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Hematology and Oncology ERIN > Acute leukemia > Flashcards

Acute leukemia Flashcards

1
Q

What happens to the bone marrow in acute leukemia?

A

Increased blasts crowd out normal hematopoiesis resulting in acute presentation with anemia, thrombocytopenia or neutropenia

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2
Q

What will you see in the blood in acute leukemia?

A

Blasts which are large immature cells with punched out nucleoli

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3
Q

Subdivisions of Acute leukemia ?

A

Acute lymphoblastic leukemia (ALL)

Acute myelogenous leukemia (AML)

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4
Q

Acute lymphoblastic leukemia bone marrow findings?

A

> 20% lymphoblasts in the bone marrow

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5
Q

How are lymphoblasts characterized?

A

Positive nuclear staining for TdT (a DNA polymerase) which is absent in myeloid blasts and mature lymphocytes

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6
Q

Who commonly gets ALL ?

A

Children with down syndrome, AFTER age 5

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7
Q

Subdivision of ALL ?

A

B-ALL, T-ALL

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8
Q

Which type of ALL is more common?

A

B-ALL

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9
Q

Markers of B-ALL?

A

Tdt+ with CD10, CD19, CD20

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10
Q

Treatment of B-ALL?

A

excellent response to chemotherapy, requires prophylaxis to scrotum and CSF

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11
Q

Prognosis of B-ALL?

A

Determined based on cytogenic abnormalities

t(12:21) good prognosis
t(9:22) poor prognosis (philadelphia chromosome)

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12
Q

Who commonly has the t(12;21) abnormality?

A

children

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13
Q

Who commonly has the t(9;22) abnormality?

A

adults

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14
Q

Markers to T-ALL?

A

Tdt+ with markers from CD2 to CD8.

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15
Q

which population is T-ALL more common in and how does it present?

A

presents in teenages as thymic mass (aka acute lymphoblastic lymphoma)

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16
Q

Acute myeloid leukemia findings in bone marrow?

A

More than 20% immature myeloid cells in bone marrow

17
Q

Marker for AML

A

positive cytoplasmic staining for MPO

aggregate can be seen as Auer rods

18
Q

Which population commonly gets AML ?

A

older adults

19
Q

What are some of the subtypes of AML?

A

Acute promyelocytic leukemia (APL)
Acute monocytic leukemia
Acute megakaryblastic leukemia

20
Q

Acute promyelocytic leukemia pathophys

A

t(15:17) translocation results in retinoic acid receptor (RAR) on chromosome 17 to 15; RAR disruption blocks maturation and promyelocytes accumulate
These promyelocytes contain numerous granules that increase risk for DIC

21
Q

Treatment of acute promyelocytic leukemia?

A

All-trans-retinoic acid which binds the altered receptor and causes the blasts to mature

22
Q

Characteristics of acute monocytic leukemia

A

proliferation of monoblasts that usually lack MPO

-usually infiltrate gums

23
Q

Who more commonly get acute megakaryoblastic leukemia?

A

people with down syndrome

Hematology and Oncology ERIN (12 decks)

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