Acute Leukemias Flashcards
What is the main difference between acute and chronic leukemia?
Arrested development and Hiatus phase in acute leukemia
ID how the stains would look in for myeloblasts,monoblasts,lymphoblasts,rubricytes and megakaryocytes in
MPO
SPe
NSe
SSe w/ NaF
MPO: myelo (+), mono (weak pos), lymph (-), rub/mega(-)
Spe: myelo (strong) mono (-) lymph, rub/mega (-)
NSe: myelo (weak pos) mono (strong pos) rest negative
NSe w NaF: myelo weak pos, rest negative
Myeloperoxidase in MPO works on what specific type of cells?
phagocytic cells
In classification of leukemias, what is the main difference between the FAB and WHO in classifications?
FAB used morphology while WHO used immunotype and genetic features for ID
For the ICC (international consensus classification) what is the percentages for blasts or equivalents?
> 10% if recurrent genetic abnormalities
20% if not other specified
Describe how immunophenotyping works with flow cytometry
it IDs the ag on the surface of the cell by reacting w monoclonal Abs to determine their lineage
Describe myeloblastic leukemia without cytologic maturation (FAB M0), how does staining look?
age
> 20% blasts or equivalents
primitive blasts that show no myeloid features/lack reactivity with stains
requires flow or immunopheno
around 5% of adult AMLs (poor prog)
MPO NEG
Describe acute myeloblastic anemia leukemia without maturation (FAB M1), how does staining look?
ages
wbc counts
little more mature than M0
>20% blasts or equiv
poss. auer rods
wbc 4000-300000
decreased pet
usually adults/neonates
MPO +, SPe +, Sse weak pos
Describe acute myeloblastic leukemia w maturation (M2), how does staining work, what about translocation?
age
(hint..shift)
> 20% blasts/equiv
25% translocation with 8 and 21 chrom
maturation at promyelo and beyond
poss auer rods
25% of adult AMLs
Shift to the left + blasts
T/F: in AML M2, there may not be a blast crisis or acute phase of chronic myeloid leukemia
false, in M2 there is a blast or crisis phase
Describe acute promyelocytic leukemia acute myeloid leukemia w T(15:17), (M3 and M3m)
ages
possible disease correlation
> 20% blasts and pros
frequent auer rods
abnorm pros have heavy granules (M3) or no appearance of none (M3m) or both
usually in adults
very high WBC
DIC POSSIBLE
T/F: In M3/M3m there is a thromboplastin effect that can initiate the coag cascade
true
Describe the micro granular variant of M3m
so small granules
abnormal nuclear shape, H and N shaped
can be mistaken for AML or AMoL
Describe acute monomyelocytic leukemia (M4)
age groups
> 20% blasts w mono/myelo
may have auer rods
high wbc
mostly adults
invasion of skin..etc due to monos
positive in all stains
Describe acute myelomonocytic leukemia w Eosinophilia (M4e)
similar to M4 with marrow eos
>10% blasts
abn/immature
may be in peripheral
Describe acute monoblastic/monocytic leukemia (M5)
ages
mostly children/young adults
infiltration of skin/gums
M5a –> >20% monoblasts poorly differentiated high wbc
M5b –> more mature, cytochem markers
Nse+
Describe acute erythroid leukemia (M6)
whatkind of changes?
Pure eryth cells
used to be M6b
>80% marrow cellularity with eryth precursors
megaloblasTOID changes to rbcs/bizzar morph many nRBCs
T/F M6 does not have a high MCV
False it does have high mcv
describe acute megakaryoblastic leukemia (M7)
common?
cell lines
associated with?
RARE <1% of cases
>20% blasts (50% megakary in BM)
dysplastic features In all cell lines
assoc. w myelofibrosis
“dry-tap”
Briefly describe acute basophilic leukemia
must distinguish from AML
briefly describe leukemia of ambiguous lineage
both lymphs and myelos
mixed pop (bilineages)
bi-phenotypes
briefly describe acute panmyeosis with myelofibrosis
malignancy un myeloid cell lines
BM fibrosis
Describe acute lymphocytic leukemias (ALLs), Most common form
wbc ranges
staining
disease of children 2-10yrs
most common –> B cells
2nd peak in midlife
wbc above 100000> but 50% have norm or low
no auer rods
all stains negative
CNS infiltration common
describe FAB L1
small lymphoblasts
little cytoplasms
occ cletting
MOST COMMON
Describe FAB L2
large lymphs
irreg nucleus and cytoplasm
not cookie cutter (looks like reactive lymphs)
describe L3,how do the cells look? (hint cytoplasm) how does testing look?
leukemic conversion of Burketts lymphoma
large blasts with basophilic cytoplasm
punch-out vacuoles
TdT negative
starry night pattern
What is M0?
AML W/Out cytologic maturation/no staining
What is M1? auer rods?
AML W out maturation (aeur rods)
What is M2? Aeur rods? special extra words?
AML W maturation + left shift, blast crisis, can have auer rods
What is M3? M3m? Auer rods? Trans location?
Acute PROlymph leukemia (DIC)
T(15,17) auer rods in doubles
What is M4? Auer rods?
Acute monomyelo leukemia, can have aeur rods
What is M5a? Aeur rods? types of cells? Differentiation?
Acute myelocytic leukemia, poor differentiation/blasts/pros Auer rods
What is M5b?
AMol with differentiation (promonos/monos)
What is M6? Aeur rods?
Erythroleukemia Nrbcs
No auer rods
What is M7? Aeur rods?
Acute megakaryoblastic leukemia, no auer rods
What is L1?
small blasts w small cytoplasm ALL
What is L2?
Large blasts, look like reactive lymphs
