C h a p t e r 1 1
Disorders of White Blood Cells and Lymphoid Tissues
259
R E V I EW E X E R C I S E S
1.
Many of the primary immunodeficiency disorders,
in which there is a defect in the development of
immune cells of T- or B-lymphocyte origin, can
be cured with allogeneic stem cell transplantation
from an unaffected donor.
A.
Explain why stem cells are used rather than
mature lymphocytes. You might want to refer
to Figure 11-5.
B.
Describe how the stem cells would go about
the process of repopulating the bone marrow.
2.
A mother brings her 4-year-old son into the
pediatric clinic because of irritability, loss of
appetite, low-grade fever, pallor, and complaints
that his legs hurt. Blood tests reveal anemia,
thrombocytopenia, and an elevated leukocyte
count with atypical lymphocytes. A diagnosis of
acute lymphocytic leukemia (ALL) is confirmed
with bone marrow studies.
A.
What is the origin of the anemia,
thrombocytopenia, elevated leukocyte count,
and atypical lymphocytes seen in this child?
B.
Explain the cause of the child’s fever, pallor,
increased bleeding, and bone pain.
C.
The parents are informed that the preferred
treatment for ALL consists of aggressive
chemotherapy with the purpose of achieving
a remission. Explain the rationale for using
chemotherapy to treat leukemia.
D.
The parents are told that the child will need
intrathecal chemotherapy administered by
a lumbar puncture. Why is this treatment
necessary?
3.
A 36-year-old man presents to his health care
clinic with fever, night sweats, weight loss, and
a feeling of fullness in his abdomen. Subsequent
lymph node biopsy reveals a diagnosis of non-
Hodgkin lymphoma (NHL).
A.
Although lymphomas can originate in any of
the lymphoid tissues of the body, most originate
in the lymph nodes, and most (80% to 85%)
are of B-cell origin. Hypothesize as to why B
cells are more commonly affected than T cells.
B.
A newly developed monoclonal antibody,
rituximab, is being used in the treatment of
NHL. Explain how this agent exerts its effect
and why it is specific for B-cell lymphomas.
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