269/270 - Leukemias (AML and ALL) Flashcards
On immunophenotyping, what markers prove that a cell population is made up of immature myeloid cells?
- Immature
- CD34+
- CD117+
- Myeloid
- CD13+
- CD33+
- MPO
Also - auer rods are important! Can’t see on flow but indicates myeloid lineage
Which translocation is most common in each of the following presentations of B-ALL?
- Infants:
- Children:
- Adults:
- Infants:
- t(v;11) - KMT2A/MLL
- The KMT2A part of chromosome 11 is moved somewhere else; not a specific location
- Children:
- t(12;21) - ETV6/RUNX1
- Adults:
- t(9;22) BCR-ABL1
- Can occur spontaneously or trasnform from CML
What are the diagnostic criteria for AML?
Bone marrow biopsy
- >20% blasts in bone marrow or blood
-
Evidence of myeloid differentiation
- Auer rods
- MPO+ (NSE+ = monoblasts)
- Myeloid-associated markers by immunophenotyping
What is the lineage-defining marker of T-cells?
CD3
What translocation is associated with acute promyelocytic leukemia?
What product is created?
t(15;17)
Creates PML-RARA; causes cells to arrest in promyelocytic stage
What is the lineage-defining marker of B-cells?
CD19
CD20 is acquired later; can be lost in malignancy (ex: classic nodular sclerosing hodgkin lymphoma)
Bone pain and refusal to bear weight are common symptoms of which hematopologic malignancy?
ALL
Due to intramedullary expansion of leukemic blasts
List the key differences in presentation between B-ALL and
T-ALL (often LBL)
- B-ALL
- Abrupt onset
- Bone marrow failure (thrombocytopenia, neutropenia, anemia)
- B symtoms (fever, night sweats, generalized lymphadenopathy)
- Bone pain (B for Bone Pain)
- T-ALL (LBL)
- High white count
- SVC syndrome (T for Tall like Superior Vena Cava)
- CNS involvement (T for Tall like Spinal Cord)
What is the most important prognostic factor in AML?
Chromosomal abnormalities
What is the cell of origin in AML?
Common myeloid progenitor
Which malignancy, in which population, is associated with t(12;21)?
Is this translocation prognostic?
B-ALL in children 1-10 years old
Favorable prognosis
What is the most common cancer of children?
ALL
Peak incidence of B-ALL is 3 years
What is the most important prognostic factor in ALL?
Time to response to induction chemotherapy
Fast response = good prognosis
Genomic alterations in AML can be used:
- For further classification
- For Prognostication
- For Targeted therapy
- For the detection of minimal residual disease
- All of the above
e. All of the above
Which part of which chromosome is most commonly involved in B-ALL in infants <1 year old?
11q23.3
Results in abnormal expression KMT2A
Can be translocated to various different locations (I think)
In the learning guide, the explanation for guiding question 2 is “B-ALL with t(v;11q23.3), KMT21 (or MLL) rearrangement is the most common leukemia in infants <1 year)”