6.2 Acute Leukemia

Question 1

What is the basis for acute leukemia?

Answer 1

Accumulation of blast cells d/t cell inability to mature properly

Question 2

Acute leukemia is defined as what?

Answer 2

When there is >20% of blasts in the bone marrow

Question 3

What is the cause of the ssx of acute leukemia?

Answer 3

blast cells crowding out normal cells/not producing normal cells (so anemia, neutropenia, leukopenia etc)

Question 4

Why is there a high WBC count if there are not any mature cells being produced in leukemia?

Answer 4

Tons of blasts

Question 5

What are the histological findings of acute leukemia?

Answer 5

Large, immature cells with punched out nucleoli

Question 6

What is the marker for ALL? AML?

Answer 6

ALL = tdt
AML= myeloperoxidase

Question 7

tdt in the nucleus of an immature WBC = what disease? What is tdt?

Answer 7

ALL

DNApol in lymphoblasts

Question 8

Auer rod = what disease?

Answer 8

AML

Question 9

Down syndrome is associated with what hematological malignancy? What age does this appear after?

Answer 9

ALL

After age of 5 yo

Question 10

Who usually gets ALL?

Answer 10

Children

Question 11

What are the two division of ALL?

Answer 11

B-ALL

T-ALL

Question 12

B-ALL surface markers = ?

Answer 12

CD10
CD19
CD20

Question 13

What is the prognosis for B-ALL?

Answer 13

Good with chemo

Question 14

What parts of the body need to be given prophylaxis of chemo for B-ALL?

Answer 14

scrotum and CSF

Question 15

What are the two translocations associated with B-ALL? Which is associated with children and has a good prognosis, and which with adults and has a bad prognosis?

Answer 15

t(12;21) = kids
t(9;22) = adults (philadelphia chromosome)

Question 16

What are the cell markers for T-ALL?

Answer 16

CD2 thru CD8

Question 17

What are the signs of T-ALL that distinguish it from B-ALL?

Answer 17

Thymic mass in a teenager

Question 18

Diseases whose names end in -oma are what?

Answer 18

Masses

Question 19

What are auer rods?

Answer 19

Crystallized myeloperoxidase–an enzyme only found in myeloblasts, hence why these are pathognomonic for AML

Question 20

Punched out nucleolus = ?

Answer 20

Lymphoblasts

Question 21

Who gets AML?

Answer 21

Old people (50-60)

Question 22

What are the three types of classification in AML?

Answer 22

• Cytogenetic abnormalities
• Lineage of myeloblasts
• Surface markers

Question 23

What is the chromosomal translocation found in acute promyelocytic leukemia?

Answer 23

t(15;17)

Question 24

What disease is caused by a t(15;17)? how?

Answer 24

Acute promyelocytic leukemia

Retinoic acid receptor disrupted, inhibiting promyelocyte maturation

Question 25

Promyelocytes that contain numerous Auer rods, as seen in acute promyelocytic leukemia, poses a risk for what complication?

Answer 25

DIC

Question 26

What is the treatment for acute promyelocytic leukemia?

Answer 26

ATRA (all trans-retinoic acid)–very good prognosis

Question 27

What is the cause of acute monocytic leukemia? What is the telltale sign of this?

Answer 27

Proliferation of monoblasts that lack MPO

Infiltration of the gums = gingival hypertrophy

Question 28

What is the cause of acute megakaryoblastic leukemia? What disease is associated with this?

Answer 28

Proliferation of megakaryocytes that lack MPO

Down syndrome BEFORE age 5)

Question 29

What is the CA that appears before the age of 5 for down syndrome pts? After?

Answer 29

Before = acute megakaryoblastic leukemia
After = ALL

Question 30

What chemotherapeutic agent can lead to AML?

Answer 30

Alkylating agents

Question 31

What condition may cause an increased risk of developing AML?

Answer 31

Preexisting dysplasia

Question 32

What is myelodysplastic syndrome?

Answer 32

Cytopenia with hypercellular bone marrow

Question 33

Abnormal maturation of myeloid progenitor cells with 20%?

Answer 33

20% acute myeloid leukemia