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USMLE Hematology Leukemmia and Lymphoma > Acute Leukemia > Flashcards

Acute Leukemia Flashcards

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USMLE® Step 1 flashcards
1
Q

How is acute leukemia defined?

A

Accumulation of >20% of blasts in the bone marrow

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2
Q

What is the normal percentage of blasts?

A

~ 1-2%

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3
Q

How is does acute leukemia present?

A
  • Results in acute/sudden presentation w. anemia (RBCs), thrombocytopenia (bleeding), neutropenia (infection)
  • High WBCs
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4
Q

What do blasts look like on blood smear?

A

Large, w. punched out nucluei (nucleolus)

- Small cytoplasm

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5
Q

How can you differentiate between Myeloblasts and lymphoblasts?

A

Lymphoblast
- tdt +ve in nucleus

Myeloblasts

  • MPO (myeloperoxidase) in cytoplasm
  • Can crystalise into AUer rods
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6
Q

What is TdT?

A

DNA polymerase

- In nucleus of lymphoblasts

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7
Q

When is ALL associated with Downs Syndrome?

A

After the age of 5

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8
Q

What is the most common type of ALL?

A

B-ALL

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9
Q

What do the lymphoblasts classically express in B-ALL?

A

CD10, CD19, CD20

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10
Q

What areas require prophylactic chemotherapy in ALL?

A

Scrotum and CSF

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11
Q

What are the cytogenic abnormalities in B-ALL?

A
  • t(12;21) - good prognosis - more commonly seen in kids

- t(9;22) has a poor prognosis - more commonly seen in adults

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12
Q

What is T-ALL also known as

A

Acute lymphoblastic lymphoma

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13
Q

What does T-ALL (Acute lymphoblastic lymphoma) present as?

A

Mediastinal (thymic) mass in teenager

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14
Q

What ages are usually affected by AML?

A

50-60

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15
Q

How can AML be subclassified?

A
  • Cytogenetic abnormalities
  • Lineage of myeloblasts
  • Surface markers
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16
Q

What translocation is present in Acute promyelocytic leukemia?

A

t(15;17)

17
Q

Describe Acute promyelocytic leukemia (15;17)?

A
  • RAR (retinoic acid receptor) receptor disrupted; promyelocytes accumulates
  • Promyelocytes contain numerous Auer rods; risk for DIC
  • ATRA causes blasts to mature
18
Q

What can Auer rods cause?

A

DIC

- May activate coagulation cascade

19
Q

What are patients given in Acute promeyelotic leukemia?

A

ATRA

- Causes blasts to mature

20
Q

What is characteristic of acute monocytic leukemia?

A
  • Proliferation of monoblasts; lack MPO

- Blasts characteristically infiltrate gums

21
Q

What is acute megakaryoblastic leukemia associated with / characterised by?

A
  • Lack of MPO

- Down syndrome after age of 5

22
Q

What is the classic circumstance by which AML can arise from pre-existing dysplasia?

A

Prior exposure to alkylating agents or radiotherapy

23
Q

What is seen in myelodysplastic syndromes?

A
  • Cytopenias with hypercellular bone marrow
  • Abnormal maturation with increased blasts (<20%)
  • Most patients die from infection or bleeding
  • May progress to Acute leukemia (>20% blasts)

USMLE Hematology Leukemmia and Lymphoma (14 decks)

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