Glossary of terms

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Ablative therapy

High dose chemotherapy or radiotherapy aimed at destroying any residual cancer cells but which at the same time destroys the patient’s own bone marrow and therefore requires stem cell rescue

Acute leukaemia

A rapidly progressive cancer of the blood, usually of sudden onset, and characterised by the uncontrolled growth of immature blood cells which take over the bone marrow and spill into the bloodstream. If left untreated, it is fatal within a few weeks or months

Acute lymphoblastic leukaemia (ALL)

A rapidly progressing cancer of the blood affecting the type of white blood cells known as lymphocytes. It is the most common form of childhood cancer but also occurs in adults

Acute myeloid leukaemia (AML)

A rapidly progressing cancer of the blood affecting immature cells of the bone marrow, usually of the white cell population. It is more common in adults than in children

Adenosine deaminase inhibitors

Drugs used in the treatment of chronic lymphocytic leukaemia and lymphoma that appear to be less toxic because they act by encouraging cell death rather than actively killing cells. They may be more effective in some diseases than more conventional chemotherapy

Aetiology

The scientific study of the factors that cause a disease, for example, environmental factors such as infections and radiation

Alkylating agent

Anti-cancer drugs that interact with genetic material (DNA) in such a way as to prevent division of the cells. Drugs of this type include busulphan, chlorambucil, cyclophosphamide, and melphalan

Allogeneic stem cell or bone marrow transplant

A stem cell transplant using marrow collected from a matched healthy donor, usually a brother or sister. The risk associated with such a transplant increases with age and 55 has until now been regarded as the upper age limit for patients

Alopecia

The loss of hair. A side-effect of some forms of chemotherapy or radiotherapy used to treat leukaemia and other cancers. Usually temporary

Amyloid

An abnormal, insoluble protein, which deposits in organs and tissues of the body

Amyloidosis

A general term for a group of diseases in which an abnormal protein called amyloid is produced and distributed in organs and tissues of the body

Anaemia

Deficiency of red blood cells and/or the oxygen carrying pigment haemoglobin in the blood. Causes pallor and tiredness

Anorexia

Loss of appetite

Anthracyclines

Drugs used in leukaemia therapy to prevent cell division by disrupting the structure of DNA. Drugs of this type include daunorubicin, doxorubicin (adriamycin), epriubicin, and idarubicin

Antibiotics

Drugs that kill or stop the growth of bacteria, for example, penicillin

Antibodies

Naturally produced substances in the blood that destroy or neutralise specific toxins or foreign bodies, for example, viruses. They are produced by the white blood cells known as lymphocytes in response to exposure to the antigens of the foreign body against which they act. They form an important part of the body’s defence system against infection

Anti-emetic

A drug to prevent or alleviate nausea and vomiting that can sometimes be a side-effect of chemotherapy. Drugs of this type include metoclopramide (maxolon), zofran (ondansetron)

Anti-fungal

A drug used to treat fungal infections

Antigen

A substance, usually on the surface of foreign body such as a virus or bacteria that stimulates cells of the body’s immune system to react against the antigen by producing antibodies

Antihistamines

Drugs given to diminish allergic reactions

Antilymphocyte globulin

Antibodies that attach to and destroy lymphocytes.This may be used clinically by injection into a vein, for example, in aplastic anaemia or in other conditions where the body’s immune system is being harmful. (See also auto-immune diseases.)

Antimetabolites

A group of anti-cancer drugs that prevent cells growing and dividing by blocking the chemical reactions required in the cell to produce DNA. Drugs of this type include mercaptopurine, azathioprine, thioguanine, and methotrexate

Anti-viral

A drug used to treat viral infections

Apheresis

From the Greek ‘aphairesis’ meaning ‘removal’. The process of ‘skimming off’ the stem cells from the blood to be used for transplant or stored in frozen form until needed. This occurs through an apheresis machine that filters the blood, gradually separating and collecting the stem cells and progressively returning the processed blood to the person. Stem cells are usually not seen in the blood stream and so special drugs are used to mobilise the stem cells to move from their normal place in the bone marrow into the blood stream

Aplastic anaemia

A rare disorder characterised by failure of the bone marrow to produce blood cells, as opposed to leukaemia where cells are produced but do not mature. It may occur as an inherited condition (see Fanconi’s anaemia) or, more often, the disease develops in later life, the cause of which may or may not be known. It leads to a severe shortage of all types of blood cells, causing tiredness, susceptibility to infection and serious problems with bleeding. It may be treated by antithymocyte globulin or bone marrow (stem cell) transplant

Audiogram

Hearing test charted for different frequencies. Usually used for early detection of drug toxicity to the nerve controlling hearing

Auto-immune disease

A disease caused by an individual’s immune system producing antibodies against tissues of its own body. The type of antibody so produced must have an adverse effect in the body, as some antibodies are necessary for normal function. Examples include some haemolytic anaemia, rheumatoid arthritis and systemic lupus erythematosis (Lupus)

Autologous bone marrow (stem cell) transplant (ABMT)

A bone marrow transplant using stem cells taken from the patient’s own bone marrow. These stem cells are collected and stored at an early disease stage or after treatment that has not controlled the disease. The marrow may be manipulated in the laboratory to try to reduce the risk of contamination with malignant cells and to increase the stem cell numbers. There are no problems with tissue matching, so this type of procedure may be carried out on patients in their 60s

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B cell (B lymphocyte)

A type of white blood cell normally involved in the production of antibodies to combat infection. The mature B cell is often called a plasma cell. An antibody ‘sticks’ to an antigen on a foreign cell, causing the antibody-antigen cell to be destroyed or to break down. Tumours of mature B cells result in B cell lymphoma and sometimes myeloma

Bacteria

Microscopic organisms which cause many types of infectious disease, for example pneumonia. The reduced ability of patients to fight infections following chemotherapy or bone marrow transplantation means that even normally harmless bacteria existing, for example, on the skin or mouth, may cause serious illness. Bacterial infections are often are easier to treat than viruses

Basophil

A type of white blood cell which is involved in allergic and inflammatory reactions. Normally present in low numbers in the blood. It is called a basophil because the granules in the cell take up basic dye in a test tube and can be recognised under the microscope

Basophilia

An increase in the number of basophils in the blood

Bence-Jones protein (BJP)

A characteristic protein found in the urine of some patients with multiple myeloma. It is derived from the antibody produced by myeloma cells and can be used to help in diagnosis of the disease and to monitor the effects of treatment. The amount of BJP in the urine may reflect the amount of myeloma left in the body

Benign

Non-cancerous. Such a growth may or may not need to be surgically removed

Beta-2 microglobulin

A protein found on the surface of many cells including white blood cells. A very high level of beta-2 microglobulin in the blood at diagnosis of myeloma may indicate more advanced disease and a poorer prognosis

Biopsy

A small sample of fresh tissue, for example, lymph node or bone marrow, removed for laboratory analysis to establish exact diagnosis

Bisphosphonates

A group of drugs commonly used to treat and prevent osteoporosis. These drugs work by protecting the bone surfaces from the action of osteoclasts, cells normally involved in bone breakdown

Blast cells

Blood blast cells that normally represent up to five per cent of the cells in the bone marrow and those cells which divide to replenish the normal cells in the bone marrow. They are not normally visible in healthy blood. Acute leukaemia is characterised by the accumulation of abnormal blast cells that take over the bone marrow and often spill out into the bloodstream

Blood cells

There are three main types of cells in the bloodstream – the red blood cell, which carries oxygen, the white blood cell, which fights infection, and the platelet, which helps prevent bleeding. The correct balance between each cell type must be maintained for the body to remain healthy

Blood count

A routine test requiring a small blood sample to estimate the number and type of cells circulating in the blood

Blood disease

This is a misleading term, for although malignant cells are often found in the blood, they do not originate there. Diseases are classified by their origin eg. lymphoma, from lymph gland

Bone marrow

The tissue that forms the blood cells and is found within the hollow cavities of many of the flat bones of the body. Bone marrow contains stem cells from which all blood cells are derived. Bone marrow is not found in the bones of the arms and legs in adults

Bone marrow aspirate

A small volume of bone marrow removed under local or general anaesthetic usually from the hipbone (pelvis) or occasionally breastbone (sternum). The cells in the sample can then be examined under the microscope or with a special test to identify any abnormality in the developing blood cells

Bone marrow biopsy

The removal of a sample of bone marrow tissue, under local or general anaesthetic, from the bone marrow at the back of the hip or the breastbone

Bone marrow transplant (BMT)

An old-fashioned term for a procedure, best called a stem cell transplant, used in the treatment of a variety of bone marrow disorders including leukaemia, lymphoma and myeloma. The patient receives very high doses of chemotherapy and/or radiotherapy to treat the disease. This empties the bone marrow and makes the blood count fall. Replacement marrow is taken from a matched donor (allogeneic stem cell transplant) or from the patient’s own bone marrow (autologous stem cell transplant) and returned to the patient through a vein (or central venous line) in similar way to a blood transfusion

Brachytherapy

A means of delivering radiotherapy directly to a tumour by an implanted tube. It avoids the use of external beams of radiation and often allows stronger treatment without an increase in toxicity

Burkitt’s lymphoma

A rapidly growing type of non-Hodgkin’s lymphoma. First descriptionribed in Africa where it may present as a cancer of the facial bones. However, in other countries it more usually affects the abdomen. It requires immediate treatment and is uncommon in western countries

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C-reactive protein (CRP)

A protein released by the liver in response to inflammation in the body. Level of CRP may be elevated in advanced Myeloma

Cancer

Disease due to the uncontrolled growth, accumulation, division and maturation of cells; often called malignant disease or neoplasia. It causes problems as a result of the cells acquiring abnormal ailments or losing normal activities

Cannula

A plastic tube which can be inserted into a vein to allow fluid to enter the blood circulation

Carcinogen

A substance that may have the ability to cause cells to become cancerous. The best known example is the relationship between cigarette smoking and lung cancer. Not all cancers have recognised carcinogens as a cause or high risk

Carcinogenesis

The development of cancer

Cardiac

Related to the heart

CT scan (CAT scan)

Computer assisted tomography (CAT) is a complex x-ray technique used to produce serial detailed internal images of any part of the body.The patient lies on a couch, which gradually moves through the X-ray machine, and the image is built up by a computer as a cross-section of the body. It is a special type of tomography.

Catheter

A hollow tube inserted into organs of the body for admitting or removing gases or liquids. For example, for the removal of urine from the bladder

CD 34 cells

Number allocated to the population of cells in the blood and marrow which contain most of the stem cells used in transplant. A ‘CD 34 count’ is used to measure a patient’s readiness to have cells collected after mobilisation

Cell biology

The study of the structure, composition and function of cells

Cell markers

Biochemical or genetic characteristics that distinguish and discriminate between different cell types. They are like flags stuck to the outside of a cell which can be analysed in special machines

Cells

The individual units from which tissues of the body are formed. They are not visible to the naked eye, but can be seen under the microscope and can be grown in culture

Central nervous system (CNS)

The brain and spinal cord

Central venous catheter (CVC)

Also known as a central venous access device (CVAD). A line tube passed through the large veins of the arm, neck, chest or groin and into the central blood circulation. It may be used for taking samples of blood, giving intravenous fluids, blood, chemotherapy and other drugs without the need for repeated venepuncture

Cerebrum

The thinking part of the brain

Cerebrospinal fluid (CSF)

Fluid that surrounds and protects the brain and spinal cord. Samples can be obtained by lumbar puncture and chemotherapy also can be injected by the same route

Chemotherapy

Treatment using anti-cancer drugs. These may be used singly or in combination to kill or prevent the growth and division of cells. Although aimed at the cancer cells, modern chemotherapy will still, to a degree, unavoidably affect rapidly dividing normal cells such as in the scalp and gut, causing hair loss and nausea, which are usually temporary and reversible. There are a range of substances under development that may be able to protect the normal cells during chemotherapy treatment

Chromosomes

Chromosomes contain the genetic code compactly packaged.They are visible under the microscope when a cell divides. Chromosomes carry the 100,000 genes that provide the inherited blueprint of each individual. In humans there are normally 23 pairs contained in the nucleus of each cell. Alterations in the number or organisation of the chromosomes may play a key role in the development of cancer.

Chronic leukaemia

A persistent cancer of the blood, usually of gradual onset and generally of slow progression. May be diagnosed by chance following a routine blood test and before clinical symptoms appear. The leukaemia is usually called chronic because the leukaemic cells are more mature than acute leukaemia cells

Chronic lymphocytic leukaemia (CLL)

A slowly progressing form of leukaemia characterised by an increased number of the type of white blood cells known as lymphocytes. It is the most common form of leukaemia and occurs predominantly in late middle age onwards. It has variable symptoms and unknown cause but may be diagnosed by chance long before the patient develops any clinical symptoms of disease

Chronic myeloid leukaemia (CML)

A leukaemia which is initially slow progressing.It is characterised by the presence of large numbers of abnormal mature granulocytes circulating in the blood. Often referred to as chronic granulocytic leukaemia (CGL) and typically will transform over time into acute leukaemia.

Chronic myelomonocytic leukaemia (CMML)

A form of myelodysplasia characterized by an increase in the number of circulating white blood cells ofmonocyte type. It may transform into acute leukaemia or patients may develop problems with infection or bleeding.

CJS Village

Clem Jones – Sunland Village. Accommodation facility of Leukaemia Foundation of Queensland, located at Coopers Plains in the south of Brisbane

Complete remission

When anti-cancer treatment has been successful and so much of the disease has been destroyed that it can no longer be detected using current technology. In people with leukaemia this means that proportion of blast cells in the marrow has been reduced to less than five per cent. There are no blast cells present in the circulating blood and the blood count has returned to normal

Clinical trial

A controlled and carefully monitored assessment of new forms of treatment. Trials can vary in design and size from small-scale trials of experimental treatments to large national trials that compare subtle variations in current therapies.The patient will be informed and will always be given the option not to join, or not without detriment to their treatment when their treatment is part of a trial.

Clinical haematologist

A specialist trained as a physician and pathologist to diagnose and treat diseases of the blood, marrow and lymph glands, e.g. the person who normally diagnoses and treats leukaemia, lymphoma and myeloma

Clone

A population of genetically identical cells arising from a single parent cell.Leukaemia is believed to be a clonal disease, that is, all the leukaemia cells may originate from one abnormal cell.

Clotting factors

A group of chemical constituents of the fluid part of the blood (factors I to XIII) which interact to make blood clot

CNS leukaemia

Invasion of the brain, central nervous system, or spinal cord byleukaemic cells. This may be diagnosed by examination of cerebrospinal fluid obtained by a lumbar puncture.

Coagulation

Clotting of the blood. A complex reaction depending on a series of biochemical components and platelets in the blood

‘Common’ acute lymphoblastic leukaemia (cALL)

A sub-type of acute lymphoblastic leukaemia affecting cells early in the B lymphocyte family which accounts for about 80 per cent of all acute lymphoblastic leukaemias

Congenital

A term used to descriptionribe deformities or diseases that are present at the time of birth

Consolidation treatment

A course of treatment with anti-cancer drugs given to the patient while in remission with the aim of killing any remaining small number of cancerous cells

Cord blood

The blood contained in the umbilical cord and placenta at birth. This blood contains a rich supply of blood stem cells. These stem cells have the capacity to repopulate the bone marrow spaces and produce blood cells. Cord blood can be collected through a cord blood banking program. The collection of cord blood does not harm the baby in any way

Cord blood transplant

The use of donated cord blood as part of an allogeneic transplant

Corticosteroids (steroids)

A group of synthetic hormones including prednisone,prednisolone, methylprednisolone and dexamethasone used in the treatment of some leukaemia and also to suppress graft rejection and graft versus host disease following bone marrow transplant. Side- effects include an increased risk of infection, weight gain, mood changes and sometimes bone softening with long term use.

Creatinine

A waste product of muscle breakdown normally excreted by the kidneys. The level of creatinine in the blood will be raised if the kidneys are not functioning properly

Cryopreservation

The storage of blood stem cells at a very low temperature. The technique used does not harm the stem cells and ensures that they remain intact and functional when they are thawed out months and even years later

Cure

This means that there is no evidence of disease and no sign of the disease reappearing, even many years later

Cyclosporin

A drug used to prevent and treat rejection and graft versus host disease in transplant patients by suppressing their normal immune system

Cytogenetics

The study of the structure of chromosomes. Cytogenetic tests are carried out on samples of blood and bone marrow taken from leukaemia patients to detect chromosomal abnormalities associated with the disease. These help in the diagnosis and selection of optimal treatment. Results can be delayed because the cells may need to be grown for days in a test tube before analysis

Cytomegalovirus (CMV)

A virus which is usually harmless in healthy people but may cause serious disease in immunosuppressed patients. Particularly dangerous following a bone marrow transplant

Cytopenia

(Cells in reduced numbers.) A reduction in the number of cells circulating in the blood

Cytoplasm

The jelly-like substance inside each cell

Cytotoxic drugs

Anti-cancer drugs that act by killing or preventing the division of cells.

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Dendritic reticulin cells (DRC)

Cells of bone marrow origin whose job is to present antigens from foreign agents to the immune cells to allow the development of immunity. These cells may one day be used in therapy to enhance the immune system against cancer cells

Depletion

A laboratory procedure for reducing the number of specific cell types within bone marrow donated for transplantation, for example, the removal of some types of lymphocytes to avoid mismatch problems (particularly in relation to unrelated donor transplants) or to remove a sub-set of potentially malignant cells in the autograft

Differentiation

The gradual maturation of a cell whereby its functions and properties become increasingly specialised. Leukaemic cells often are poorly differentiated, that is, show immature characteristics. The more a cell is differentiated, usually the less able it is to divide

Diphosphonates

A very important new drug type used to prevent or treat high calcium levels in cancer. It is very useful in strengthening bones in breast cancer and myeloma to prevent fractures and pain

Disseminated disease

Disease in which the cancerous cells have spread from the tissue of origin into several other organs

Diuretic

A drug to increase the production of urine by the kidneys. May be used during chemotherapy to assist the excretion of anti-cancer drugs

DNA (Deoxyribonculeic acid)

Provides the essential building block for storing genetic material in ‘tapes’ or chromosomes. There are four different chemical compounds of DNA (bases) arranged in coded sequence as genes that determine an individual’s inherited characteristics

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Echocardiogram

Ultrasound scan of the heart

Electrocardiogram (ECG)

Electrical trace of the heart

Electroencephalogram (EEG)

Electrical brain recording

Electrolytes

Various salts in the blood. Measurement helps to monitor kidney function

Embolus

A blood clot that starts in the leg or other distant vein or artery, which breaks loose only to lodge elsewhere in the body and block blood supply. For example, a clot in a vein may cause a problem in the lung, (pulmonary embolism)

Enzymes

Proteins that control the chemical reactions essential for life. Every cell contains many enzymes that control all of its functions

Eosinophil

A type of white blood cell involved in inflammatory, allergic or ant parasitic responses. Usually present in the circulation in very low numbers. It is called an eosinophil, as cells in a test tube take up acidic (eosinophilic) dyes

Eosinophilia

Increased numbers of eosinophils circulating in the blood. It occurs occasionally in some cases of Hodgkin’s disease, in drug reactions, in asthma, hay fever and parasitic infections

Epidemiology

The science of studying the occurrence of disease in populations and relating this to genetic and/or environmental causes. This is not a very precise science as yet because of difficulty in collecting and collating disease data

Epstein Barr virus

A common virus which causes glandular fever. Also associated with Burkitt’s lymphoma. Epstein and Barr first descriptionribed this virus

Erythroleukaemia

A rare cancer of the blood affecting immature red blood cells, e.g. acute erythroleukaemia which is a type of myeloid leukaemia

ESA (Epsolm sigma Alpha) Village

Accommodation facility of Leukaemia Foundation of Queensland based at South Brisbane

Essential thrombocythemia

A condition caused by abnormal marrow growth (myeloproliferative disease) related to polychythemia rubra vera. The disease occurs when part of the bone marrow produces cells normally but they do not mature. It is characterised by the production of large numbers of platelets. Symptoms include bleeding, blood clots and enlargement of the spleen. Treatment varies according to the severity of the disease

Exterial beam

Delivering radiotherapy to the inside of the body through an ‘exterial beam’ – that is, by ‘shining’ radiotherapy thorough the skin as opposed to delivering it internally through an implant in or near a tumour (known as brachytherapy or internal radiation)

Extra nodal lymphoma

A lymphoma that presents outside the lymph nodes, but in tissues containing lymph cells. A term used to descripribe the extent and site of disease

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Fanconi’s anaemia

A rare inherited type of aplastic anaemia which carries an increased risk to the patient of developing leukaemia. May be treated by bone marrow transplant

Febrile

Having a fever or high temperature

Folic acid

A vitamin necessary for marrow cell growth that is obtained from green leafy vegetables, for example, spinach. It is essential for production of DNA and therefore the growth and division of cells

Folic acid antagonist

A chemical which inhibits a cell’s capacity to use folic acid and so prevents cell division for example, methotrexate

Freemasons Village

Accommodation facility of Leukaemia Foundation of Queensland, located in Townsville, near the Townsville Hospital

Fungus

A minute infective agent such as a mould or yeast, causing particular problems in immunosuppressed patients. Usually larger than bacteria and harder to treat, fungi require different drugs which are not yet as easy to use as bacterial antibiotics. Many fungi live normally in the mouth and other parts of the body and are usually helpful to the body’s functioning

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Gallium scan

A way of looking at the spread of lymphoma by injecting a dye that is taken up by active lymph glands. A way of staging lymphoma and Hodgkin’s disease. This test takes a couple of days to read

Gamma globulin

A concentrated solution of the antibody fraction of human blood given through the vein to fight infections, for example, measles in patients with low resistance. Gamma globulin is a very important by-product from blood donations

Generic drug

This is a more scientific name for a particular drug. Each drug company will have its own name to a particular drug. This is called the ‘brand name’ for the drug. For example, allopurinol (generic name) is called zyloprim (brand name) by one drug company and progout (brand name) by another drug company. There may be differences in the costs and pharmaceutical benefits of different brands. This should be discussed with your specialist

Genes

Collection of DNA on a chromosome. Genes direct the activities of cells. They are responsible for the inherited characteristics that distinguish one individual from another. Each human individual has an estimated 100,000 separate genes

Graft rejection

When the new graft fails to grow

Graft versus host disease (GVHD)

A common, and sometimes serious, complication of allogeneic stem cell transplantation. Some of the donor’s immune cells try to reject the patient’s own cells as foreign. The skin, liver and gut may be affected. It can occur in either chronic or acute forms and is treatable by immunosuppressive drugs. It is the cause of most of the deaths following transplantation

Graft versus leukaemia (GVL)

Cells either identical to or similar to the cells that cause GVHD disease (usually mature T lymphocytes). GVL is a very important mechanism in stem cell (bone marrow) transplants. Much effort is being expended in trying to separate cells responsible for GVL from GVHD in the hope of reducing risk of transplantation without losing efficacy

Granulocyte

A type of white blood cell containing granules in its cytoplasm (e.g. neutrophil, eosinophil, basophil). They protect the body against infection by seeking out and killing micro-organisms. Neutrophilic granulocytes are commonly called neutrophils

G-CSF (granulocyte-colony stimulating factor)

A naturally occurring and man-made growth factor which stimulates bone marrow’s stem cells to produce more white cells, particularly neutrophils

Growth factors

A complex family of proteins produced by the body to control growth, division and maturation of blood cells by the bone marrow. Some are now available as products of genetic engineering and may be used clinically to stimulate normal cell production following chemotherapy or bone marrow transplantation. For example, G-CSF (granulocyte-colony stimulating factor)

Growth hormone

A biochemical secreted by the pituitary gland in the brain which controls growth and is particularly important during adolescence. Radiotherapy given to the head and neck of children with leukaemia may lead to a deficiency in growth hormone. This may be replaced by intramuscular injections

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Haematologist

A doctor specialising in the diagnosis and treatment of blood diseases

Haematology

The study of blood diseases including leukaemia

Haemoglobin

The iron containing pigment in red blood cells, which carries oxygen around the body. Lack of haemoglobin is one cause of anaemia. Normal adult values can be between 120 grams to 180 grams per litre, but normal levels vary greatly with age and sex. Haemoglobin levels can vary significantly in any person on any given day

Haemopoiesis

The formation of blood cells

Haemorrhage

Bleeding either to the outside through the skin, or internally

Haemorrhagic cystitis

A potential side effect of some high-dose chemotherapy (usually given before stem cell transplant) characterised by painful bladder spasms and blood in the urine

Hairy cell leukaemia

A rare leukaemia distantly related to chronic lymphocytic leukaemia and characterised by the presence of abnormal cells with hair-like projections. It occurs in middle age onwards. Treatment may involve removal of the spleen but usual current therapy is a single course of the drug 2- chlorodeoxyadenosine (2CDA) which usually induces sustained remissions

Hepatitis

Inflammation of the liver

Hepatomegaly

Enlargement of the liver

Hickman catheter

A narrow plastic tube inserted through the skin, under anaesthetic, into a major blood vessel in the chest. It is used for patients undergoing intensive therapy and provides a route for taking blood samples and the administration of drugs without repeated needle puncture of a vein. It may have a single, double, or triple tube or lumen. Other companies produce similar venous access devices with different names

High dose therapy

The use of higher than normal doses of chemotherapy to kill off resistant and/or residual (left over) cancer cells that have survived standard-dose therapy

High-grade lymphoma

A fast-growing lymphoma

Histology

The investigation of tissue samples by chemical and microscopic analysis

HLA antigens (human leukocyte antigens)

A complex family of genetically inherited proteins which are found on the surface of cells throughout the body. They determine the match between patient and potential donor in bone marrow transplantation. HLA factors are inherited from the mother and father and so the greatest chance of having the same HLA type is between brothers and sisters that is one in four. HLA types are inherited differently from the red blood cell types

Hodgkin lymphoma

A type of lymph gland tumour named after Thomas Hodgkin, who first descriptionribed the disease in the 19th century

HTLV

Human T cell lymphotropic virus. A family of viruses which invade T cells. Includes a rare leukaemia virus, HTLV-1, found primarily in Japan and the Caribbean, causing an increased incidence of T cell leukaemia in these populations. The family also includes the AIDS-causing virus, HIV

Hypercalcaemia

Abnormally high levels of calcium in the blood. It is commonly associated with multiple myeloma due to degradation of the bones but can occur in other cancers such as lung cancer. It is dangerous if not controlled and leads to constipation, confusion, dehydration and renal failure and death due to heart irregularity. It is now commonly controlled by tablets or infusion of bonefos or aredia (diphosphonates)

Hyperviscosity

Increased viscosity (thickness) of the blood, usually caused by a build-up of paraprotein in the blood. Blood flow becomes more sluggish and slows the blood supply to various parts of the body including the brain and eyes may be affected

Hyperviscosity syndrome

The effects on the body of increased blood viscosity. These may include confusion and drowsiness as a result of reduced blood flow to parts of the brain. Impaired vision and retinal bleeds (bleeding into the retina of the eyes) may also occur

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Iatrogenic disease

A disease produced as a consequence of medical or surgical treatment

Idiopathic

Term applied to diseases to indicate their cause is unknown, i.e. ‘unknown pathogens’

Idiopathic thrombocytopenia pupura (ITP)

A rare disorder characterised by an acute shortage of platelets as a result of their increased destruction in the spleen that can result in bruising and spontaneous bleeding. Anti-platelet antibodies are detectable in some cases. It may present in either an acute or a chronic form and the immediate viral or other cause is often unknown

Iliac crest

The back of the hip bone. A common site for a bone marrow biopsy

Immune deficiency

Impaired ability of the body’s defence mechanisms to combat infections by bacteria, viruses and fungi and may also imply impaired surveillance of a resistance to cancer

Immune response

The reaction of the body to a foreign antigen, for example, an infectious agent, or to the tissues of another individual as in the rejection of an organ transplant

Immune system

The body’s defence system against infection and disease

Immunoglobins

Proteins in the blood plasma which function as antibodies and play an important part in controlling infections. Some new therapies of synthesised antibodies are useful in controlling lymphoma without chemotherapy

Immunophenotyping

Specialised laboratory test used to detect markers on the surface of cells. These markers identify the origin of the cell

Immunosuppression

A treatment induced reduction in the body’s defence mechanisms. Deliberate immunosuppression is a necessary part of the bone marrow transplant procedure to prevent graft versus host disease and graft rejection

Immunosuppressive drug

A drug which inhibits the body’s normal defence mechanisms. For example, cyclosporin

Infusion

The giving of antibiotics, blood products, anti-cancer drugs or nutrients into a patient’s vein over a prolonged period of time

Intensification

Increasing the amount, number or combination of anti-cancer drugs given to a patient in an attempt to kill drug-resistant or residual leukaemic cells

Interferon

A family of proteins derived from human cells which normally has a role in fighting viral infections. It is now available as a product of molecular engineering to be used in the treatment of leukaemia and blood related diseases including malignant lymphoma, chronic myeloid leukaemia and myeloma

Inversion

Where parts of a chromosome turn upside down or when two parts of a chromosome reverse their positions

Intramuscular injection

Injection into the muscle

Intrathecal injection

Injection of drugs into the spinal fluid to prevent or treat CNS Leukaemia or lymphoma. The space between the brain and spinal cord and their coverings is known as the intrathecal space

Intravenous injection

The giving of drugs into a vein through a needle

In vitro

Literally meaning ‘in glass’. Used to descriptionribe studies carried out on living cells or tissues grown in the laboratory in a test tube

In vivo

Within the living body

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Karyotype

Analysis to check the number, form and structure of chromosomes.This can give valuable information to aid in the diagnosis and the selection of treatment.

Karyotypic abnormality

Abnormality in the number, form or structure of chromosomes. Particular abnormalities are associated with particular sub-types of leukaemia

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Lactate dehydrogenase (LDH)

An enzyme normally produced by the body. Higher than normal blood levels of LDH may indicate the presence of tissue damage, a large amount of tumour, or a fast growing tumour in the body

Laparotomy

An operation in which the abdominal cavity is opened. May rarely be required in some cases of lymphoma to investigate the extent of the disease

Late effects

Side-effects of chemotherapy and/or radiotherapy which only become apparent with long-term monitoring of the patient over a period of years. These are of particular concern in patients treated before puberty

Leucocytes

Collective term for white blood cells. Leuco = white; cyte = cell

Leucopenia

Condition in which the number of white cells in the blood is greatly reduced. Leads to increased risk of infections

Leucopheresis

Method of separating blood into its liquid and cellular components for the removal of white blood cells before returning the remainder of the blood to the patient. It is used to reduce an abnormal white cell count when chemotherapy is to be avoided, for example, during pregnancy. It is the technique used to collect stem cells from the blood to be used in transplants

Leukaemia

From the Greek meaning ‘white blood’. Characterised by the widespread, uncontrolled growth or proliferation of large numbers of abnormal blood cells, which in the blood look like white cells but usually involve all cell types. These cells take over the bone marrow and often spill into the bloodstream and may spread to spleen and lymph glands eventually

Leukaemic blasts

Abnormal blast cells which multiple in an uncontrolled manner, crowding out the bone marrow and preventing it from producing normal blood cells. These abnormal cells also spill out into the blood stream and can accumulate in other organs

Leukaemogenesis

The generation of leukaemia

LFQ

Leukaemia Foundation of Queensland

LFA

Leukaemia Foundation of Australia

Lineage

Term used to descriptionribe cell families with a common ancestry that is, developing from the same type of identifiable immature cell, e.g. myeloid lineage and lymphoid lineage

Localised disease

Disease that is confined to a small area or areas in the body

Long-term survival

Term used to descriptionribe the survival leukaemia patients who have been disease-free for prolonged periods of time, usually at least five years. The chance of disease returning (relapse) decreases with time

Low-grade lymphoma

A slow-growing lymphoma

Lumbar puncture

A procedure for removing fluid from around the spinal cord using a fine needle in the lower part of the back. Samples are analysed for evidence of any infection or CNS Leukaemia. Also used to administer anti-cancer drugs either to prevent or cure CNS disease

Lymphoid

Pertaining to the lymphatic system including lymphocytes, lymph nodes and lymph cell channels

Lymphoma

A cancer of lymphatic cells whose normal counterparts have already left the bone marrow to be found in lymph glands and spleen and other tissues. Lymphoma can spread back to involve the bone marrow and blood and then look like leukaemia. The disease results from the uncontrolled production of the white blood cell known as the lymphocyte. The general term includes about a dozen different forms of the disease but there are two main categories: Hodgkin’s disease and non-Hodgkin’s lymphoma

Lymphoproliferation

An increase in the production of lymphocytes. This may occur as a normal response to infection for the whole marrow or for only part. Only lymph cells are involved

Lymphangiography

A method of detecting enlarged lymph nodes sometimes used to determine the extent of disease in lymphoma patients. It involves the injection of dye into the feet, which allow the lymph system and lymph nodes inside the body to be detected on an X-ray. Very rarely used now in modern practice as other means such as MRI are safer, more sensitive and less invasive

Lymph nodes or glands

Structures found throughout the body, for example, in the neck, groin, armpit, and abdomen, which contain both mature and immature lymphocytes. There are millions of very small lymph glands in all organs of the body

Lymphocyte

A type of white blood cell which is involved in the immune defences of the body. There are two main groups – B cells (which make antibodies) and T cells (involved in cell-to-cell combat)

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Macrophage

A type of white blood cell which migrates from the blood into tissues and acts as a scavenger, ingesting particles such as bacteria

Magnetic resonance imaging (MRI)

A body scanning technique, which uses an intense magnetic field to generate images of the internal organs. Properties of normal and cancerous tissue differ, allowing malignant tumours to be visualised by the computer processing of the signals detected. It also is very good for detecting blockages in veins

Maintenance treatment

Treatment given for a period of months or years to maintain remission and eliminate or suppress any residual leukaemic cells in the body, usually for acute lymphoblastic leukaemia

Malignancy

A term applied to tumours characterised by the uncontrolled proliferation of cells. See also cancer

Matched unrelated donor (MUD) transplant

An allogeneic stem cell transplant where the donor is unrelated to the patient, but with a similarly matched tissue type. Also called voluntary unrelated donor (VUD) transplant, or unrelated donor transplant (URP)

Mediastinum

The central part of the chest surrounded by lungs and heart containing thymus and lymph glands

Megakaryocyte

Large cell in the bone marrow that produces platelets by maturing and fragmenting into discrete platelets

Menopause

The stopping of menstruation (periods). Also called ‘the change of life’

Mincom Village

Accommodation facility of Leukaemia Foundation of Queensland located at Herston in the inner north of Brisbane

Mini allogeneic (mini allo stem cell transplant)

A blood stem cell transplant involving the use of reduced doses instead of high-dose chemotherapy

Mixed lymphocyte culture (MLC)

Final matching test for donor and patient prior to bone marrow transplantation. For example, mixing patient and potential donor cells in test tube and measuring their activity or ability to fight one another

Mobilisation

Process by which stem cells are moved out of the bone marrow into the blood stream. This is done to permit collection of stem cells for later reinfusion (stem cell transplant)

Mononclonal antibodies

Highly specific antibodies produced by cells grown in the laboratory. Current research is investigating their clinical application for targeted delivery of drugs to leukaemia cells. Some antibodies against lymphoma have been developed which are directly toxic to lymphoma cells

Monocyte

A type of white blood cell of relatively large size which acts as a scavenger and ingests large particles. A macrophage of the blood

Monocytic leukaemia

Cancer of the bone marrow due to growth or proliferation of cells of the monocyte series, usually a subtype of acute myleogenous leukaemia called acute monocytic leukaemia (M5)

Monosomy

Term which indicates the loss of a whole chromosome. Each person usually carries 46 chromosomes (23 pairs) but in monosomy this is reduced to 45

Mucositis

Inflammation of the lining of the mouth and throat, which also can extend to the lining of the whole of the gastro-intestinal tract (stomach and intestines)

Mutation

A minute change to the DNA code, caused for example by exposure to hazardous chemicals or copying errors during cell division. If these affect normal cell function it can lead to disease development by loss of normal function or the development of abnormal functions for that cell

Myeloblasts

Immature cells of the myeloid series. They develop from primitive cells and develop into mature granulocytes and monocytes

Myelodysplasia

(Myelodysplastic syndromes, MDS, smouldering leukaemia) A group of closely linked conditions in which the process of blood cell formation is disturbed by a failure of the immature cells to grow and develop normally. Unlike acute leukaemia, myelodysplasia is associated with some cell maturation beyond the blast or stem cell stage. Sometimes referred to as preleukaemia or smouldering leukaemia. Treatment may be based on supportive therapy or involve the use of anti-cancer drugs, depending on the sub-type of disease or in younger people an allogeneic stem cell transplant

Myelofibrosis

: A disease in which the bone marrow is taken over by fibrous tissue and is no longer able to produce adequate numbers of mature blood cells. It is a myeloproliferative disease overproducing scar tissue. Often accompanied by enlargement of the spleen. It is occasionally found secondarily in cases of acute myeloid, acute lymphoid, or chronic myeloid leukaemia

Myeloid

Collective term for the non-lymphocyte groups of white blood cells. It includes cells from the red cell, granulocyte, monocyte and platelet families. Occasionally used to refer to all cells of marrow origin

Myeloma

A cancer caused by uncontrolled growth or proliferation of mature lymph cells specialised to make antibodies (called plasma cells) within the bone marrow. The abnormal cells do not usually accumulate in the blood and the tumour growth is often restricted to the bones but may spread locally beyond the bones. This leads to bone destruction and is often associated with kidney problems. The damage done by myeloma is a result of the abnormal properties of the secreted antibody, e.g. bone softening, high calcium content and blood thickening

Myeloproliferative neoplasms

A group of disorders characterised by the overproduction of blood cells by the bone marrow, normally without impairment in maturity. One or more of the cell families – red, white, platelet, support tissue, may be involved and treatment varies according to the type and severity of the disease. Includes polycythemia rubra vera, essential thrombocythaemia and myelofibrosis

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Neutropenia

A condition in which the neutrophil count is reduced. It may be caused by high dose chemotherapy and carries an increased risk of infection. It also may result from vitamin deficiency, the effect of drugs or viruses

Neutrophil

The most common type of cell within the granulocyte group of white blood cells

Non-Hodgkin lymphoma

A group of lymphoma that differs in important ways from Hodgkin’s disease and is classified according to the microscopic appearance of the cancer cells. The disease is classified either as low grade (slow growing), intermediate grade or high grade (rapidly growing) and may be treated in a variety of ways depending on the exact diagnosis

Nucleus

The central body of a cell that contains the chromosomes which contain the genetic code and controls the cell’s activities

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Oncogenes

Genes with the potential to cause cancer

Oncologist

General term for a specialist who treats cancer. e.g. medical, surgical, radiation oncologist

Osteoporosis

A condition whereby the bones become weak and can break more easily

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Packed cell volume

Measurement of the proportion of the blood occupied by the red blood cells when packed down in a tube. Normal values are 40-54% in males, and 35-47% in females

Palliative care

Treatment aimed at relieving symptoms and pain rather than effecting a cure or reduction of tumour size or activity

Pancytopenia

Condition in which there are reduced numbers of all types of blood cells

Paraprotein (malignant)

Abnormal accumulation of the antibody protein produced by mature B cells (usually plasma cells). Paraproteins are usually associated with diseases such as myeloma but do occur commonly in older people sometimes without any disease evolving

Paroxysmal nocturnal haemoglobinuria (PNH)

A rare disorder characterised by an increased rate of breakdown of red blood cells and platelets. This leads to excretion of the red blood pigment, haemoglobin, in the urine, particularly at night. The cause is unknown and the severity of disease variable

Pathogenesis

The process of disease development

Pathologist

A doctor who specialises in the laboratory diagnosis of disease and how disease affects the organs of a body

Peripheral blood stem cell collection

The collection of stem cells from the circulating blood stream via a large vein, using a cell separator machine

Pernicious anaemia

An autoimmune disease of the stomach which leads to a deficiency of vitamin B12 absorption required for red blood cell production and, thus, anaemia. It is treatable by regular intramuscular B12 injections. There are other causes of vitamin B12 deficiency

Petechiae

Small red or purple pin-head spots on the skin. They are small haemorrhages and usually the result of a shortage of platelets. They have greater clinical importance than bruises or purpura

PET scan

A special type of radiological examination which appears to have the capacity to distinguish between cancerous and non-cancerous tissue deep in the body. It also is able to detect smaller sized tumours than CT scans

Pharmacokinetics

The study of the action of a drug in the body over a period of time, including the processes of absorption, metabolism and excretion

PICC line

Peripherally inserted central venous catheter (see central venous catheter). It is inserted in the middle of the forearm. PICCs are sometimes used for people having chemotherapy

Plasma

Peripherally inserted central venous catheter (see central venous catheter). It is inserted in the middle of the forearm. PICCs are sometimes used for people having chemotherapy

Plasma cells

Large B cells derived from mature lymphocytes. Not normally found in circulating blood but restricted to bone marrow and lymph nodes

Plasma cell leukaemia

The end stage of multiple myeloma when immature plasma cells are found circulating in the blood

Plasmapheresis

A procedure that uses a special machine called a ‘cell separator’ to remove the straw-coloured fluid part of the blood (plasma) while returning the rest of the blood and a suitable plasma substitute to the patient

Plateau phase

Stable stage of disease in multiple myeloma following good response to anti-cancer treatment, where the myeloma although not cured is not growing or causing disease

Platelets

Tiny cell-like bodies derived from megakaryocytes in the bone marrow. They circulate in the blood and play an important role in the prevention and control of bleeding. Normal values, 150-400 x 109 per litre

Polycythemia rubra vera (PRV)

A myeloproliferative disease characterised by the over-production of red blood cells by the bone marrow. Diagnosis is based on an increased number and volume of red cells. The total number of white blood cells and platelets also may be increased. Treatment will vary according to the age of the patient and severity of the disease but is usually by blood letting or venesection. This condition carries a small risk of developing into acute leukaemia

Preleukaemia

A general term referring to some cancerous blood disorders, such as myelodysplasia or smouldering leukaemia, which carry an increased risk of the patient developing acute leukaemia

Progenitor cell (Precursor cell)

Immature cell in the bone marrow which is responsible for producing mature blood cells

Prolymphocytic leukaemia

An aggressive variant of chronic lymphocytic leukaemia in which the malignant cells have a more immature appearance. The disease may require removal of the spleen, chemotherapy and/or radiotherapy

Promyelocytic leukaemia (acute promyelocytic leukaemia)

A variant of acute myeloid leukaemia characterised by the over production of cells of intermediate maturity and often associated with particular bleeding problems. Treatment includes the use of retinoic acid in addition to conventional chemotherapy. Retinoic acid is the first substance to be used effectively to cause leukaemia cells to mature

Prognosis

An assessment of the likely benefits of treatment for patients, particularly concerning the chances of cure and complete recovery or likely years of survival

Prophylaxis

Precautionary treatment given with the aim of preventing a disease occurring. For example, an antibiotic to prevent infection

Protocol

A schedule of treatment. For example, the number, frequency and timing of administration of courses of anti-cancer drugs

Pulmonary

Of the lungs

Purging

The laboratory treatment of bone marrow harvested from a patient for an autologous bone marrow stem cell transplant with the aim of removing any residual leukaemic cells and thus reducing the theoretical chance of relapse. The use of this procedure varies between treatment centres and depends on the type of leukaemia being treated

Purpura

A condition characterised by the occurrence of purple spots on the skin, often accompanied by bleeding from the gums. It is caused by a shortage of platelets as well as skin fragility but does not imply the same severity as petechiae

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Radiology

The use of X-rays in the diagnosis of a disease

Radiotherapy

The use of X-rays and other forms of radiation in treatment. It kills cancer cells in the area of the body being treated and is therefore effective treatment for localised disease, particularly in lymphoma and multiple myeloma. Side-effects vary according to the type of treatment and will be discussed with the patient by the hospital staff. It can be administered by injection, by an external beam or by internally placed tube (brachytherapy)

Randomised trial

A scientific study where patients are randomly allocated to one or two or more therapies to test effectiveness and toxicity. The trial is regularly reviewed and if at any time one treatment option is found to be superior, all future patients will receive that therapy

Recombinant

A term used to descriptionribe drugs which have been produced using genetic engineering techniques. The products are exact equivalents of compounds produced naturally by the body

Red blood cells

The cells of the blood which contain the red pigment haemoglobin and carry oxygen to all the tissues of the body. Normal red cell count in the blood is 4.5 – 5.0 x 1012 per litre. They are the petrol tankers of the blood which carry oxygen

Refractory anaemia

A type of myelodysplasia which primarily affects red cell production by the bone marrow. In some cases the developing red cells show an internal ring of iron granules. These cells are called sideroblasts. Refractory anaemia (RA) and refractory anaemia with sideroblasts (RAS) are the common forms of myelodysplasia. These are usually the least aggressive types

Refractory anaemia with excess blasts (RAEB)

A form of myelodysplasia characterised by the accumulation of immature white blood cells in the bone marrow. If the immature cells are particularly numerous it may indicate a risk of transformation to acute leukaemia and the condition is called RAEB in transformation

Relapse

The recurrence of disease in marrow or other organs. In leukaemia this may be indicated by changes in the blood, bone marrow, CNS or testicle, even before the patient experiences any symptoms

Remission

Restoration of the blood, bone marrow and general health of the patient to normal. Induced by chemotherapy and/or radiotherapy

Remission induction

The initial course of treatment given to patients on admission to hospital to remove all clinically detectable cancer

Renal

Related to the kidney

Resistant or Refractory Disease

When the disease is not responding to treatment

Reticulocytes

Immature red blood cells normally restricted to the bone marrow and present in the bloodstream in very low numbers (0.2-2%). An increase in numbers in the blood indicates increased activity in the bone marrow, for example following chemotherapy. It may include increased red cell production due to bleeding

Retinoic acid

A synthetic compound related to vitamin A which can stimulate some marrow cells to become fully mature. It may be used clinically to treat some forms of leukaemia, notably a sub-type of acute myeloid leukaemia called acute promyelocytic leukaemia

RNA (ribonucleic acid)

A copy of the genetic code, used by cells as a template for making proteins. It copies the message given out by the DNA

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Secondary leukaemia

A leukaemia arising from either previous chemotherapy or radiotherapy often for a cancer other than leukaemia or as the development of a pre-existing condition such as myelodysplasia

Septicaemia

This is a general term to descriptionribe serious bacterial infection in the body with leakage into the blood of substances which cause high fever and sometimes shock

Serum

The part of the blood plasma which remains after cells, platelets and fibrinogen have been removed, usually by allowing the blood to clot

Spleen

An organ that accumulates lymphocytes, acts as a reservoir for red blood cells for emergencies, and destroys red cells, white cells and platelets at the end of their lifespan. Situated high in the abdomen on the left-hand side. It is often enlarged in leukaemia and some other blood diseases

Splenectomy

Surgical removal of the spleen. This is sometimes done in leukaemia or lymphoma as part of a patient’s treatment

Splenomegaly

Enlargement of the spleen. Megalo = big

Staging

As assessment of the spread of disease through the body, for example, in lymphoma. Stage 1 usually means localised disease only, whereas stage IV represents widespread disease. Staging is of importance for the selection of the best treatment

Standard therapy

The most effective and safest therapy currently being used

Stem cells

The most primitive cells in the bone marrow from which all the various types of blood cell are derived. These can be normal or leukaemic

Stem cell mobilisation

The use of chemotherapy and/or growth factors to move blood stem cells out of the bone marrow and into the blood stream, where they can be collected, or ‘harvested’

Stem cell transplant

The more modern and correct term for ‘bone marrow transplant’. Stem cells can be collected from the blood by apheresis or blood separation machines after mobilisation. They are still sometimes collected by separation of stem cells from bone marrow collected directly from the bone. This is usually done by inserting a needle into the hip bone under a general anaesthetic. Stem cell transplants can be autologous (collected from the patient) or allogeneic (collected from another person). Occasionally stem cells can be collected by separation from the umbilical cord discarded after the birth of a baby (cord blood stem cells). These cord blood stem cells can be stored against future need

Sternum

The breastbone, a site sometimes used for a bone marrow biopsy

Subcutaneous injection

An injection into tissue immediately under the skin.Syndrome: A characteristic collection of medical symptoms and signs; for example, the syndrome in myelodysplastic syndromes, refers to the fatigue due to anaemia, increased tendency to infections and increased bruising which are all features of myelodysplasia

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T cell (T lymphocyte)

A type of white blood cell derived from the thymus (hence T cells) involved in controlling immune reactions. Uncontrolled growth of this type of cell gives rise to T cell leukaemia/lymphoma

Testicular relapse

Recurrence of leukaemia in the testicles. The disease may be restricted to the testicles or may also show evidence of involvement of either the bone marrow or CNS. Treatment will depend on the timing and extent of the relapsed disease

Thalidomide

A drug used to reduce the growth and survival of myeloma cells

Thrombocythemia

Over-production of platelets. A myeloproliferative disease involving the megakaryocytes which produce platelets

Thrombosis

The development of a clot in a blood vessel, usually in a vein but sometimes in an artery. Potentially life-threatening if left untreated

Thymus

A gland at the base of the neck concerned with the production of functional T cells. Lymphocytes destined to be thyplocytes are ‘finished’ in the thymus after they leave the bone marrow

Tissue typing

Identification of an individual’s HLA type. Analysis of blood samples from both the patient and prospective donors is performed when a bone marrow transplant is being considered

Tomography

Serial X-ray pictures of internal organs of the body. CT scanning is a special type of tomography

Total body irradiation (TBI)

Radiotherapy often given in several doses prior to bone marrow transplantation with the aim of killing any residual leukaemia in the patient. It is used in conjunction with high dose anti-cancer drugs. The procedure and its side-effects will be discussed individually with the patient. This treatment may in future be delivered by attaching radioactive substances which are injected and home in on lymph glands and bone marrow

Transformation

A term to descriptionribe either the change of a normal cell into a cancerous cell, or the acceleration of disease (e.g. in chronic myeloid leukaemia from the chronic to a more acute phase characterised by the production of large numbers of blast cells). Also occurs in CLL (rarely) and low grade lymphoma

Translocation

A chromosome abnormality in which part of one chromosome has become transferred to another

Trephine biopsy

Removal of a small ‘core’ of bone marrow under local anaesthetic. It is used to assess bone marrow structure, the number and distribution of all the blood cell types. Trephines are usually taken from the back of the pelvis (hip) in adults under special anaesthetic or relaxing drugs

Trisomy

Term which indicates the presence of an additional whole chromosome. Each cell usually has 46 chromosomes but in trisomy this is increased to 47

Tumour

An accumulation of abnormal cells which may be benign or malignant

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Ultrasonography (ultrasound)

Pictures of the body’s internal organs built up from the interpretation of reflected sound waves

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Veno-occlusive disease (VOD)

A complication of stem cell transplantation or high dose chemotherapy where the blood vessels that pass through the liver become blocked. Blood flow in the liver is reduced leading to toxic changes in the liver and a reduction in normal liver function

Ventilator

Machine which maintains a patient’s breathing by mechanical means

Voluntary unrelated donor (VUD) transplant

See matched unrelated donor (MUD) transplant

Vinca alkaloids

Anti-cancer drugs originally derived from vinca (periwinkle) plants.Drugs of this type include vincristine, vinblastine.

Virology

The study of viruses and viral diseases

Virus

A minute infective agent which depends on the cell it infects for its replication and survival. Sometimes, it behaves like a ‘wild gene’ and attaches to the genetic code

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Waldenstroms Macroglobulinaemia (Lymphoplasmacytic Lymphoma)

is an indolent (slow growing) type of non-Hodgkin lymphoma which starts in the white cells of our immune system. It is also known as lymphoplasmacytic lymphoma. In WM, abnormal lymphoplasmacytic cells multiply out of control, causing an overproduction of a protein called monoclonal immunoglobulin M (IgM or “macroglobulin”) antibody

White blood cells (also leucocytes)

They comprise several different types of cells within three main groups: granulocytes, lymphocytes and monocytes. They are formed in the bone marrow and it is usually their uncontrolled proliferation that leads to leukaemia. Normal values are within the range 4.5 – 11.0 x 109 per litre

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X-rays

A form of radiation used both in diagnosis and treatment

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Zoster immune globulin (ZIG)

Gamma globulin directed specifically against chicken pox, which sometimes can be given to an immuno-suppressed patient following direct contact with the disease to prevent infection

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