11-19 L3 Leukemias

Question 1

ALL

Acute lymphoblastic leukemia

Answer 1

• Most common cancer in childhood
• B>T
• Lymphoblasts in blood, BM, LN, Mediastinal mass

Question 2

Id the 2 subtypes of ALL

Answer 2

• T-ALL
  
  • Thymys and mediastinal mass
  • Terminal deoxytransferae
  • CD2/3
• B-ALL
  
  • CD19

Question 3

AML

Acute meyloid Leukemia

Answer 3

• Affects primarily adults
• Blast morphology (large granules, Auer rods (crystalline-like enzyme inclusions)
• mirrior like cells

Question 4

Give an subtype of AML that has good prognosis

Answer 4

• APL (acute promyelocytic leukemia)
  
  • causes block in differentiation at the promyelocyte stage
  • Abdunent in Auer rods!
• Treat with ATRA: all trans retinoic acid

beware dangerous DIC from Auer rod/granule release

Question 5

CLL/SLL

Chronic lymphocytic leukemia/small lymphocytic lymphoma

Answer 5

• most common leukemia
• epidelionlogy: elderly males, familial predis
• Smudge cells
• Immunophenotypes
  
  • B-cell CD19, CD20
  • Abnormal CD5 (a T cell antigen)
  • CD23

Question 6

Hairy cell leukemia

Answer 6

• Males, 50s
• Pancytopenia, splenomegaly
• Hairy cells
• Immunophenotype
  
  • B cell antigens (CD19,CD20)
  • TRAP (tartrate-resistant acid phosphatase)
• Genetics BRAF V600E mutations

Question 7

Chronic Myelogenous leukemia

Answer 7

• Middle aged adults
• left-shift, basophilia, splenomegaly
• BCR-ABL fusion oncogene
• Respons to tyrosine kinase inhibitors (TKIs)
  
  • Gleevec (Imatinib)