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Hem > 120314 lymphoid leukemias > Flashcards

120314 lymphoid leukemias Flashcards

1
Q

what does open, light chromatin in a cell that looks like a lymphocyte but is bigger suggest?

A

immature

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2
Q

CD20 is a marker for

A

mature B cells

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3
Q

what does flow cytometry allow you to assess?

A

identification of cells (forward scatter reflects size, side scatter reflects complexity of cell cytoplasm, immunophenotype)

identify aberrancye

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4
Q

smudge cell count is positive for

A

anything with too many lymphocytes

isn’t always CLL. could be mono

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5
Q

CD34 is a marker for

A

blasts (immature cells) or stem cells

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6
Q

in B-ALL, where can the lymphoblasts be found

A

CSF, lymph nodes, bone marrow, splenic sinusoids

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7
Q

prognosis of B-ALL looks at

A

cytogenetic abnormalities

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8
Q

CD3 is positive on

A

T cells

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9
Q

most common leukemia of adults in Western world

A

CLL

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10
Q

in mono, what kind of B cells can result with latent infection?

A

polyclonal B cells that proliferate

CD8 T cells against virus develop as atypical lymphocytes

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11
Q

ginger snap (irregular condensations)

A

CLL

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12
Q

CLL’s immunophenotype

A

CD5 +
CD19 +
CD 23 +

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13
Q

CLL is indolent or aggressive?

A

indolent

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14
Q

prognostic indicators for CLL

A

good prognosis: deletion 13q, mutated IgHV

intermediate: trisomy 12
bad: deletion 11q, deletion 17p, unmutated IgHV, high Rai stage, CD38/ZAP70 expression

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15
Q

absolute lymphocytosis is defined as

A

more than 4,000/microliter

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16
Q

reactive vs neoplastic lymphocytosis

A

duration
morphology (heterogeneous for reactive, monomorphic favors neoplasia)

absolute lymphocyte count (20-40k favors neoplastic)

clinical findings (LAD-shared by both reac and neoplastic)

flow cytometry findings (to determine polyclonal vs monoclonal)

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17
Q

differential for benign lymphocytosis

A

infectious mononucleosis
mono like syndromes (CMV, adeno, acute HIV)
other viruses
TB
transient stress lymphocytosis (common)–trauma, MI, stroke

pertussis

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18
Q

lymphocytosis–neoplastic/clonal differential

A 
CLL
leukemic lymphoma
sezary syndrome
hairy cell leukemia
adult T cell leukemia
T cell large granular lymphocytic leukemia
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19
Q

how do you test for clonality in lymphocytes?

A

B cells:

  • light chain restriction on cell surface (kappa vs lambda) by flow cyto or immunohistochem
  • IgH variable gene PCR
  • immunophenotypic aberrancy

T cells/NK cells:

  • TCR gene PCR
  • immunophenotypic aberrancy
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20
Q

define acute leukemia

A

greater or equal to 20% blasts in blood or bone marrow

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21
Q

myeloid CDs for acute leukemia

A

CD13, 14, 15, 33, 117

22
Q

how can acute leukemias be divided?

A

myeloid vs lymphoid (important for therapy)

by morphology and immunophenotype (Auer rods, CDs)

23
Q

AML is more common in adults or children?

A

adults

24
Q

ALL types–percentage prevalance

A

85% B ALL

15% T ALL

25
Q

of B cell ALLs, what is notable about t(12;21)

A

most common in kids

26
Q

adolescent males w/ mediastinal mass

A

T cell ALL

27
Q

prognostic factors in B ALL

A 
age
cytogenetics
WBC count
CSF involvement
marrow involvement following therapy
28
Q

good prognostic indicators in B-ALL

A

2-10 years old
hyperdiploidy (>50)
t(12;21)

29
Q

bad prognostic indicators in B-ALL

A 
under 2, over 10 yr old
t(9;22), MLL gene
hypodiploidy (<45)
elevated WBC (over 100k/uL)
CSF involvement
marrow involvement at day 15
30
Q

tx for philadelphia chromosome positive B-ALL

A

tyrosine kinase inhibitor (dasatinib, imatinib)–survival is 50%

31
Q

leukemoid rxn WBC usually

A

NOT over 100,00

32
Q

CLL/SLL has what immunophenotype

A

CD5, CD19, CD20, CD23

33
Q

CLL/SLL clinical behavior in the majority of cases is?

A

indolent

34
Q

CLL/SLL is both a leukemia and lymphoma-true or false?

A

true

35
Q

small B cell leukemia/lymphoma that is CD5 positive is

A

CLL/SLL (CD23 positive) or

mantle cell lymphoma (CD23 negative)

36
Q

small B cell leukemia/lymphoma that is CD5 negative is

A 
follicular lymphoma (CD10 positive) or
marginal zone lymphoma (CD10 negative)
37
Q

dry tap

A

hairy cell leukemia (in HCL, also has accumulation of hairy cells in red pulp of spleen)

38
Q

atypical lymphocytes +/- lymphocytosis

A 
CLL/SLL
leukemic lymphoma (follicular, mantle, etc)
hairy cell leukemia
hairy cell leukemia
adult T cell leukemia/lymphoma
Sezary syndrome
39
Q

splenomegaly due to RED PULP infiltration

A

hairy cell leukemia

40
Q

TRAP + cells

A

hairy cell leukemia

41
Q

course of hairy cell leukemia

A

indolent

42
Q

cerebriform nuclei

A

Sezary syndrome

43
Q

triad of Sezary syndrome

A

erythroderma
generalized LAD
circulating Sezary cells

44
Q

Sezary syndrome is what type of neoplasm

A

CD4 + T cell

chronic leukemia

45
Q

adult T cell leukemia/lymphoma is what type of neoplasm

A

CD4 + T cell

46
Q

HTLV-1 association

A

adult T cell leukemia

47
Q

seen more commonly in Japan, Caribbean, Africa

A

adult T cell leukemia

48
Q

flower cell with lymphocytosis

A

adult T cell leukemia/lymphoma

49
Q

course of adult T cell leukemia

A

aggressive

50
Q

when you see a lymphocyte with pink granules, it’s either

A

T or NK cells

51
Q

large granular lymphocytic leukemia

A

lymphoproliferative disorder of cytotxic T cells

associated with autoimmune disorders

Hem (10 decks)

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