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White blood Cell disorders > Acute Leukemia- P > Flashcards

Acute Leukemia- P Flashcards

1
Q

What is leukemia and what is needed for the definition of acute?

A

Lymphoid or myeloid neoplasms with widespread involvement of bone marrow. Tumor cells are usually found in the blood
- >20% blasts for the Dx of Acute Leukemia

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2
Q

Increased blast cells take up space and Crowd out other areas of the BM causing what?

A
  1. Erythrocytopenia = Anemia- fatigue
  2. Thrombocytopenia- bleeding
  3. Neutropenia- infection
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3
Q

What do blast cells look like and what do they do the WBC?

A

Large, immature cells with punch out nucleoli.
Lacking cytoplasm
- Usually enter blood and increase WBC

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4
Q

Acute leukemias can be broken down into divisions and those divisions subdivided. name them.

A
  1. ALL- Acute lymphoid leukemia
    a. B-ALL
    b. T-ALL
  2. AML- Acute myeloid Leukemia
    a. Acute Promyelocytic leukemia
    b. Acute Monocytic Leukemia
    c. Acute Megakaryoblastic leukemia
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5
Q

What is Acute lymphoid leukemia? how can it be identified?

A

Neoplastic accumulation of lymphoblasts (>20%) in the BM

- TdT= Key marker of lymphBLASTS, found in the nucleus

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6
Q

What is TdT and where is it absent?

A

DNA polymerase

- absent in myeloid blasts and mature lymphocytes

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7
Q

ALL most likely presents in what age group. What individual is susceptible to this dz?

A

Mostly commonly in children

  • Ass with Down syndrome (this would however present after the age of 5)
  • if found in Adults it has a bad prognosis
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8
Q

CD10, CD19, CD20 and a TdT + lymphoblasts is indication of what?

A

B-ALL subdivision

CD10+ is most valuable cell marker

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9
Q

What is the prognosis of B-ALL and what determines this?

A

Excellent response to chemo (most responsive)

  • however may spread to testes or brain (needs separate therapy for this due to BBB and TBB)
  • Prognosis based off a cytogenetic abnormalities
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10
Q

What are the cytogenetic abnormalities related to B-ALL and what are their prognosis’s?

A

t(12,21) good prognosis found commonly in kids

t(9,22) poor prognosis found in adults

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11
Q

What is t(9,22) translocation also called and what dx process is it also seen?

A

Philadelphia chromosome

- Seen in CML more commonly

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12
Q

What cell markers does T-ALL express?

A

TdT+ lymphoblasts

- CD2-CD8

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13
Q

T-ALL usually presents in what Age group and with what types of symptoms?

A

Teenagers

  • SVC (superior vena cava like symptoms)
  • Due to Mediastinal (thymic) mass
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14
Q

What is the correct way to call a T-ALL?

A

Acute lymphoblastic lymphoma

- Due to mass in the thymus

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15
Q

What is acute myeloid leukemia? and how do you know they are myeloids?

A

neoplastic accumulating of immature myeloid cells (>20%) in the bone marrow
- they are characterized by a cytoplasmic staining for Myeloperoxidase (MPO)

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16
Q

What is one distinguishing factor of Myeloid cells that differs from all other cells?

A

Auer Rods- which are crystal aggregates of MPO

17
Q

What age group is AML most common?

A

Adults from 50-60 years old

18
Q

What are 3 ways to subclass AML?

A
  1. Cytogenetic abnormalities
  2. Linage of immature myeloid cells
  3. Surface markers
19
Q

Patient shows up having been experiencing fevers, nigh sweats, chills malaise and weight loss. After exam you notice petechia in mouth. You do a work up and its hows anemia, thrombocytopenia and neutropenia. Cytogenetics show t(15:17). Is this a medical emergency? Whats the treatment? Whats the dx?

A

yes this is a medical emergency.

  • Treat with Trans retinoic acid (ATRA)
  • Acute promyeloocytic leukemia (APL)
20
Q

What is the significant of the 15:17 translocation in APL?

A

It disrupts the retinoic acid receptor which leads to blocking maturation of promyelocytes. Which then build up

21
Q

What cause the petechia?

A

DIC from the granules of the promyelocytes being released

22
Q

ATRA is the treatment for APL how does this work?

A

Lets the promyelocytes mature and eventually die.

- keeps you healthy enough to receive other treatment as you could die from DIC in hours

23
Q

What is acute monocytic leukemia? and what is it clinical pearl?

A

Proliferation of monoblasts–> usually LACK MPO

- usually infiltrate the gums= inflammation

24
Q

What is acute megakaryoblastic leukemia?

A

Proliferation of Megakaryocytes which also lack MPO

- ass. with down syndrome and presents after the age of 5

25
Q

What is myelodysplastic syndrome and what can it lead to?

A

It is dysplasia of that presents with cytopenias, hypercellular bone marrow, abnormal maturation of cell and increased blasts which is LESS than 20%

  • Can lead to AML
  • caused by prior exposure to alkylating agents, radiation or other forms of chemo
  • most die from bleeding or infection before they progress to AML

White blood Cell disorders (10 decks)

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