Acute Leukemia

Question 1

True or False: Leukemia is characterized by unregulated proliferation of the blood forming cells called blasts.

Answer 1

True

Question 2

True or False: Without treatment, leukemia can be fatal in weeks to months if untreated.

Answer 2

True

Question 3

AML blasts are forming at the _____ level of cell development.
A. Multipotential hematopoietic stem cell
B. Common myeloid progenitor
C. Common lymphoid progenitor
D. B lymphocyte
E. Plasma cell

Answer 3

B. Common myeloid progenitor

Question 4

ALL is forming at the _____ level of cell development.
A. Multipotential hematopoietic stem cell
B. Common myeloid progenitor
C. Common lymphoid progenitor
D. B lymphocyte
E. Plasma cell

Answer 4

C. Common lymphoid progenitor

Question 5

CML is forming at the _____ level of cell development.
A. Multipotential hematopoietic stem cell
B. Common myeloid progenitor
C. Common lymphoid progenitor
D. B lymphocyte
E. Plasma cell

Answer 5

B. Common myeloid progenitor

Question 6

True or False: CLL is not considered a leukemia and has been reclassified as a lymphoma.

Answer 6

True

Question 7

True or False: Leukemia is most common in females.

Answer 7

FALSE! It is more common in males than females. 5th on the estimated deaths list for men vs. 6th for women.

Question 8

Children ages 0 to 14 are most commonly diagnosed with which type of cancer?
A. Acute lymphocytic leukemia (ALL)
B. Acute myeloid leukemia (AML)
C. Chronic lymphocytic leukemia (CLL)
D. Chronic myeloid leukemia (CML)

Answer 8

A. Acute lymphocytic leukemia (ALL)

Question 9

True or False: Children are almost never diagnosed with chronic leukemias.

Answer 9

True

Question 10

Which of the following is most common in children but can affect adults? The peak age of onset for this type of cancer is 2-3 years of age.
A. Acute lymphocytic leukemia (ALL)
B. Acute myeloid leukemia (AML)
C. Chronic lymphocytic leukemia (CLL)
D. Chronic myeloid leukemia (CML)

Answer 10

A. Acute lymphocytic leukemia (ALL)

Question 11

This type of leukemia can occur in both adults and children with no preference of one over the other.
A. Acute lymphocytic leukemia (ALL)
B. Acute myeloid leukemia (AML)
C. Chronic lymphocytic leukemia (CLL)
D. Chronic myeloid leukemia (CML)

Answer 11

B. Acute myeloid leukemia (AML)

Question 12

This type of leukemia mainly occurs in adults over the age of 55.
A. Acute lymphocytic leukemia (ALL)
B. Acute myeloid leukemia (AML)
C. Chronic lymphocytic leukemia (CLL)
D. Chronic myeloid leukemia (CML)

Answer 12

C. Chronic lymphocytic leukemia (CLL)

Question 13

This type of leukemia is common in adults of any age, but rarely ever see it in children.
A. Acute lymphocytic leukemia (ALL)
B. Acute myeloid leukemia (AML)
C. Chronic lymphocytic leukemia (CLL)
D. Chronic myeloid leukemia (CML)

Answer 13

D. Chronic myeloid leukemia (CML).

Note: CLL is adults > 55

Question 14

Which of the following is NOT a general risk factor for leukemia?
A. Down Syndrome
B. Chemotherapy
C. Smoking
D. Myelodysplatic Syndrome
E. Radiation exposure

Answer 14

C. Smoking

Question 15

True or False: AML most likely arises from pluripotent stem cell or more committed myeloid precursor v. ALL from immature lymphoblasts.

Answer 15

True

Question 16

True or False: A common feature among AML and ALL is the failure to maintain balance of proliferation, differentiation, and apoptosis.

Answer 16

True

Question 17

True or False: AML and ALL each arise from a single leukemic cell, usually a blast.

Answer 17

True

Question 18

This is a phenomenon in leukemia called ________, in which there is rapid cellular growth of leukemic cells in the bone marrow that crowds the bone marrow and causes decreased production of other blood cell counts. These blasts eventually become too packed in the bone marrow and split out into circulation.

Answer 18

“Crowding Out”

Question 19

Which of the following is a rare symptom in the presentation of leukemia?
A. Thrombocytopenia resulting in bruising, petechiae, and bleeding
B. Splenohepatomegaly from accumulation of blast cells there
C. Anemia resulting in fatigue and loss in energy
D. Chloromas resulting in bluish spots under the skin which are leukemic cells.
E. Leukopenia resulting in fever, chills, and rigor

Answer 19

D. Chloromas resulting in bluish spots under the skin which are leukemic cells.

Question 20

The most important test for diagnosis of leukemia is:
A. CBC with differential
B. Peripheral blood smear
C. Bone marrow biopsy and aspirate
D. Lumbar puncture
E. Chest radiograph

Answer 20

C. Bone marrow biopsy and aspirate

Question 21

Which of the following types of leukemia can be characterized by Auer rods on peripheral blood smear?
A. ALL
B. AML
C. CLL
D. CML

Answer 21

B. AML

Question 22

True or False: Problems with coagulation are frequently seen in ALL, and are not seen often in AML.

Answer 22

False! They are seen AML, not in ALL.

Question 23

Regardless of how many blasts are in the peripheral blood, a blast percentage of greater than ___% in the bone marrow, which is checked through bone marrow aspirate, is indicative of AML.

Answer 23

20%

Question 24

True or False: An AML patient can present with leukopenia OR leukocytosis.

Answer 24

True (leukocytosis due to blasts in periphery)

Question 25

______ is an enzyme on the myeloid precursor that is specific for AML. A dye is used to look for this enzyme, and if it is positive, it almost always means AML.

Answer 25

Myeloperoxidase (MPO)

Question 26

``` Of the following possible mutations that can occur in AML, which are correlated with a good prognosis? A. NPM1 B. t(9;22) C. c-KIT D. CEBPA E. FLT3-ITD ```

Answer 26

A. NPM1 | D. CEBPA

Question 27

Describe the 7+3 induction regimen that is used in AML patients.

Answer 27

Give cytarabine 100-200 mg/m2 continuous infusion on days 1-7 and you give an anthracycline like daunorubicin or idarubicin IVP on days 1-3.