6.2 Acute Leukemia Flashcards
What is the hallmark of leukemia?
Neoplastic proliferation of blast cells - accumulation of >20% blasts in the bones marrow
What are the signs of acute leukemia?
- Anemia
- Thrombocytopenia
- Neutropenia
Due to blasts crowding out normal hematopoiesis
What will the peripheral blood count be like in acute leukemia?
High
What is an accumulation of myeloblast called?
AML
What is an accumulation of lymphoblast called?
ALL
What is the marker for accumulation of lymphoblasts?
TdT
What is the marker for the accumulation of myeloblasts?
MPO - crystallization into Auer Rods
What patient population is ALL associated with?
Children older than 5 - particularly Down Syndrome
What are the B-ALL markers?
B-ALL - CD10/19/20
What is the most common type of ALL?
B-ALL
What is the prognosis of B-ALL to chemotherapy?
Excellent response to chemotherapy - requires prophylaxis to the scrotum and CSF as it cannot cross the blood barrier normally
Most Common Translocation of B-ALL
t(12;21) - good prognosis and is more common in children
Philadelphia Chromosome Translocation of B-ALL
t(9;22) - poor prognosis and is seen in adults
What are the T-ALL markers?
CD2-CD8
Do NOT express CD10
How does T-ALL express normally?
Thymic mass in a teenager - referred to as a lymphoma as it forms a mass
What are the cells seen in AML?
Myeloblasts with Auer Rods
Who does AML tend to affect?
Older adults 50-60 years of age
Translocation of APL (acute promyelocytic leukemia)
t(15;17) PML/RAR
Why is there a risk for DIC in APL?
Auer Rods can cause DIC risk
What is the problem in APL and how is it treated?
RAR receptor is disrupted fo promyelocytes accumulated. This can be treated with the administration of ATRA which will cause the blasts to mature.
Acute Monocytic Leukemia
Proliferation of monoblasts with involvement of the gums
-NO MPO
Acute Megakaryoblastic Leukemia
Proliferation of megakaryoblasts and is associated with Down syndrome before the age of 5
-NO MPO
How does AML arise from pre-existing dysplasia?
Prior exposure to alkylating agents or radiotherapy
Myelodysplastic Syndrome
Cytopenia with hyper cellular bone marrow of increased blasts, but not greater than 20% - most patients die from infection or bleeding
