6.2 Acute Leukemia

Question 1

What is the hallmark of leukemia?

Answer 1

Neoplastic proliferation of blast cells - accumulation of >20% blasts in the bones marrow

Question 2

What are the signs of acute leukemia?

Answer 2

• Anemia
• Thrombocytopenia
• Neutropenia

Due to blasts crowding out normal hematopoiesis

Question 3

What will the peripheral blood count be like in acute leukemia?

Answer 3

High

Question 4

What is an accumulation of myeloblast called?

Answer 4

AML

Question 5

What is an accumulation of lymphoblast called?

Answer 5

ALL

Question 6

What is the marker for accumulation of lymphoblasts?

Answer 6

TdT

Question 7

What is the marker for the accumulation of myeloblasts?

Answer 7

MPO - crystallization into Auer Rods

Question 8

What patient population is ALL associated with?

Answer 8

Children older than 5 - particularly Down Syndrome

Question 9

What are the B-ALL markers?

Answer 9

B-ALL - CD10/19/20

Question 10

What is the most common type of ALL?

Answer 10

B-ALL

Question 11

What is the prognosis of B-ALL to chemotherapy?

Answer 11

Excellent response to chemotherapy - requires prophylaxis to the scrotum and CSF as it cannot cross the blood barrier normally

Question 12

Most Common Translocation of B-ALL

Answer 12

t(12;21) - good prognosis and is more common in children

Question 13

Philadelphia Chromosome Translocation of B-ALL

Answer 13

t(9;22) - poor prognosis and is seen in adults

Question 14

What are the T-ALL markers?

Answer 14

CD2-CD8

Do NOT express CD10

Question 15

How does T-ALL express normally?

Answer 15

Thymic mass in a teenager - referred to as a lymphoma as it forms a mass

Question 16

What are the cells seen in AML?

Answer 16

Myeloblasts with Auer Rods

Question 17

Who does AML tend to affect?

Answer 17

Older adults 50-60 years of age

Question 18

Translocation of APL (acute promyelocytic leukemia)

Answer 18

t(15;17) PML/RAR

Question 19

Why is there a risk for DIC in APL?

Answer 19

Auer Rods can cause DIC risk

Question 20

What is the problem in APL and how is it treated?

Answer 20

RAR receptor is disrupted fo promyelocytes accumulated. This can be treated with the administration of ATRA which will cause the blasts to mature.

Question 21

Acute Monocytic Leukemia

Answer 21

Proliferation of monoblasts with involvement of the gums

-NO MPO

Question 22

Acute Megakaryoblastic Leukemia

Answer 22

Proliferation of megakaryoblasts and is associated with Down syndrome before the age of 5

-NO MPO

Question 23

How does AML arise from pre-existing dysplasia?

Answer 23

Prior exposure to alkylating agents or radiotherapy

Question 24

Myelodysplastic Syndrome

Answer 24

Cytopenia with hyper cellular bone marrow of increased blasts, but not greater than 20% - most patients die from infection or bleeding