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Hematology > Acute leukemias > Flashcards

Acute leukemias Flashcards

1
Q

What is the median age of onset for AML? Gender?

A

66 yo

Male:female (5:3)

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2
Q

What is the 5 year survival rate of acute leukemia?

A

24%

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3
Q

What is the median age of onset for ALL?

A

14 years

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4
Q

What is the 5 year survival rate for ALL?

A

65%

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5
Q

What are the genetic abnormalities that predispose pts to leukemia?

A

Downs
Turners (X)
Klinefelters(XXY)
NF-1

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6
Q

What are the three malignant conditions that are associated with acute leukemia?

A

MDS
Myeloproliferative syndrome
Marrow failure syndromes

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7
Q

What are the chemical exposure that can lead to MDS?

A

Benzenes
Tobacco
Alkylating agents

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8
Q

What chemo agents predispose to leukemia?

A

Alkyating agents

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9
Q

Who gets CML?

A

65 yo males

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10
Q

What is the incidence of CLL?

A

4/100000, but way underreported

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11
Q

What is the 5 year survival rate of CML? CLL?

A 
CML = 60%
CLL = 80%
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12
Q

True or false: CLL does not usually need to be treated

A

True

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13
Q

What are the SSx of acute leukemia? (4)

A

General fatigue
Pallor
Ostalgia
Fever

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14
Q

What is sweet syndrome?

A

red/violaceous tender nodules and plaques (dermatosis) d/t PMN sequestration

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15
Q

What are the eye findings with acute leukemia?

A

Retinal hemorrhage

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16
Q

What are the CNS findings with acute leukemia?

A

CN palsies

HA

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17
Q

What are the oropharyngeal findings with acute leukemia?

A

wet purpure

Gum infiltration

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18
Q

Is organomegaly common in acute leukemia?

A

No

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19
Q

What is the classification system for AML?

A

FAB (M0-M7)

WHO classification

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20
Q

What is M3 leukemia?

A

acute progranulocytic leukemia

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21
Q

Auer rods = ?

A

AML

fused lysosomes and PMN granules with enzymes and crystalline inclusions

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22
Q

What is leukemia cutis?

A

skin manifestations of leukemia

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23
Q

What are the mouth findings of leukemia?

A

gingival hyperplasia

24
Q

What are the drugs that can cause gingival hyperplasia?

A

Phenytoin

25
Q

What is the recommended site of bone marrow extraction?

A

PSIS

26
Q

What are the risk factors for bone marrow exams?

A

DIC
Bleeding
Infx

27
Q

What is William Damesheck’s insight?

A

Had to give a big dose of chemo to ablate the bone marrow

28
Q

What is the 7+3 induction therapy for AML?

A

Anthracycline x 3 days + cytarabine x7 days

29
Q

What are the drugs used to consolidation therapy?

A

High dose cytarabine, then bone marrow transplant

30
Q

What is APL? What is the treatment?

A

Acute

31
Q

Can there be a philadelphia chromosome with AML?

A

Yes

32
Q

AML induction support is what?

A

Transfused pRBCs (irradiate)
Abx
Antiemetics

33
Q

What is the risk of transfusion with AML during induction support?

A

TA-GvHD

34
Q

What are the growth factors that can be used with AML induction support?

A

GM-CSF or G-CSF

35
Q

What food should be avoided in induction support for AML?

A

no raw berries or veggies grown in dirt

36
Q

What is the problem with tumor lysis in treating leukemia? How do you treat this?

A

Uric

Allopurinol and alkanization of urine

37
Q

What happens with 1st trimester prego with new diagnosis of leukemia?

A

Child will not survive

38
Q

What is APL genetic cause?

A

t(15;17) resulting in the fusion of PML/RAR-alpha

39
Q

What is the treatment for APL?

A

All trans-retinoic acid with 7+3 induction

40
Q

What is the prognosis for APL?

A

Highly curable

41
Q

What is the major complication with APL?

A

DIC

42
Q

What is the median age of ALL?

A

14 years

43
Q

What is the prognosis for ALL if >35 yo

A

Bad

44
Q

What are the chromosomal translocation for ALL?

A

t(9;22)

45
Q

What is the treatment for ALL induction?

A

Ara-c with methotrexate

46
Q

What is the treatment for ALL in adults?

A

Bone marrow transplant

47
Q

What are the drugs used for ALL maintenance therapy in adults?

A

6MP
Vincristine
Methotrexate

48
Q

Is there a maintenance therapy in AML?

A

NO

49
Q

What are the ssx of CML?

A

Easy bleeding

Usual CA

50
Q

What did Jane Rowley do?

A

Argued that specific gene translocations cause specific diseases

51
Q

What is the translocation associated with CML?

A

9;22

BCR-ABL promotes Y kinase to promote cell growth

52
Q

What are the three risk factors for CML?

A

Age
Radiation exposure
Male

53
Q

What is the treatment for CML?

A

Imatinib (Gleevec)
Dasatinib
Nilotinib

54
Q

What is the chemo treatment for CML?

A

Hydroxyurea

55
Q

What is the major issue with imatinib?

A

Keep pts on the drug may cause relapse

Hematology (32 decks)

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