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MDTI > Acute Leukemias > Flashcards

Acute Leukemias Flashcards

1
Q

CBC chart diagram

A

WBC, Hgb/Hct, Platelets

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2
Q

acute leukemia

A

abrupt onset of pancytopenia (decrease in all cell types). dysfunctional immature neoplastic cells replace everything. quickly become sick

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3
Q

acute

A

immature neoplastic cells predominate

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4
Q

chronic

A

mature neoplastic cells predominate

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5
Q

what types of leukemias are better prognostically?

A

acute better than chronic

myeloid better than lymphoid

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6
Q

myeloproliferative neoplasms (MPNs)

A

clonal expansion of an abnormal hematopoietic stem cell with retained differentiation leading to expansion of mature hematopoietic cells. can become ALL or AML

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7
Q

subtypes of myeloproliferative neoplasms

A

polythemia vera, essential thrombocytosis, chronic myeloid leukemia, chronic idiopathic myelofibrosis (RBCs, platelets, neutrophils, megakaryocytic respectively)

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8
Q

myelodysplastic syndrome

A

clonal expansion of an abnormal HSC with abnormal differentiation leading to decreased number of mature hematopoietic cells, resulting in anemia, thrombocytopenia, or neutropenia. can lead to AML (rarely ALL)

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9
Q

what types of chemotherapy can lead to acute leukemia?

A

alkylating agents (cyclophosphamide) or topoisomerase 2 inhibitors (etoposide, doxorubicin)

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10
Q

acute leukemia transformation

A

can arise from MDS, MPNs, and clonal marrow failure syndromes

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11
Q

most common childhood cancer?

A

ALL acute lymphocytic leukemia

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12
Q

how do leukemias arise?

A

marrow is constantly turning over cells in order to maintain normal blood cell pools. unfortunately gives more chances for mutations to occur. in acute leukemias, these occur at proliferative stage, blocking maturation somehow

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13
Q

who has an increased chance of getting acute leukemia?

A

children with inherited errors of dna repair

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14
Q

clinical definition of MDS

A

acquired, persistent reduction in circulating myeloid blood cell counts with abnormal blood cell morphology. indolent growth

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15
Q

MDS marrow morphology

A

hypercellular marrow, increased apoptosis. hypo granular granulocytic precursors. hypolobated, micromegakaryocytes. increased marrow blasts.

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16
Q

what types of mutations lead to acute leukemias?

A

nonrandom, multiple ones: recurrent chromosomal abnormalities and gene mutations seen.

17
Q

APL (acute promyelocyte leukemia)

A

AML with t(15;17). fuses PML TF with retinoid acid receptor RARa, which then strongly binds DNA and recruits histone deacetylases, leading to transcription repression and maturational arrest.

18
Q

treatment for APL

A

all-trans retinoid acid (ATRA). ligand for PML-RARa that restores transcription and induces cell maturation.

19
Q

prognosis for ALL (childhood vs adult)

A

childhood ALL cured by intensive chemotherapy. Very difficult to cure in adults.

20
Q

clinical symptoms of leukemia

A

fatigue, fever, infection, bleeding, lymph node enlargement, bone pain due to marrow expansion, cranial neuropathy (involvement of spinal fluid), testicular masses

21
Q

clinical consequence of APL

A

highly dangerous bleeding risk

22
Q

why is cancer in testes particularly bad?

A

chemotherapy can’t gain access, must be radiated, which sterilizes

23
Q

signs of leukemia

A

pallor, petechial rashes, splenomegaly, swollen gums

24
Q

leukostasis

A

rare but serious complication of leukemia in which too many WBCs in circulation cause a leukothrombosis

25
Q

how can you distinguish AML for ALL

A

flow cytometry

26
Q

cytologic abnormality in AML

A

Aeur rods in cytoplasm

27
Q

Aeur rods

A

aggregates of myeloperoxidase that form cytoplasmic needle like inclusions.

28
Q

B lymphoid lineage immunophenotype

A

CD19, CD79a, Ig

29
Q

T lymphoid lineage immunophenotype

A

CD2,3,4,7

30
Q

myeloid lineage immunophenotype

A

CD13, 33, myeloperoxidase (MPO)

31
Q

best predictor for treatment response and survival for acute leukemias?

A

karyotype

32
Q

favorable AML karyotypes

A

t(15;17) (PML treat with ATRA)
t(8;21)
inv16

33
Q

acute leukemia

A

hematologic malignancy in which rapidly progressive marrow failure occurs

MDTI (42 decks)

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