Acute Leukemia

Question 1

AML vs ALL demographics/prognosis

Answer 1

AML: 65 years old, prognosis good if between 1-10
ALL: 75% under 6 years old - 80% cure for kids, 50% cure for adults

Question 2

ALL markers

Answer 2

CD34 - immaturity
TdT - common lymphoblast
CD19, CD22 - B cell lineage
CD 3, CD7 - T cell lineage

Question 3

AML markers

Answer 3

CD117 (C-Kit) - myeloblasts
CD64, CD14 - monocytic
CD41, CD61 - megakaryoblastic

Question 4

B-ALL in 25% of adults

Answer 4

t(9;22) BCR-ABL1 - poor prognosis

Question 5

B-ALL in neonates and infants

Answer 5

11q23; MLL - poor prognosis

Question 6

B-ALL in 25% of children

Answer 6

t(12;21) ETV6-RUNX1 - very good prognosis

Question 7

5 factors for good ALL prognosis

Answer 7

Between age 1-10
Low WBC
Hyperdiploidy
Quick response to therapy
B-ALL

Question 8

2 factors to diagnose AML

Answer 8

Myeloblasts over 20% marrow or blood

Auer rods in abnormal myeloblasts

Question 9

AML in younger patients

Answer 9

t(8;21) RUNX1-RUNX1T1 - good prognosis

inv(16) or t(16;16) CBFB-MYH11 - good prognosis

Question 10

AML with new treatment

Answer 10

t(15;17) PML-RARa - good prognosis
DIC risk
Treat with ATRA/arsenic

Question 11

AML in infants with Down Syndrome

Answer 11

t(1;22) RBM15-MKL1 - good prognosis

Question 12

AML with poor prognosis

Answer 12

11q23; MLL

Question 13

t-AML from alkylating agents or radiation

Answer 13

2-8 year latency with MDS initial phase

Very poor prognosis

Question 14

t-AML from topo II inhibition

Answer 14

1-2 year latency without MDS initial phase

Very poor prognosis

Question 15

AML NOS prognostic markers

Answer 15

FLT3 ITD - bad and trumping factor
NPM1 - good
CEBPA - good