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2nd U2 Path > Acute Leukemia > Flashcards

Acute Leukemia Flashcards

1
Q

A disease involving a neoplastic proliferation of blasts and is defined by a >20% of blasts in the bone marrow…

A

Acute leukemia

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2
Q

What is the acute presentation that occurs with an increased number of blasts seen with acute leukemia?

A

Anemia (Fatigue)
Thrombocytopenia (bleeding)
Neutropenia (infection)

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3
Q

A large, immature cells with a punched out nucleoli seen with acute leukemias?

A

Blast

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4
Q

What are the 2 subdivisions of acute leukemia?

A

Acute lymphoblastic leukemia (ALL)

Acute myelogenous leukemia (AML)

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5
Q

Disease characterized by a neoplastic accumulation of lymphoblasts in the bone marrow…

A

Acute lymphoblastic leukemia

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6
Q

What nuclear stain is characteristic of acute lymphoblastic leukemia?

A

TdT

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7
Q

What is TdT?

A

A DNA polymerase seen within lymphoblasts

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8
Q

Acute lymphoblastic leukemia commonly arises in children and is associated with what disorder?

A

Down syndrome—usually arises AFTER age 5

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9
Q

What are the two subclassifications seen with acute lympoblastic leukemia?

A

B-ALL

T-ALL

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10
Q

What are the characteristics of B-acute lymphoblastic leukemia?

A

TdT + expressing CD 10, 19, and 20

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11
Q

B-acute lymphoblastic leukemia has an excellent response to chemotherapy, but what is required in order to effectively treat this disease?

A

Prophylactic chemotherapy to the scrotum and CSF due to tight barriers preventing the spread to drug to these areas

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12
Q

What are the two chromosomal translocations seen with acute lymphoblastic leukemia?

A

T(12;21)

T(9;22)

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13
Q

Of the two translocations seen in acute lymphoblastic leukemia, which one has a good prognosis and is commonly seen in children?

A

T(12;21)

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14
Q

Of the two translocations seen in acute lymphoblastic leukemia, which one has a poor prognosis and is commonly seen in adults?

A

T(9;22)

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15
Q

What are the characteristics of T-acute lymphoblastic lymphoma?

A

TdT + with expression of markers ranging from CD2-CD8

Blasts DO NOT express CD10

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16
Q

What is the typical presentation for T-acute lymphoblastic lymphoma?

A

Typically presents in teenagers as a mediastinal thymic mass

Called a lymphoma because a mass is formed

17
Q

A disease involving the neoplastic accumulation of immature myeloid cells in the bone marrow?

A

Acute myeloid leukemia

18
Q

What is the characteristic cytoplasmic stain that is seen with acute myeloid leukemia?

A

Myeloperoxidase (MPO)

19
Q

What are the crystal aggregates of MPO seen with acute myeloid leukemia called?

20
Q

What is the average age range associated with the development of acute myeloid leukemia?

A

50-60 years

21
Q

What sub classifies the different acute myeloid leukemias?

A

Cytogenetic abnormalities
Lineage of immature myeloid cells
Surface markers

22
Q

What are the most common subtypes of acute myeloid leukemia?

A

Acute promyelocytic leukemia
Acute monocytic leukemia
Acute megakaryoblastic leukemia

23
Q

What is the characteristic chromosomal translocation seen with acute promyelocytic leukemia?

24
Q

What does the t(15;17) seen in acute promyelocytic leukemia involve?

A

Retinoic acid receptor (RAR) on chromesome 17

25
Q

What does the translocation of RAR from chromosome 17 to 15 seen in acute promyelocytic leukemia cause?

A

Blocks maturation and causes promyelocytes (blasts) to accumulate

26
Q

When promyelocytes accumulate in acute promyelocytic leukemia, what are patients at an increased risk of developing?

27
Q

What is the treatment for acute promyelocytic leukemia?

A

All-trans-retinoic acid—ATRA, which is a vitamin A derivative

28
Q

What is the mechanism of action of all-trans-retinoic acid when treating acute promyelocytic leukemia?

A

The ATRA binds to the altered RAR and causes the maturation of the blast

29
Q

What are the characteristic findings with acute monocytic leukemia?

A

A proliferation of monoblasts
Usually lacks MPO
Infiltration of the gums by the blasts

30
Q

What are the characteristic findings with acute megakaryoblastic leukemia?

A

A proliferation of megkaryoblasts
Lack MPO
Is associated with Down syndrome and arises BEFORE age 5

31
Q

Myelodysplastic syndromes may develop into acute myeloid leukemia after exposure to what?

A

Alkylating agents
OR
Radiotherapy

32
Q

What is the usually presentation seen with myelodysplastic syndrome?

A

Cytopenias
Hypercellular bone marrow
Abnormal maturation of cells
Increased blasts

33
Q

What does most patients die from before myelodysplastic syndrome progresses into acute leukemia?

A

Infection or bleeding

2nd U2 Path (31 decks)

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