acute leukemia Module 10 Flashcards
Compare AML to CML
- AML common in adults, ALL common in children. Both have anemia, thrombocytopenia, neutropenia, AML has myeloblasts, ALL has lymphoblassts. ALL small nuclei, indistinct nucleoli, AML medium to large nuclie distinct nucleoli, ALL PAS positive TdT positive, AML sudan black and peroxidase positive.
Determine ALL from CLL flow cytometry
CD13 and 33 are AML markers, CD 10 is Calla, T and B cell specific. CD2,3,5,7 T cell positive.
Common ALL A marke
CD10 zinc metalloprotease, B and T cell positive.
CD13 and CD 33 markers in AML
- M0 - M3 (promyelocytic leukemia)
CD 11 and CD14 AML differentiation -
M3 and M4 (promylocytic and promonmyleocytic)
Gycophorin AML differentiation - only ertyhroid,
AML - promylocytic - cell shape -
auer rods, hypergranulated promyleocytes with odd shaped nuclei. rar fusion. treat with retinoic acid.
Retinoic acid therapy
- promyleocytic leukemia
AML with multilineage dysplasia -
de novo or following MPD / MDS treatment. Dysplasia 2 or more cell lines. Dysplasia includes: hypogranular PMNs, hyposegmentation, erythroblasts that are megaloblastoid or have fragmented nuclei, ringed sideroblasts, and micromegakaryocytes
AML and MDS therapy related
- from alkylating agent or topoisomerase II agent. Ie ringed sideroblasts, micromegakryocytes, hyposegmentation or hypgranular PMNs
AML without differentiationcell looks
- myloblasts, auer rods, vacuoles.
AML with differentiation cell looks -
myeloblasts and PMN.
Acute myelomoncytic leukemia
neutrophils and monocytes have impaired differentiation therefore myleoblasts and monocytes muramidase / lysozyme high.
Acute erythroid leukemia cell looks
Myeoloid ertyhroid more serious than pure AEL. Megaloblastoid with ringed sideroblasts, BFU e or CFU-e is cancer cell.
Cell morphology in pediatric all
indented nuclei inconspicuous nucleol homgenous lymphoblasts in bone marrowi fewer mutations
Cell morphology in Adult ALL
- irregular nuclei conspicuous nuceloli heterogeneous lymphoblasts in bone marrow
Morphologic features of Non burkitt ALL -
heterogeneous cell size, fine or clumped chromatin, everything else variable
Morphologic features Burkitt ALL
- Large cells, fine chromatin, regular oval nuclei, prominent nucleoli and deep basophilia.
Pan B cell Marker -
cd19
CD2 tcell expression
- pre tcell
Pan t cell markers
- cd3 and cd7
AML treatment -
ATRA, BMT/ SCT, Epigenetic therapies
ALL treatment -
Induction therapy, CNS radiation or intrathecal irradiation, Maintenace chemotherapy, cord blood transfusion
Promyelocytic leukemia L
retinoic acid causes differentiation of myeloid precursors into granulocytes
- The PML-RAR fusion protein does not respond to physological levels of retinoic acid
- Blocks differentiation
- Extra retinoic acid given to treat
First 3 types AML
minimally differentiated and without maturation (both CD34 / HSC +)
with maturation usually cd34 -
Lineage speific AMLs
myelomonocutic leukemia, monoblastic leukemia, erythroid leukemia, megakaryoblastic leukemia (usually cd34 HSC +)
CD 11b abd CD14
more specific for AMML, monoblastic leukemia because they are monocyte markers.
Gycophorin positive for
erythroid leukemia
Non Burkitt ALL types
Btype, T type, lymphoblastic lymphoma
Compare burkitt vs non burkitt ALL
Burkitt type: Large cells, fine homogenous chromatin, regular oval or round nucleus, prominent nucleoli, abundant cytoplasm
