recognize and attack the cancer cells of the patient.

Hematologist

A doctor who specializes in blood cell diseases.

Anthracyclines (Antitumor Antibiotics)

Chemotherapy agents that interact directly with the DNA in the nucleus of cells, thus interfering with cell survival.

Genes

Parts of cells that give instructions for making proteins. Proteins help the cell do its job.

Hematopoiesis

The formation of all types of blood cells that starts in the marrow. For the blood cell development process.

Monocyte/Macrophage

A type of red blood cell that represents about 5 to 10 percent of the cells in normal human blood.

Multidrug Resistance (MDR)

A cell characteristic that makes cells resistant to certain types of drugs.

Pancytopenia

A health condition when there is a decrease in the numbers of the three major blood cell types: red blood cells, white blood cells and platelets.

Alkylating Agent

A type of chemotherapy used to kill cancer cells by interfering with cancer cell division. Alkylating agents cause side effects because they also interfere with cell division in certain healthy tissues where cell division is frequent, such as the gastrointestinal tract. Cyclophosphamide is one of several types of alkylating agents.

Clonal

The designation for a population of cells derived from a single transformed parent cell. Virtually all cancers are derived from a single cell with an injury (mutation) to its DNA and thus are monoclonal. Leukemia, lymphoma, myeloma and myelodysplastic syndromes are examples of clonal cancers; that is, cancers derived from a single abnormal cell.

Immunophenotyping

A process used to find specific types of cells within a blood sample. It looks at antigens or markers on the surface of the cell to identify antibodies.

Absolute Neutrophil Count (ANC)

The number of neutrophils (a type of white blood cell that fights infection) that are identified in the blood count.

Basophil

A type of white blood cell present in certain allergic reactions.

DNA Synthesis Inhibitors

Chemotherapy drugs that react with DNA to alter it chemically and keep it from permitting cell growth.

Eosinophil

A white blood cell that helps to fight some parasitic infections and participates in allergic responses.

Hyperleukocytosis

A very high white blood cell count, often found in people when they are diagnosed with leukemia.

Myelocyte

A marrow cell that is a precursor of the mature granulocytes of the blood. Myelocytes are not present in the blood of healthy individuals.

Neutropenia

An abnormal decrease in the number of neutrophils, a type of white blood cell, in the blood.

Flow Cytometry

A test that finds specific cell types within a cell sample, During this test, cells flow through the instrument called a “flow cytometer.” When the cells pass through its laser beam, those with the antibody-specific features light up and can be counted. This test may be used to examine blood cells, marrow cells, or cells from a biopsy.

Karyotype

The order, number and appearance of chromosomes within a cell. There are 46 human chromosomes with the sex chromosomes shown as a separate pair (either XX or XY). The 22 pairs with each cell are called “autosomes.” See FISH (Fluorescence In Situ Hybridization).

Zap-70

An abbreviation for the cell protein “zeta-associated protein 70.” A high level of ZAP-70 expression on the cells of patients with B-cell CLL is one of several factors that may predict more progressive disease. Outside of a research laboratory this test is generally not very reliable and should not be used.

Complete Hematologic Response

A response to treatment in which the number of cancer cells is decreased, immature cancer cells are mostly eliminated from the blood and the hemoglobin concentration, white cell count and platelet count are at or near normal values.

DNA Repair Enzyme Inhibitors

Chemotherapy drugs that prevent certain cell proteins from working and make the DNA more susceptible to injury.

Tyrosine Kinase

A type of enzyme that plays a key role in cell function. It is normally present in cells, and a normal gene, ABL on chromosome 9, directs its production. In chronic myeloid leukemia, an alteration in the DNA results in a mutant fusion gene, BCR-ABL, which produces an abnormal or mutant tyrosine kinase. This abnormal enzyme leads to a cascade of effects in the cell that transforms it into a leukemic cell.

Proto-oncogene

A gene involved in normal cell growth. Mutations (changes) in a proto-oncogene may cause it to become an oncogene, which can cause the growth of cancer cells.

Macrophage

A monocyte in action (this is called a “scavenger cell”). When monocytes leave the blood and enter the tissue, they are known as “macrophages.” Macrophages fight infection, eat dead cells and help lymphocytes with their immunity functions. See Monocyte.

Bone Marrow

A spongy tissue in the hollow central cavity of the bones where blood cells are made. By puberty, the marrow in the spine, ribs, breastbone, hips, shoulders and skull is most active in blood cell formation. In adults, the bones of the hands, feet, legs and arms no longer contain blood-forming marrow—these bones are filled with fat cells. When marrow cells have matured into blood cells, they enter the blood that passes through the marrow and are carried in the bloodstream throughout the body.

Radioactive Isotope

A form of a molecule that emits radiation. Certain types of radiation can damage cancer cells. Physicians use radioactive isotopes to treat cancer in several ways, including attaching the isotope to antibodies. The antibodies can attach to the cancer cell, and the radiation can destroy it.

Refractory Anemia (RA)

Also known as “myelodysplasia,” this clonal myeloid disorder mostly affects red blood cell production in the marrow. It can also be associated with mild to moderate decreases in the numbers of white blood cells and platelets. In some classification systems, it is an MDS subtype.

Lymphocyte

A type of white blood cell that is important to the body’s immune system. There are three major types of lymphocytes: B lymphocytes, which produce antibodies to help combat infectious agents such as bacteria, viruses and fungi; T lymphocytes, which have several functions, including assisting B lymphocytes in making antibodies; and natural killer (NK) cells, which can attack virus-infected cells or tumor cells.

Cytokines

Cell- (cyto-) derived chemicals that are secreted by various types of cells and act on other cells to stimulate or inhibit their function. Chemicals derived from lymphocytes are called "lymphokines." Chemicals derived from lymphocytes that act on other white cells are called "interleukins"; that is, they interact between two types of leukocytes. Some cytokines can be made commercially and used in treatment. Granulocyte-colony stimulating factor (G-CSF) and granulocyte macrophage-colony stimulating factor (GM-CSF) are examples of cytokines. These stimulate the production of neutrophils and shorten the period of low neutrophil counts in the blood after chemotherapy. Cytokines that stimulate cell growth are sometimes referred to as "growth factors."

BCR-ABL

A mutant gene that is formed when a piece of chromosome 9 attaches to the end of chromosome 22. The BCR-ABL cancer gene gives the cell instructions to make a protein that leads to CML. BCR-ABL is found in some patients with ALL.

Lymphoblastic

A term used to describe a type of blood cell disease caused by young or immature lymphocytes or "lymphoblasts." An example is acute lymphoblastic leukemia, which is characterized by the presence of malignant (cancerous) lymphoblasts (immature lymphocytes).

BCL-2 Gene Rearrangement

Rearrangements in the BCL-2 gene that occur on B cells. The BCL-2 gene rearrangement is associated with a chromosome translocation t(14;18) (q32;q21) that places BCL-2 (normally on chromosome 18) adjacent to the joining region (JH) of the immunoglobulin heavy chain locus (normally on chromosome 14). The rearrangement results in a high level of expression of the BCL-2 protein. The overexpression of the bcl-2 protein gives cells a survival advantage by inhibiting cell death. Overexpression of the Bcl-2 protein can occur without detection of the BCL-2 gene rearrangement.

Cluster Designation (CD)

A term used with a number to identify a specific molecule on the surface of an immune cell. It is commonly used in its abbreviated form, for example, “CD20” (the target of the monoclonal antibody therapy rituximab [Rituxan®] and “CD52” (the target of the monoclonal antibody therapy alemtuzumab [Campath®])

Neutrophil

A type of white blood cell and the main type that works to fight infection. People with some blood cancers, or those who have received treatment (such as chemotherapy) for cancer, often have low neutrophil counts. People with low neutrophil counts are very susceptible to infections.

Central Nervous System (CNS) Prophylaxis

In certain types of leukemia, particularly acute lymphoblastic leukemia and acute monocytic leukemia with high blood cell counts, there is a propensity of the leukemic cells to enter the covering of the spinal cord and brain (the meninges). This process is often not apparent until months or years after remission when the leukemia returns, first in the coverings of the CNS, then in the marrow and blood. To prevent this type of relapse (meningeal leukemia), virtually all children and adults with acute lymphblastic leukemia who enter remission are treated by placing appropriate chemotherapy in the fluid that bathes the spinal cord and brain to prevent the leukemia from returning in these sites. In some cases, x-ray therapy is administered to the head as well. These approaches are very effective in eliminating leukemia cells in the coverings of the brain and spinal cord.

Opportunistic Infections

Unusual infections to which patients treated for cancer may be susceptible because of the suppression of their immune system. "Opportunistic" is the term used to describe infections with bacteria, viruses, fungi or protozoa to which individuals with a normal immune system are not susceptible. The infecting organisms take advantage of the opportunity provided by immunodeficiency, especially when coupled with very low white cell counts resulting from therapy or the disease itself.

Myeloblasts

See Blast Cells.

G-Banding Karyotyping

A testing method that makes a certain characteristic of chromosomes easier to see. A “karyotype” is the systematic arrangement, using images, of the 46 human chromosomes of a cell. Karyotypes are examined for deviations from the expected arrangement, number, size, shape or other characteristics of the chromosomes. Each chromosome pair has a characteristic banding pattern. To make the banding pattern easier to see, a dye called “Giemsa” may be used as a stain. This process is also referred to as “G-banding.” G-banding karyotyping and other cytogenetic tests provide doctors with information that contributes to determining the best treatment approach for an individual patient. The test takes longer than the FISH test, but has the advantage of being able to detect any changes that are visible because it does not rely on specific probes. Usually, both tests are done on samples from the marrow, especially at the time of diagnosis.

Myeloma

A type of cancer that begins in the bone marrow. It is a cancer of plasma cells, which are a type of white blood cells (also called plasma B cells).

Toxin

A naturally derived substance that is poisonous to cells. A toxin can be attached to antibodies that then attach to cancer cells. The toxin may kill the cancer cells.

Cytopenia

A reduction in the number of cells circulating in the blood.

Erythrocytes

See Red Blood Cells.

Leukocytes

See White Blood Cells

CD38

An antigen on CLL cells and other cells. The expression of CD38 may be a marker to assist in predicting CLL progression.

Beta 2-microglobulin

B2M is a protein found on the surface of white blood cells. Increased production or destruction of these cells causes B2M levels in the blood to increase. This increase is seen in people with cancers involving white blood cells.

Complete blood count (CBC)

A series of tests used to measure levels of red cells, white cells, and platelets in the blood, and the appearance of cells on a blood film. The CBC is used diagnose and manage many diseases.

plgarci1@stvincent.org

Cytogenetic Analysis

A type of test that looks at the number and size of the chromosomes in cells. It is often used in cancer treatment and to see changes in the cells before and after treatment.

Minimal Residual Disease (MRD)

The small amounts of cancer cells that may remain after treatment. These cells are only identified by sensitive molecular techniques.

Monoclonal Antibodies

Antibodies made by cells of a single clone. They are used in cancer treatment to target cancer cells. They can be made in a lab.

Refractory Cytopenia With Multilineage Dysplasia (RCMD)

One of the more common WHO MDS subtypes. There are too few of at least two types of blood cells (red blood cells, white blood cells, or platelets). In the bone marrow, those same types of cells look abnormal (dysplasia) under the microscope. Less than 5 percent of the cells in the bone marrow are blasts. In patients with more than 15 percent ringed sideroblasts, the subtype is called “RCMD-RS.”

Antiglobulin Test

A laboratory procedure that can identify antibodies on the surface of red cells or platelets. Patients may make antibodies to their own red cells or platelets (auto- or self-directed antibodies). These autoantibodies may lead to anemia or a low platelet count in patients. The antiglobulin test can be used to identify the presence of autoantibodies on blood cells.

Graft-Versus-Host Disease (GVHD)

A disease that happens when the donor cells (“the graft”) attack the cells of the patient (“the host”). Most often this disease attacks a patient’s skin, liver, and the stomach and gastrointestinal tract.

Histone Deacetylase Inhibitor (HDAC Inhibitor)

A substance that causes a chemical change that stops cancer cells from dividing. HDAC inhibitors appear to have a greater effect on cancer cells than on normal cells. As a result they may cause less toxicity than other chemotherapeutic agents.

Myeloproliferative Neoplasms (MPNs)

A group of diseases that occur when certain types of blood cells are overproduced. Examples of MPNs are essential thrombocythemia, polycythemia vera and myelofibrosis. Some people with MPNs have abnormal-looking cells in their bone marrow that are similar to MDS cells.

Oligoblastic Myelogenous Leukemia

Also known as “refractory anemia excess blasts” (RAEB), this type of MDS shows signs of leukemic blast cells when the blood or marrow is examined. There may only be a small number of these blast cells in the marrow, but their presence indicates that leukemic cells are developing.

Radioimmunotherapy

A treatment that uses antibodies to carry a radioactive substance to lymphoma cells to kill them. Radioimmunotherapy such as Zevalin® carries a radioactive substance to the lymphoma cells that then irradiates lymphoma cells locally and selectively. This approach minimizes the effects of radiation on normal tissues.

Hemoglobin

The iron-containing substance in red blood cells that carries oxygen around the body. Hemoglobin concentration decreases when there is a reduction in the number of red blood cells. This condition is called “anemia.”

Chemotherapy

A treatment that uses medicine (chemical agents) to kill cancer cells.

Complete Cytogenetic Response

A response to treatment in which there are no cancer cells in the marrow that can be detected by FISH.

Cytogenetic response (cytogenetic remission)

A treatment response in which there is no leukemia, lymphoma or myeloma cells detected in the blood and/or marrow by the FISH test.

Cytogeneticist

A health care expert who uses special types of tests to look at cells and chromosomes

Cytotoxic Drugs

Anticancer drugs that act by killing or preventing the division of cells. (See Chemotherapy.)

Hematopathologist

A doctor or scientist who studies the blood cells and blood tissues to identify disease.

Leukocytosis

An increase above the upper limit of normal in the concentration of blood leukocytes (white blood cells).

Leukopenia

A decrease below normal in the number of leukocytes (white blood cells) circulating in the blood.

Peripheral Blood Smear

A sample of blood placed on a slide and stained (dyed) so that the cells can be examined under a microscope.

Resistance to Treatment

When cancer cells continue to grow even after strong drugs and/or treatments.

RNA

Abbreviation for ribonucleic acid, a molecule in cells that carries out DNA's instructions for making proteins.

Side effect

The signs or symptoms a patient may have from the effects of treatment on healthy cells.

Apheresis

A process using a machine to take out needed parts of the donor’s blood and return the unneeded parts to the donor. This process lets certain blood components, including red blood cells, white blood cells and platelets to be removed separately and in large volumes. See Platelet Transfusion.

Aplastic Anemia

A health condition that occurs when your body stops producing enough new blood cells. Any blood cells that the marrow does make are normal, but there are not enough of them. Aplastic anemia can be moderate, severe, or very severe.

B Lymphocyte

One of three specialized lymphocyte types. They produce antibodies in response to any foreign substance, but to bacteria, viruses, and fungi in particular. These lymphocytes are a vital part of the immune system and are important to our defense against infection. Some B lymphocytes mature into plasma cells, which are the principal antibody-producing cells.

Chromosomes

Threadlike structures within cells that carry genes in a linear order. Human cells have 23 pairs of chromosomes: chromosome pairs 1 to 22 and one pair of sex chromosomes (XX for females and XY for males). See Translocation.

Platelets

Also known as “thrombocytes,” platelets are small colorless blood cells. They travel to and collect at the site of a wound. Once they get there, the platelets' sticky surface helps them to form clots and stop bleeding. Platelets make up about one tenth of the volume of red blood cells.

Bilirubin

A brownish yellow substance that is produced mainly when the liver breaks down old red cells. It can be measured in a blood sample.

Complete Molecular Response

A response to treatment in which polymerase chain reaction (PCR) testing reveals no evidence of cells containing cancer genes (oncogenes).

Granulocytosis

An increase above normal of the concentration of blood leukocytes (white cells)—specifically, granulocytes (neutrophils, eosinophils and basophils). This excludes lymphocytes and monocytes.

Molecular response

A treatment response is called a complete molecular remission if no leukemia cells in the blood and/or marrow can be detected by PCR.

Monoclonal Antibody Therapy

Immune proteins made in the laboratory. This type of therapy targets and kills specific cancer cells. It does not cause many of the side effects of chemotherapy.

Positron Emission Tomography (PET) Scan

Abbreviated as "PET scan," this test may be used as a follow-up to other tests to determine if a tumor is malignant (cancerous) or benign. A PET scan may also be used to measure response to treatment for certain types of cancer. For a PET scan, glucose (a type of sugar) is labeled with a positron particle emitting a radioisotope, such as fluorine-18. Since cancer cells take up more glucose than normal cells, the radioisotope becomes concentrated in areas with cancer cells. Both a PET scan and a computed tomography (CT) scan may be done to establish the precise location of masses of cancer cells; this is called a PET-CT.

Richter transformation

In a small number of patients, there is a progression in their disease. In these patients, CLL takes on the characteristics of an aggressive lymphoma. This change is not a second cancer, but a transformation of the CLL cells.

Extracorporeal Photopheresis

A procedure being studied to treat steroid-refractory graft versus host disease (GVHD). The procedure involves a series of treatments. Blood is removed through a vein, then white cells are isolated and treated with methoxsalen (UVADEX®), a drug that sensitizes the cells to ultraviolet light. UVA rays are used to irradiate the cells, which are then reinfused into the patient.

Fluorescence In Situ Hybridization (FISH)

A technique to study chromosomes in tissue. It uses probes with fluorescent molecules that emit light of different wavelengths and colors. The probes match to the chromosomes within the cells, and the chromosomes fluoresce in color. FISH can be helpful in assessing risk and treatment needs, and for monitoring treatment effectiveness, by providing a sensitive test to see abnormal cells, such as cells with deletions of 17p.

Immunotherapy

A treatment that uses the body’s immune system to treat diseases. Such therapies include - Monoclonal antibody therapy: a type of drug using antibodies designed to attack specific parts of the cancer cells - Radioimmunotherapy: a type of drug that uses radioactive substances and antibodies to attack cancer cells - Vaccine therapy: drugs used to stimulate the immune system to fight cancer cells.

Phagocytes

Cells that protect the body from infection by eating and killing microorganisms such as bacteria and fungi. Neutrophils and monocytes are the two main types of these cells. Once an infection occurs, phagocytes migrate from the bloodstream and enter the infected tissue. Chemotherapy and radiation can decrease the numbers of these cells, so patients are more likely to get an infection.

Refractory Anemia with Ringed Sideroblasts (RARS)

This is a form of anemia where the bone marrow produces ringed sideroblasts rather than healthy red blood cells (erythrocytes). In the case of abnormal sideroblasts, large amounts of iron are trapped in the developing red cells in abnormal sites. Refractory anemia and RARS are often associated with mild to moderate decreases in the numbers of white blood cells and platelets. This disorder is also called “myelodysplasia” or “acquired sideroblastic anemia.” In some classifications, RARS is an MDS subclass. Also called “myelodysplasia” or “acquired sideroblastic anemia.”

Mucous Membranes

The inner lining of cavities such as the mouth, nose, and sinuses. These linings require new cells to be made to replace those that drop off. This replacement is a normal process and keeps the lining intact and moist. Radiation therapy or chemotherapy drugs that block cells from dividing prevent the replacement of lost cells. The linings become dry, defective, and may ulcerate in patients who receive such treatment. This change can be painful, such as when ulcers develop in the mouth. These painful, ulcerating lesions are referred to as oral "mucositis." Anal ulcers can also develop. The loss of what is referred to as the barrier function of mucous membranes permits microbes to enter the tissue or blood and often leads to infection.

Antigen

A foreign substance, mostly a protein, that creates an immune response when it is eaten, inhaled, or comes into contact with the skin or mucous membranes. Examples are bacteria, viruses and allergens. Antigens stimulate plasma cells to produce antibodies

Bone Marrow Aspiration

A test to find abnormal marrow cells. The area around the hip bone is numbed and then a special needle is inserted and a marrow sample (fluid) is drawn out. Usually this test is done at the same time as a bone marrow biopsy.

Bone Marrow Biopsy

A test to find abnormal marrow cells. The area around the hip bone is numbed and then a special needle is inserted and a piece of bone containing marrow is withdrawn. Usually this test is done at the same time as a bone marrow aspiration.

Consolidation Therapy

A term usually applied to the treatment of acute leukemia for drug treatment given to patients in remission after induction therapy. The aim of consolidation therapy is to kill as many of the remaining cancer cells as possible.

Granulocytic Sarcoma

A localized tumor of leukemic cancer cells. These tumors are found outside the marrow, may occur beneath the skin or other places, and may be the first sign of leukemia

HLA (human leukocyte-associated antigen)

Human leukocyte-associated antigen. Proteins on the outer part of the cells that help fight illness. HLAs are passed from parents to their children and one in four siblings has the same type of HLA.

Induction therapy

The initial treatment with chemotherapy (or radiation therapy). The aim of induction therapy is to kill a maximum number of blood cancer cells so as to induce a remission (absence of signs or effects of the disease).

Leukocyte Alkaline Phosphate (LAP)

A test that measures the amount of a certain enzyme (alkaline phosphatase) in white blood cells. People with certain types of blood cancer often have low LAP levels.

M protein

Monoclonal immunoglobulin, a protein made by myeloma cells. This protein, also called "M protein," enters the blood. The amount of M protein in the blood can be measured. It is used to estimate the extent of the myeloma.

Maintenance Therapy

Chemotherapy given to ALL patients after several weeks of induction and consolidation therapy to help destroy the remaining ALL cells. Maintenance therapy is given for about two years.

Sanctuary Sites

Areas in which it is difficult to get a sufficient concentration of chemotherapy to destroy leukemia cells. For example, in acute lymphoblastic leukemia, the coverings (meninges) of the brain and spinal cord and the testes are notable sanctuary sites.

Vaccine therapy

A type of treatment under study for leukemia, lymphoma, or myeloma. This type of vaccine would not prevent the disease. The vaccine would increase the immune system's attack against cancer cells that remain after treatment with drugs.

Fluorodeoxyglucose (FDG)

A substance that is similar to glucose (a type of sugar) with a radioactive tracer (F-18) attached to it. FDG is injected into a patient's blood, and its activity in the body is traced using a PET scan. Because tumor cells consume significantly larger amounts of glucose than normal cells in surrounding tissue do, FDG-PET is an effective tool for detecting lymphoma and other cancers.

Anemia

A health condition that occurs when a person has a low number of red blood cells and therefore a low hemoglobin concentration. When this happens, it is hard for the blood to carry oxygen. People with severe anemia can be pale, weak, tired, and become short of breath.

Antibodies

A type of protein created by blood cells when they are invaded by bacteria, viruses, or other harmful things called antigens. Antibodies help the body fight against invaders that make people get sick. Antibodies can also be made in the lab and are used to help find certain types of cancer and in treatment.

Bisphosphonates

A class of drugs, including pamidronate and zoledronic acid, which has been helpful in preventing or minimizing bone loss. Bisphosphonates probably act by preventing cells called "osteoclasts" from dissolving bone. In myeloma, bone thinning (osteoporosis) and fracture are major problems.

Erythropoietin (EPO)

A hormone needed for normal production of red blood cells. It is made mainly by the kidneys and is released into the blood due to decreased blood oxygen levels. Synthetic EPO is available as erythropoiesisstimulating agents (ESAs). Epoetin alfa (Procrit® or Epogen®) and darbepoetin alfa (Aranesp®) are ESAs that are used to treat anemia.

Farnesyl Transferase Inhibitor

A drug that has the potential to kill cancer cells by inhibiting or reversing the effect of farnesyl transferase, an enzyme needed to activate oncogenes (cancer-causing genes). FTIs, including tipifarnib (Zarnestra®) and lonafarnib (Sarasar®), are being studied to treat myelodysplastic syndromes and other blood cancers.

Hematocrit

The portion of the blood occupied by red blood cells. Normal amounts are 40 to 54 percent in males and 35 to 47 percent in females. Anemia occurs when the hematocrit level is below normal; erythrocytosis occurs when the hematocrit level is above normal.

Intrathecal

Designation for the space between the covering or lining of the central nervous system (CNS) and the brain or spinal cord. That lining is called the "meninges." In some situations drugs have to be administered directly into the spinal canal when cancer cells are in the meninges. This procedure is called "intrathecal therapy."

Gamma Globulins

A portion or fraction of the proteins that are in plasma. The three major groups of globulins are called "alpha," "beta," or "gamma" globulins. Gamma globulins are sometimes referred to as "immune globulins" or "immunoglobulins" because they are made by the immune cells, specifically B lymphocytes and plasma cells. Gamma globulins are key elements of the immune system because they protect the body from infection. Patients with immune deficiencies whose B lymphocytes cannot make gamma globulin (such as patients with chronic lymphocytic leukemia and some patients with lymphoma) may be given injections of gamma globulin periodically in an effort to decrease the risk of infection.

Lactate Dehydrogenase (LDH)

An enzyme present in all normal and abnormal cells. It is released from cells into the blood and is present in normal amounts in the liquid portion of blood (the plasma). When blood is collected and allowed to clot, the fluid portion is called the "serum." Many chemicals are measured in the serum, including LDH. Normal serum contains low levels of LDH. The level may be elevated in many diseases, such as hepatitis and various cancers. Changes in LDH are nonspecific, but when LDH is elevated in the presence of certain cancers, the change may reflect the extent of the tumor and the rapidity of tumor growth. LDH monitoring is used in some cases along with other measures to plan the intensity of therapy.

Translocations

An abnormality of chromosomes in the marrow or lymph node cells that occurs when a piece of one chromosome breaks off and attaches to the end of another chromosome. In a balanced translocation, genetic material is exchanged between two different chromosomes with no gain or loss of genetic information. When a translocation takes place, the gene at which the break occurs is altered. This is one form of somatic mutation that may transform the gene into an oncogene (cancer-causing gene). See Mutation.

Amyloid

In myeloma, an abnormal protein made by malignant plasma cells. An amyloid deposit develops when parts of the immunoglobulin molecule, referred to as "light chains," deposit in tissues. In the type of amyloid that occurs in myeloma or closely related diseases, organ failure can occur as a result of amyloid deposits in the heart, gastrointestinal tract, kidney, nerves, and other systems.

Bence Jones protein

An abnormal protein made by the malignant plasma (myeloma) cells, which enters the blood and is excreted rapidly in the urine. This protein can cause injury to the kidney or kidney failure when excreted in large amounts. By contrast, normal immunoglobulin is too large to pass through the kidneys in large amounts, so it is present in the blood but usually not in the urine. Bence Jones proteins are also called "immunoglobulin light chains."

Cellular Immunity

That portion of the immune system that protects the individual from infection by the action of T lymphocytes, monocytes, macrophages and other specialized lymphocytes called NK cells. Deficiency in this portion of the immune system can permit infection by microbes such as the bacillus of tuberculosis, cytomegalovirus, and many other organisms that might be fended off more easily in a healthy individual. T lymphocytes also cooperate with B lymphocytes to increase the effectiveness of antibody formation.

Chloroma

A solid tumor composed of immature granulocytes, including blast cells. Chloromas tend to occur in the brain or spinal cord, bones, skin, or soft tissue of the head and neck, although they can develop anywhere in the body. They are usually treated with radiation or chemotherapy. Chloromas are an uncommon complication of AML. Other terms for chloroma are "granulocytic sarcoma" and "extramedullary myeloblastoma."

Sedimentation Rate

A blood test that measures how quickly red cells (erythrocytes) settle in a test tube in one hour. A sedimentation rate test is done to find out if inflammation is present in the body, to check on the progress of a disease or to see how well a treatment is working. This test is also called a "seed rate" or "erythrocyte sedimentation rate (ESR)."

Translocation

An abnormality of chromosomes in the marrow or lymph node cells that occurs when a piece of one chromosome breaks off and attaches to the end of another chromosome. In a balanced translocation, genetic material is exchanged between two different chromosomes with no gain or loss of genetic information. When a translocation takes place, the gene at which the break occurs is altered. This is one form of somatic mutation that may transform the gene into an oncogene (cancer-causing gene). See Mutation.

Philadelphia Chromosome (Ph Chromosome)

An abnormality of chromosome 22 found in the marrow and blood cells of patients with chronic myeloid leukemia and of some patients with acute lymphoblastic leukemia. The abnormality, a shortening of the long arm of this chromosome, was first observed and reported by doctors at the University of Pennsylvania in Philadelphia; thus the name “Philadelphia chromosome.” In most cases, the lost piece of chromosome 22 sticks (translocates) to chromosome 9. Indeed, some of chromosome 9 also sticks (translocates) to chromosome 22. This circumstance is referred to as a “balanced translocation,” because virtually equal lengths of partial chromosome arms exchange position. Because chromosome 22 is a very short chromosome and chromosome 9 is a very long one, the lengthening of chromosome 9 was less apparent than the shortening of 22 until more sensitive detection techniques became available. The abnormality of chromosome 22 is now usually abbreviated as “Ph chromosome.

Reduced-Intensity Allogeneic Stem Cell Transplantation

Reduced-intensity allogeneic transplantation (sometimes called “mini-transplant” or “nonmyeloablative transplant”) uses lower, less toxic doses of chemotherapy and radiation than the conditioning regimen that is given before standard allogeneic transplantations. This type of transplant may be an option for certain patients who are older, who have organ complications or who are otherwise not healthy or strong enough to undergo standard allogeneic transplantation. With a reducedintens ...

  • Photo
Read more

Allogeneic Stem Cell Transplantation

Allogeneic stem cell transplantation involves transferring the stem cells from a healthy person (the donor) to the patient’s body after high-intensity chemotherapy or radiation. The donated stem cells can come from either a related or an unrelated donor.  Before an allogeneic stem cell transplantation, the patient receives a conditioning regimen of chemotherapy and, sometimes, radiation therapy. This conditioning treatment is given to destroy any remaining cancer cells i ...

  • Photo
Read more

Voices of Transplant: Bone Marrow and Stem Cell Transplantation

Voices of Transplant: Bone Marrow and Stem Cell Transplantation Tuesday, March 18, 2014 6:00 - 8:00 p.m. St David's South Austin Medical Center Auditorium AB 901 W Ben White Blvd, Austin, TX Presenter: Paul J Shaughnessy, M.D. Texas Transplant Institute Program Director, Adult Blood and Marrow Stem Cell Transplant Program This program will cover: The value of early referrel for bone marrow or stem cell transplantation Who is a candidate for bone marrow or ...

Read more

Stem Cell Transplantation

What are Stem Cells? Blood stem cells are produced in the bone marrow and can become any kind of blood cell the body needs. Stem cells are constantly dividing and maturing into different types of blood cells, replacing older and worn-out blood cells in the body. They produce billions of new blood cells every day. If the stem cells cannot make enough new blood cells, many serious health problems can occur. These problems may include infections, anemia or bleeding. Healthy stem cells ar ...

  • Photo
Read more

Autologous Stem Cell Transplantation

In autologous stem cell transplantation, the procedure uses the patient’s own stem cells for the transplant. The stem cells are collected from the patient in advance and are frozen. After the patient undergoes high doses of chemotherapy, either with or without radiation therapy, the stem cells are then returned to the body. This type of transplant is often used to treat blood cancers such as Hodgkin lymphoma, non-Hodgkin lymphoma and myeloma.
 
  An aut ...

  • Photo
Read more

Pages

Glossary Results

Allogeneic Stem Cell Transplantation (Transplant)

A treatment that uses healthy donor stem cells to restore a patient’s marrow and blood cells. It uses high doses of chemotherapy and sometimes radiation to “turn off” a patient’s immune system so that the donor cells are not rejected. See the free LLS publication, Blood and Marrow Stem Cell Transplantation.

Stem Cell Transplantation

See Allogeneic Stem Cell Transplantation; Autologous Stem Cell Transplantation.

Nonmyeloablative Stem Cell Transplantation

See Reduced-Intensity Stem Cell Transplantation.

Reduced-Intensity Stem Cell Transplantation

A type of allogeneic transplantation. Patients receive lower doses of chemotherapy drugs and/or radiation to prepare for a reduced-intensity transplant. This protocol may be safer than an allogeneic stem cell transplant–especially for older patients. See the free LLS publication, Blood and Marrow Stem Cell Transplantation.

Autologous Stem Cell Transplantation

A treatment that uses a patient’s own stem cells to slow the growth of certain blood cancers. See the free LLS publication Blood and Marrow Stem Cell Transplantation.

Cord Blood Stem Cells

Stem cells that are present in blood drained from the placenta and umbilical cord (the link that attaches a mom to a new baby). These stem cells have the capability to repopulate the marrow of a compatible recipient and produce blood cells. Frozen cord blood is a source of donor stem cells for transplantation to HLA-matched recipients. Most cord-blood transplants are given by either matched or nearly matched unrelated donors.

Stem Cells

Primitive marrow cells that mature into red blood cells, white blood cells, and blood platelets. Stem cells are mostly found in the marrow, but some leave and circulate in the bloodstream. Stem cells can be collected, preserved, and used for stem cell therapy. See Hematopoiesis.

Bone Marrow Transplantation

See Allogeneic Stem Cell Transplantation; Autologous Stem Cell Transplantation

Transplantation

See Allogeneic Stem Cell Transplantation; Autologous Stem Cell Transplantation.

Autotransplant

See Autologous Stem Cell Transplantation

Somatic Cell Mutation

A change in the DNA that occurs in a specific tissue cell which may result in a tumor. Most cancers start after a somatic cell mutation.

Germ-Cell Mutation

A mutated cell in the egg or the sperm is passed from parent(s) to offspring. See Mutation.

Blast cells

A young (or immature) type of cell in the bone marrow. In healthy people, blast cells make up 5 percent or less of normally developing marrow cells.

Blood Cell Count

A lab test that measures the number and types of cells in the blood. Often called a “complete blood count” or “CBC.”

Biomarkers (cancer cell markers)

Chemicals or structures present either on the surface of or within cells or in the serum. They may aid physicians in determining when treatment (and which type of treatment) is needed by identifying disease that will progress more rapidly and/or have a better or worse response to certain treatments. Examples of biomarkers are gene expression, serum protein levels and chromosome abnormalities in cancer cells. No single feature can accurately predict disease progression in a patient; therefore, physicians use a combination of factors to make a diagnosis and a treatment plan.

Host

The recipient of the transplant who acts as "host" to the transplanted stem cells.

Graft versus cancer effect

With an allogeneic stem cell transplant, the donated stem cells make immune cells that are not totally "matched" with the patient's cells. For this reason, the donor immune cells may recognize the patient's cancer cells as foreign and kills them.

Haploidentical

A potential stem cell donor that has a 50 percent HLA antigen-match with a patient. Parents are haploidentical with children. Siblings have a 50 percent chance of being haploidentical. See HLA; Allogeneic Stem Cell Transplantation.

Matched donor

A person whose major tissue types are identical to those of a patient who is seeking a stem cell transplant. The patient can be given the donor's healthy matched stem cells, which can restore blood and immune cells after high-intensity cancer treatment.

Immune response

The reaction of the body to foreign material. Examples of foreign material are an infection-causing microorganism, a vaccine, or the cells of another person used for an allogeneic stem cell transplant.

Scavenger Cell

See Monocyte/Macrophage.

Conditioning Treatment

Intensive therapy of a patient with cytotoxic drugs or drugs and total body radiation just before receiving a stem cell transplant. The therapy serves three purposes. First, it severely depresses the lymphocytes that are the key cells in the recipient's immune system. This action helps prevent the rejection of the graft. Second, it markedly decreases the marrow cells, which may be important to open up the special niches where the transplanted stem cells must lodge to engraft. Third, if the patient is being transplanted for a malignancy, this intensive therapy greatly decreases the numbers of any remaining tumor cells.

Myeloma Cells

Malignant plasma cells that are the hallmark of myeloma. Their appearance may be similar to normal plasma cells, but they are present in increased numbers.

Blood Cells

There are three types of blood cells: red blood cells, which carry oxygen; white blood cells, which fight infections; and platelets, which help stop bleeding.

Red Blood Cells

Blood cells (erythrocytes) contain hemoglobin, which carries oxygen to the tissues of the body. Red blood cells make up about 40 to 45 percent of blood volume in healthy people

White Blood Cells

Also known as “leukocytes,” the five types of infectionfighting cells in the blood. These include neutrophils, eosinophils, basophils, monocytes and lymphocytes.

Engraftment

The process of transplanted stem cells homing to the recipient's marrow and producing blood cells of all types. This occurrence is first evident when new white cells, red cells, and platelets begin to appear in the recipient's blood following transplantation.

Myelogenous

A term used to describe a form of blood cancer that begins in a marrow stem cell or early marrow progenitor cell.

Chemokines

These are small molecules which may stimulate inflammation and which may play a role in stem cell mobilization.

Haplotype

The tissue type contributed by either the mother or father to his or her offspring. It is implied that it represents the genes on one parental chromosome. When a transplant procedure is between a donor and recipient that are haplotype identical, it means that the tissue type or HLA type of each is identical in respect to mother or father but not identical to the other. In some situations, if the discrepancy is not too great, the transplant may still be possible if the underlying disease makes the risk of partial compatibility warranted. Conditioning of the recipient and lymphocyte depletion of the donor stem cell suspension are steps taken to mitigate the risk of immune cell activation by the tissue type differences.

Differentiation

When stem cells develop and mature and take on a new function. Stem cells will either mature into red blood cells, platelets or white blood cells. See Hematopoiesis.

Tolerance

A very important event in the long-term success of transplantation. After a time, usually a year or so, the prior host and donor T lymphocytes die off and new lymphocytes are formed from the donor?s engrafted stem cells. These "adapt" to the new host and stop attacking the recipient's cells. If tolerance is present, the immune system is no longer distracted and can serve the patient by working efficiently to protect against microbes. Risk of infection diminishes and approaches that of a healthy person. Immunosuppressive therapy can be stopped.

FMS-like tyrosine kinase 3 gene (FLT3)

An abbreviation for the FMS-like tyrosine kinase 3 gene. FLT3 is expressed on blood forming stem cells and plays a role in cell development. FLT3 mutations can be detected in about one-third of AML patients. These mutations have been identified as part of the AML disease process and may become the basis for new targeted therapies.

Cryopreservation

A technique used to keep frozen cells intact and functional for many years. Blood or marrow cells, including stem cells, can be stored for very long periods and remain functional if they are suspended in a fluid that contains a chemical that prevents cellular injury during freezing or thawing. This chemical is referred to as a "cryoprotective" agent. Dimethyl sulfoxide (DMSO) is one of the most commonly used agents. The freezing temperature is much lower (colder) than that of a household freezer.

Promyelocyte

A cell that is formed during the transition from an immature cell to a mature cell during the development cycle for certain types of red blood cells.

Lymphoblast

The leukemic cell that replaces the normal marrow cell. Uncontrolled and exaggerated growth and accumulation of these leukemic cells means that they fail to function as normal blood cells.

Nucleus

A part of the cell containing the chromosomes and genes.

Tumor Suppressor Gene

A gene that works to stop cell growth.

DNA

Deoxyribonucleic acid. The genetic matter found in all cells. DNA is passed to new cells during the process of cell division. A change or mutation in the DNA can lead to cell death, changes in the cell function, and in some cases, cancer.

Donor lymphocyte infusion (DLI)

A therapy often used for patients after an allogeneic bone marrow transplant. In this procedure, patients are given lymphocytes (white blood cells) that come from the original transplant donor to help attack remaining cancer cells.

Granulocyte

A type of white blood cell with many particles (granules) in the cell body. Neutrophils, eosinophils and basophils are types of granulocytes.

Hematologic response (hematologic remission)

A treatment response where the leukemia, lymphoma or myeloma cell numbers are decreased in the blood; and, red cell count, white cell count, and platelet count are either at or near normal values.

Graft-Versus-Tumor Effect (Graft-Versus-Leukemia Effect)

The potential immune reaction of transplanted (donor) T lymphocytes causing them to recognize and attack the cancer cells of the patient.

Hematologist

A doctor who specializes in blood cell diseases.

Anthracyclines (Antitumor Antibiotics)

Chemotherapy agents that interact directly with the DNA in the nucleus of cells, thus interfering with cell survival.

Genes

Parts of cells that give instructions for making proteins. Proteins help the cell do its job.

Hematopoiesis

The formation of all types of blood cells that starts in the marrow. For the blood cell development process.

Monocyte/Macrophage

A type of red blood cell that represents about 5 to 10 percent of the cells in normal human blood.

Multidrug Resistance (MDR)

A cell characteristic that makes cells resistant to certain types of drugs.

Pancytopenia

A health condition when there is a decrease in the numbers of the three major blood cell types: red blood cells, white blood cells and platelets.

Alkylating Agent

A type of chemotherapy used to kill cancer cells by interfering with cancer cell division. Alkylating agents cause side effects because they also interfere with cell division in certain healthy tissues where cell division is frequent, such as the gastrointestinal tract. Cyclophosphamide is one of several types of alkylating agents.

Clonal

The designation for a population of cells derived from a single transformed parent cell. Virtually all cancers are derived from a single cell with an injury (mutation) to its DNA and thus are monoclonal. Leukemia, lymphoma, myeloma and myelodysplastic syndromes are examples of clonal cancers; that is, cancers derived from a single abnormal cell.

Immunophenotyping

A process used to find specific types of cells within a blood sample. It looks at antigens or markers on the surface of the cell to identify antibodies.

Absolute Neutrophil Count (ANC)

The number of neutrophils (a type of white blood cell that fights infection) that are identified in the blood count.

Basophil

A type of white blood cell present in certain allergic reactions.

DNA Synthesis Inhibitors

Chemotherapy drugs that react with DNA to alter it chemically and keep it from permitting cell growth.

Eosinophil

A white blood cell that helps to fight some parasitic infections and participates in allergic responses.

Hyperleukocytosis

A very high white blood cell count, often found in people when they are diagnosed with leukemia.

Myelocyte

A marrow cell that is a precursor of the mature granulocytes of the blood. Myelocytes are not present in the blood of healthy individuals.

Neutropenia

An abnormal decrease in the number of neutrophils, a type of white blood cell, in the blood.

Flow Cytometry

A test that finds specific cell types within a cell sample, During this test, cells flow through the instrument called a “flow cytometer.” When the cells pass through its laser beam, those with the antibody-specific features light up and can be counted. This test may be used to examine blood cells, marrow cells, or cells from a biopsy.

Karyotype

The order, number and appearance of chromosomes within a cell. There are 46 human chromosomes with the sex chromosomes shown as a separate pair (either XX or XY). The 22 pairs with each cell are called “autosomes.” See FISH (Fluorescence In Situ Hybridization).

Zap-70

An abbreviation for the cell protein “zeta-associated protein 70.” A high level of ZAP-70 expression on the cells of patients with B-cell CLL is one of several factors that may predict more progressive disease. Outside of a research laboratory this test is generally not very reliable and should not be used.

Complete Hematologic Response

A response to treatment in which the number of cancer cells is decreased, immature cancer cells are mostly eliminated from the blood and the hemoglobin concentration, white cell count and platelet count are at or near normal values.

DNA Repair Enzyme Inhibitors

Chemotherapy drugs that prevent certain cell proteins from working and make the DNA more susceptible to injury.

Tyrosine Kinase

A type of enzyme that plays a key role in cell function. It is normally present in cells, and a normal gene, ABL on chromosome 9, directs its production. In chronic myeloid leukemia, an alteration in the DNA results in a mutant fusion gene, BCR-ABL, which produces an abnormal or mutant tyrosine kinase. This abnormal enzyme leads to a cascade of effects in the cell that transforms it into a leukemic cell.

Proto-oncogene

A gene involved in normal cell growth. Mutations (changes) in a proto-oncogene may cause it to become an oncogene, which can cause the growth of cancer cells.

Macrophage

A monocyte in action (this is called a “scavenger cell”). When monocytes leave the blood and enter the tissue, they are known as “macrophages.” Macrophages fight infection, eat dead cells and help lymphocytes with their immunity functions. See Monocyte.

Bone Marrow

A spongy tissue in the hollow central cavity of the bones where blood cells are made. By puberty, the marrow in the spine, ribs, breastbone, hips, shoulders and skull is most active in blood cell formation. In adults, the bones of the hands, feet, legs and arms no longer contain blood-forming marrow—these bones are filled with fat cells. When marrow cells have matured into blood cells, they enter the blood that passes through the marrow and are carried in the bloodstream throughout the body.

Radioactive Isotope

A form of a molecule that emits radiation. Certain types of radiation can damage cancer cells. Physicians use radioactive isotopes to treat cancer in several ways, including attaching the isotope to antibodies. The antibodies can attach to the cancer cell, and the radiation can destroy it.

Refractory Anemia (RA)

Also known as “myelodysplasia,” this clonal myeloid disorder mostly affects red blood cell production in the marrow. It can also be associated with mild to moderate decreases in the numbers of white blood cells and platelets. In some classification systems, it is an MDS subtype.

Lymphocyte

A type of white blood cell that is important to the body’s immune system. There are three major types of lymphocytes: B lymphocytes, which produce antibodies to help combat infectious agents such as bacteria, viruses and fungi; T lymphocytes, which have several functions, including assisting B lymphocytes in making antibodies; and natural killer (NK) cells, which can attack virus-infected cells or tumor cells.

Cytokines

Cell- (cyto-) derived chemicals that are secreted by various types of cells and act on other cells to stimulate or inhibit their function. Chemicals derived from lymphocytes are called "lymphokines." Chemicals derived from lymphocytes that act on other white cells are called "interleukins"; that is, they interact between two types of leukocytes. Some cytokines can be made commercially and used in treatment. Granulocyte-colony stimulating factor (G-CSF) and granulocyte macrophage-colony stimulating factor (GM-CSF) are examples of cytokines. These stimulate the production of neutrophils and shorten the period of low neutrophil counts in the blood after chemotherapy. Cytokines that stimulate cell growth are sometimes referred to as "growth factors."

BCR-ABL

A mutant gene that is formed when a piece of chromosome 9 attaches to the end of chromosome 22. The BCR-ABL cancer gene gives the cell instructions to make a protein that leads to CML. BCR-ABL is found in some patients with ALL.

Lymphoblastic

A term used to describe a type of blood cell disease caused by young or immature lymphocytes or "lymphoblasts." An example is acute lymphoblastic leukemia, which is characterized by the presence of malignant (cancerous) lymphoblasts (immature lymphocytes).

BCL-2 Gene Rearrangement

Rearrangements in the BCL-2 gene that occur on B cells. The BCL-2 gene rearrangement is associated with a chromosome translocation t(14;18) (q32;q21) that places BCL-2 (normally on chromosome 18) adjacent to the joining region (JH) of the immunoglobulin heavy chain locus (normally on chromosome 14). The rearrangement results in a high level of expression of the BCL-2 protein. The overexpression of the bcl-2 protein gives cells a survival advantage by inhibiting cell death. Overexpression of the Bcl-2 protein can occur without detection of the BCL-2 gene rearrangement.

Cluster Designation (CD)

A term used with a number to identify a specific molecule on the surface of an immune cell. It is commonly used in its abbreviated form, for example, “CD20” (the target of the monoclonal antibody therapy rituximab [Rituxan®] and “CD52” (the target of the monoclonal antibody therapy alemtuzumab [Campath®])

Neutrophil

A type of white blood cell and the main type that works to fight infection. People with some blood cancers, or those who have received treatment (such as chemotherapy) for cancer, often have low neutrophil counts. People with low neutrophil counts are very susceptible to infections.

Central Nervous System (CNS) Prophylaxis

In certain types of leukemia, particularly acute lymphoblastic leukemia and acute monocytic leukemia with high blood cell counts, there is a propensity of the leukemic cells to enter the covering of the spinal cord and brain (the meninges). This process is often not apparent until months or years after remission when the leukemia returns, first in the coverings of the CNS, then in the marrow and blood. To prevent this type of relapse (meningeal leukemia), virtually all children and adults with acute lymphblastic leukemia who enter remission are treated by placing appropriate chemotherapy in the fluid that bathes the spinal cord and brain to prevent the leukemia from returning in these sites. In some cases, x-ray therapy is administered to the head as well. These approaches are very effective in eliminating leukemia cells in the coverings of the brain and spinal cord.

Opportunistic Infections

Unusual infections to which patients treated for cancer may be susceptible because of the suppression of their immune system. "Opportunistic" is the term used to describe infections with bacteria, viruses, fungi or protozoa to which individuals with a normal immune system are not susceptible. The infecting organisms take advantage of the opportunity provided by immunodeficiency, especially when coupled with very low white cell counts resulting from therapy or the disease itself.

Myeloblasts

See Blast Cells.

G-Banding Karyotyping

A testing method that makes a certain characteristic of chromosomes easier to see. A “karyotype” is the systematic arrangement, using images, of the 46 human chromosomes of a cell. Karyotypes are examined for deviations from the expected arrangement, number, size, shape or other characteristics of the chromosomes. Each chromosome pair has a characteristic banding pattern. To make the banding pattern easier to see, a dye called “Giemsa” may be used as a stain. This process is also referred to as “G-banding.” G-banding karyotyping and other cytogenetic tests provide doctors with information that contributes to determining the best treatment approach for an individual patient. The test takes longer than the FISH test, but has the advantage of being able to detect any changes that are visible because it does not rely on specific probes. Usually, both tests are done on samples from the marrow, especially at the time of diagnosis.

Myeloma

A type of cancer that begins in the bone marrow. It is a cancer of plasma cells, which are a type of white blood cells (also called plasma B cells).

Toxin

A naturally derived substance that is poisonous to cells. A toxin can be attached to antibodies that then attach to cancer cells. The toxin may kill the cancer cells.

Cytopenia

A reduction in the number of cells circulating in the blood.

Erythrocytes

See Red Blood Cells.

Leukocytes

See White Blood Cells

CD38

An antigen on CLL cells and other cells. The expression of CD38 may be a marker to assist in predicting CLL progression.

Beta 2-microglobulin

B2M is a protein found on the surface of white blood cells. Increased production or destruction of these cells causes B2M levels in the blood to increase. This increase is seen in people with cancers involving white blood cells.

Complete blood count (CBC)

A series of tests used to measure levels of red cells, white cells, and platelets in the blood, and the appearance of cells on a blood film. The CBC is used diagnose and manage many diseases.

plgarci1@stvincent.org

Cytogenetic Analysis

A type of test that looks at the number and size of the chromosomes in cells. It is often used in cancer treatment and to see changes in the cells before and after treatment.

Minimal Residual Disease (MRD)

The small amounts of cancer cells that may remain after treatment. These cells are only identified by sensitive molecular techniques.

Monoclonal Antibodies

Antibodies made by cells of a single clone. They are used in cancer treatment to target cancer cells. They can be made in a lab.

Refractory Cytopenia With Multilineage Dysplasia (RCMD)

One of the more common WHO MDS subtypes. There are too few of at least two types of blood cells (red blood cells, white blood cells, or platelets). In the bone marrow, those same types of cells look abnormal (dysplasia) under the microscope. Less than 5 percent of the cells in the bone marrow are blasts. In patients with more than 15 percent ringed sideroblasts, the subtype is called “RCMD-RS.”

Antiglobulin Test

A laboratory procedure that can identify antibodies on the surface of red cells or platelets. Patients may make antibodies to their own red cells or platelets (auto- or self-directed antibodies). These autoantibodies may lead to anemia or a low platelet count in patients. The antiglobulin test can be used to identify the presence of autoantibodies on blood cells.

Graft-Versus-Host Disease (GVHD)

A disease that happens when the donor cells (“the graft”) attack the cells of the patient (“the host”). Most often this disease attacks a patient’s skin, liver, and the stomach and gastrointestinal tract.

Histone Deacetylase Inhibitor (HDAC Inhibitor)

A substance that causes a chemical change that stops cancer cells from dividing. HDAC inhibitors appear to have a greater effect on cancer cells than on normal cells. As a result they may cause less toxicity than other chemotherapeutic agents.

Myeloproliferative Neoplasms (MPNs)

A group of diseases that occur when certain types of blood cells are overproduced. Examples of MPNs are essential thrombocythemia, polycythemia vera and myelofibrosis. Some people with MPNs have abnormal-looking cells in their bone marrow that are similar to MDS cells.

Oligoblastic Myelogenous Leukemia

Also known as “refractory anemia excess blasts” (RAEB), this type of MDS shows signs of leukemic blast cells when the blood or marrow is examined. There may only be a small number of these blast cells in the marrow, but their presence indicates that leukemic cells are developing.

Radioimmunotherapy

A treatment that uses antibodies to carry a radioactive substance to lymphoma cells to kill them. Radioimmunotherapy such as Zevalin® carries a radioactive substance to the lymphoma cells that then irradiates lymphoma cells locally and selectively. This approach minimizes the effects of radiation on normal tissues.

Hemoglobin

The iron-containing substance in red blood cells that carries oxygen around the body. Hemoglobin concentration decreases when there is a reduction in the number of red blood cells. This condition is called “anemia.”

Chemotherapy

A treatment that uses medicine (chemical agents) to kill cancer cells.

Complete Cytogenetic Response

A response to treatment in which there are no cancer cells in the marrow that can be detected by FISH.

Cytogenetic response (cytogenetic remission)

A treatment response in which there is no leukemia, lymphoma or myeloma cells detected in the blood and/or marrow by the FISH test.

Cytogeneticist

A health care expert who uses special types of tests to look at cells and chromosomes

Cytotoxic Drugs

Anticancer drugs that act by killing or preventing the division of cells. (See Chemotherapy.)

Hematopathologist

A doctor or scientist who studies the blood cells and blood tissues to identify disease.

Leukocytosis

An increase above the upper limit of normal in the concentration of blood leukocytes (white blood cells).

Leukopenia

A decrease below normal in the number of leukocytes (white blood cells) circulating in the blood.

Peripheral Blood Smear

A sample of blood placed on a slide and stained (dyed) so that the cells can be examined under a microscope.

Resistance to Treatment

When cancer cells continue to grow even after strong drugs and/or treatments.

RNA

Abbreviation for ribonucleic acid, a molecule in cells that carries out DNA's instructions for making proteins.

Side effect

The signs or symptoms a patient may have from the effects of treatment on healthy cells.

Apheresis

A process using a machine to take out needed parts of the donor’s blood and return the unneeded parts to the donor. This process lets certain blood components, including red blood cells, white blood cells and platelets to be removed separately and in large volumes. See Platelet Transfusion.

Aplastic Anemia

A health condition that occurs when your body stops producing enough new blood cells. Any blood cells that the marrow does make are normal, but there are not enough of them. Aplastic anemia can be moderate, severe, or very severe.

B Lymphocyte

One of three specialized lymphocyte types. They produce antibodies in response to any foreign substance, but to bacteria, viruses, and fungi in particular. These lymphocytes are a vital part of the immune system and are important to our defense against infection. Some B lymphocytes mature into plasma cells, which are the principal antibody-producing cells.

Chromosomes

Threadlike structures within cells that carry genes in a linear order. Human cells have 23 pairs of chromosomes: chromosome pairs 1 to 22 and one pair of sex chromosomes (XX for females and XY for males). See Translocation.

Platelets

Also known as “thrombocytes,” platelets are small colorless blood cells. They travel to and collect at the site of a wound. Once they get there, the platelets' sticky surface helps them to form clots and stop bleeding. Platelets make up about one tenth of the volume of red blood cells.

Bilirubin

A brownish yellow substance that is produced mainly when the liver breaks down old red cells. It can be measured in a blood sample.

Complete Molecular Response

A response to treatment in which polymerase chain reaction (PCR) testing reveals no evidence of cells containing cancer genes (oncogenes).

Granulocytosis

An increase above normal of the concentration of blood leukocytes (white cells)—specifically, granulocytes (neutrophils, eosinophils and basophils). This excludes lymphocytes and monocytes.

Molecular response

A treatment response is called a complete molecular remission if no leukemia cells in the blood and/or marrow can be detected by PCR.

Monoclonal Antibody Therapy

Immune proteins made in the laboratory. This type of therapy targets and kills specific cancer cells. It does not cause many of the side effects of chemotherapy.

Positron Emission Tomography (PET) Scan

Abbreviated as "PET scan," this test may be used as a follow-up to other tests to determine if a tumor is malignant (cancerous) or benign. A PET scan may also be used to measure response to treatment for certain types of cancer. For a PET scan, glucose (a type of sugar) is labeled with a positron particle emitting a radioisotope, such as fluorine-18. Since cancer cells take up more glucose than normal cells, the radioisotope becomes concentrated in areas with cancer cells. Both a PET scan and a computed tomography (CT) scan may be done to establish the precise location of masses of cancer cells; this is called a PET-CT.

Richter transformation

In a small number of patients, there is a progression in their disease. In these patients, CLL takes on the characteristics of an aggressive lymphoma. This change is not a second cancer, but a transformation of the CLL cells.

Extracorporeal Photopheresis

A procedure being studied to treat steroid-refractory graft versus host disease (GVHD). The procedure involves a series of treatments. Blood is removed through a vein, then white cells are isolated and treated with methoxsalen (UVADEX®), a drug that sensitizes the cells to ultraviolet light. UVA rays are used to irradiate the cells, which are then reinfused into the patient.

Fluorescence In Situ Hybridization (FISH)

A technique to study chromosomes in tissue. It uses probes with fluorescent molecules that emit light of different wavelengths and colors. The probes match to the chromosomes within the cells, and the chromosomes fluoresce in color. FISH can be helpful in assessing risk and treatment needs, and for monitoring treatment effectiveness, by providing a sensitive test to see abnormal cells, such as cells with deletions of 17p.

Immunotherapy

A treatment that uses the body’s immune system to treat diseases. Such therapies include - Monoclonal antibody therapy: a type of drug using antibodies designed to attack specific parts of the cancer cells - Radioimmunotherapy: a type of drug that uses radioactive substances and antibodies to attack cancer cells - Vaccine therapy: drugs used to stimulate the immune system to fight cancer cells.

Phagocytes

Cells that protect the body from infection by eating and killing microorganisms such as bacteria and fungi. Neutrophils and monocytes are the two main types of these cells. Once an infection occurs, phagocytes migrate from the bloodstream and enter the infected tissue. Chemotherapy and radiation can decrease the numbers of these cells, so patients are more likely to get an infection.

Refractory Anemia with Ringed Sideroblasts (RARS)

This is a form of anemia where the bone marrow produces ringed sideroblasts rather than healthy red blood cells (erythrocytes). In the case of abnormal sideroblasts, large amounts of iron are trapped in the developing red cells in abnormal sites. Refractory anemia and RARS are often associated with mild to moderate decreases in the numbers of white blood cells and platelets. This disorder is also called “myelodysplasia” or “acquired sideroblastic anemia.” In some classifications, RARS is an MDS subclass. Also called “myelodysplasia” or “acquired sideroblastic anemia.”

Mucous Membranes

The inner lining of cavities such as the mouth, nose, and sinuses. These linings require new cells to be made to replace those that drop off. This replacement is a normal process and keeps the lining intact and moist. Radiation therapy or chemotherapy drugs that block cells from dividing prevent the replacement of lost cells. The linings become dry, defective, and may ulcerate in patients who receive such treatment. This change can be painful, such as when ulcers develop in the mouth. These painful, ulcerating lesions are referred to as oral "mucositis." Anal ulcers can also develop. The loss of what is referred to as the barrier function of mucous membranes permits microbes to enter the tissue or blood and often leads to infection.

Antigen

A foreign substance, mostly a protein, that creates an immune response when it is eaten, inhaled, or comes into contact with the skin or mucous membranes. Examples are bacteria, viruses and allergens. Antigens stimulate plasma cells to produce antibodies

Bone Marrow Aspiration

A test to find abnormal marrow cells. The area around the hip bone is numbed and then a special needle is inserted and a marrow sample (fluid) is drawn out. Usually this test is done at the same time as a bone marrow biopsy.

Bone Marrow Biopsy

A test to find abnormal marrow cells. The area around the hip bone is numbed and then a special needle is inserted and a piece of bone containing marrow is withdrawn. Usually this test is done at the same time as a bone marrow aspiration.

Consolidation Therapy

A term usually applied to the treatment of acute leukemia for drug treatment given to patients in remission after induction therapy. The aim of consolidation therapy is to kill as many of the remaining cancer cells as possible.

Granulocytic Sarcoma

A localized tumor of leukemic cancer cells. These tumors are found outside the marrow, may occur beneath the skin or other places, and may be the first sign of leukemia

HLA (human leukocyte-associated antigen)

Human leukocyte-associated antigen. Proteins on the outer part of the cells that help fight illness. HLAs are passed from parents to their children and one in four siblings has the same type of HLA.

Induction therapy

The initial treatment with chemotherapy (or radiation therapy). The aim of induction therapy is to kill a maximum number of blood cancer cells so as to induce a remission (absence of signs or effects of the disease).

Leukocyte Alkaline Phosphate (LAP)

A test that measures the amount of a certain enzyme (alkaline phosphatase) in white blood cells. People with certain types of blood cancer often have low LAP levels.

M protein

Monoclonal immunoglobulin, a protein made by myeloma cells. This protein, also called "M protein," enters the blood. The amount of M protein in the blood can be measured. It is used to estimate the extent of the myeloma.

Maintenance Therapy

Chemotherapy given to ALL patients after several weeks of induction and consolidation therapy to help destroy the remaining ALL cells. Maintenance therapy is given for about two years.

Sanctuary Sites

Areas in which it is difficult to get a sufficient concentration of chemotherapy to destroy leukemia cells. For example, in acute lymphoblastic leukemia, the coverings (meninges) of the brain and spinal cord and the testes are notable sanctuary sites.

Vaccine therapy

A type of treatment under study for leukemia, lymphoma, or myeloma. This type of vaccine would not prevent the disease. The vaccine would increase the immune system's attack against cancer cells that remain after treatment with drugs.

Fluorodeoxyglucose (FDG)

A substance that is similar to glucose (a type of sugar) with a radioactive tracer (F-18) attached to it. FDG is injected into a patient's blood, and its activity in the body is traced using a PET scan. Because tumor cells consume significantly larger amounts of glucose than normal cells in surrounding tissue do, FDG-PET is an effective tool for detecting lymphoma and other cancers.

Anemia

A health condition that occurs when a person has a low number of red blood cells and therefore a low hemoglobin concentration. When this happens, it is hard for the blood to carry oxygen. People with severe anemia can be pale, weak, tired, and become short of breath.

Antibodies

A type of protein created by blood cells when they are invaded by bacteria, viruses, or other harmful things called antigens. Antibodies help the body fight against invaders that make people get sick. Antibodies can also be made in the lab and are used to help find certain types of cancer and in treatment.

Bisphosphonates

A class of drugs, including pamidronate and zoledronic acid, which has been helpful in preventing or minimizing bone loss. Bisphosphonates probably act by preventing cells called "osteoclasts" from dissolving bone. In myeloma, bone thinning (osteoporosis) and fracture are major problems.

Erythropoietin (EPO)

A hormone needed for normal production of red blood cells. It is made mainly by the kidneys and is released into the blood due to decreased blood oxygen levels. Synthetic EPO is available as erythropoiesisstimulating agents (ESAs). Epoetin alfa (Procrit® or Epogen®) and darbepoetin alfa (Aranesp®) are ESAs that are used to treat anemia.

Farnesyl Transferase Inhibitor

A drug that has the potential to kill cancer cells by inhibiting or reversing the effect of farnesyl transferase, an enzyme needed to activate oncogenes (cancer-causing genes). FTIs, including tipifarnib (Zarnestra®) and lonafarnib (Sarasar®), are being studied to treat myelodysplastic syndromes and other blood cancers.

Hematocrit

The portion of the blood occupied by red blood cells. Normal amounts are 40 to 54 percent in males and 35 to 47 percent in females. Anemia occurs when the hematocrit level is below normal; erythrocytosis occurs when the hematocrit level is above normal.

Intrathecal

Designation for the space between the covering or lining of the central nervous system (CNS) and the brain or spinal cord. That lining is called the "meninges." In some situations drugs have to be administered directly into the spinal canal when cancer cells are in the meninges. This procedure is called "intrathecal therapy."

Gamma Globulins

A portion or fraction of the proteins that are in plasma. The three major groups of globulins are called "alpha," "beta," or "gamma" globulins. Gamma globulins are sometimes referred to as "immune globulins" or "immunoglobulins" because they are made by the immune cells, specifically B lymphocytes and plasma cells. Gamma globulins are key elements of the immune system because they protect the body from infection. Patients with immune deficiencies whose B lymphocytes cannot make gamma globulin (such as patients with chronic lymphocytic leukemia and some patients with lymphoma) may be given injections of gamma globulin periodically in an effort to decrease the risk of infection.

Lactate Dehydrogenase (LDH)

An enzyme present in all normal and abnormal cells. It is released from cells into the blood and is present in normal amounts in the liquid portion of blood (the plasma). When blood is collected and allowed to clot, the fluid portion is called the "serum." Many chemicals are measured in the serum, including LDH. Normal serum contains low levels of LDH. The level may be elevated in many diseases, such as hepatitis and various cancers. Changes in LDH are nonspecific, but when LDH is elevated in the presence of certain cancers, the change may reflect the extent of the tumor and the rapidity of tumor growth. LDH monitoring is used in some cases along with other measures to plan the intensity of therapy.

Translocations

An abnormality of chromosomes in the marrow or lymph node cells that occurs when a piece of one chromosome breaks off and attaches to the end of another chromosome. In a balanced translocation, genetic material is exchanged between two different chromosomes with no gain or loss of genetic information. When a translocation takes place, the gene at which the break occurs is altered. This is one form of somatic mutation that may transform the gene into an oncogene (cancer-causing gene). See Mutation.

Amyloid

In myeloma, an abnormal protein made by malignant plasma cells. An amyloid deposit develops when parts of the immunoglobulin molecule, referred to as "light chains," deposit in tissues. In the type of amyloid that occurs in myeloma or closely related diseases, organ failure can occur as a result of amyloid deposits in the heart, gastrointestinal tract, kidney, nerves, and other systems.

Bence Jones protein

An abnormal protein made by the malignant plasma (myeloma) cells, which enters the blood and is excreted rapidly in the urine. This protein can cause injury to the kidney or kidney failure when excreted in large amounts. By contrast, normal immunoglobulin is too large to pass through the kidneys in large amounts, so it is present in the blood but usually not in the urine. Bence Jones proteins are also called "immunoglobulin light chains."

Cellular Immunity

That portion of the immune system that protects the individual from infection by the action of T lymphocytes, monocytes, macrophages and other specialized lymphocytes called NK cells. Deficiency in this portion of the immune system can permit infection by microbes such as the bacillus of tuberculosis, cytomegalovirus, and many other organisms that might be fended off more easily in a healthy individual. T lymphocytes also cooperate with B lymphocytes to increase the effectiveness of antibody formation.

Chloroma

A solid tumor composed of immature granulocytes, including blast cells. Chloromas tend to occur in the brain or spinal cord, bones, skin, or soft tissue of the head and neck, although they can develop anywhere in the body. They are usually treated with radiation or chemotherapy. Chloromas are an uncommon complication of AML. Other terms for chloroma are "granulocytic sarcoma" and "extramedullary myeloblastoma."

Sedimentation Rate

A blood test that measures how quickly red cells (erythrocytes) settle in a test tube in one hour. A sedimentation rate test is done to find out if inflammation is present in the body, to check on the progress of a disease or to see how well a treatment is working. This test is also called a "seed rate" or "erythrocyte sedimentation rate (ESR)."

Translocation

An abnormality of chromosomes in the marrow or lymph node cells that occurs when a piece of one chromosome breaks off and attaches to the end of another chromosome. In a balanced translocation, genetic material is exchanged between two different chromosomes with no gain or loss of genetic information. When a translocation takes place, the gene at which the break occurs is altered. This is one form of somatic mutation that may transform the gene into an oncogene (cancer-causing gene). See Mutation.

Philadelphia Chromosome (Ph Chromosome)

An abnormality of chromosome 22 found in the marrow and blood cells of patients with chronic myeloid leukemia and of some patients with acute lymphoblastic leukemia. The abnormality, a shortening of the long arm of this chromosome, was first observed and reported by doctors at the University of Pennsylvania in Philadelphia; thus the name “Philadelphia chromosome.” In most cases, the lost piece of chromosome 22 sticks (translocates) to chromosome 9. Indeed, some of chromosome 9 also sticks (translocates) to chromosome 22. This circumstance is referred to as a “balanced translocation,” because virtually equal lengths of partial chromosome arms exchange position. Because chromosome 22 is a very short chromosome and chromosome 9 is a very long one, the lengthening of chromosome 9 was less apparent than the shortening of 22 until more sensitive detection techniques became available. The abnormality of chromosome 22 is now usually abbreviated as “Ph chromosome.