Acute Leukemias- Biology, Clinical Features, and Therapy Flashcards
What is not a common symptom of acute leukemia?
Fever Nose bleeding Fatigue Hearing loss Rash
hearing loss (cholormas (masses of leukemia cells) can form around ears but rare
True of false: acute myeloid leukemia and acute lymphoid leukemia can be easily differentiated by review of the peripheral blood smear?
False
Which of the following tests are important in diagnosing and treating acute leukemias?
Bone marrow biopsy Flow cytometry Cytogenetics Molecular analysis All of the above
All of the above
What are leukemias?
Group of heterogenous disorders characterized by the accumulation of malignant white cells in the BM and blood. These abnormal cells cause morbidity and mortality because of:
1) BM failure: anemia, neutropenia, thrombocytopenia
2) Infiltration of organs: liver, spleen, lymph nodes, meninges, brain, skin or testes
What is the patient population in ALL?
Most common form of leukemia in children
its incidence is highest at age 3 to 7 years, falling off by 10 years and then a smaller secondary rise by age 40 years
What is the patient population in AML?
It is the most common form of acute leukemia in adults and is increasingly common with age.
What is the difference clinically between primary AML (de novo) and secondary AML (develops from MDS or other hematatological malignancies)?
Secondary AML is more difficult to treat (part of it is the older patient population)
Which of the following are major causes of AML?
A) Smoking B) Chemotherapy C) Pre-existing hematological disorder such as myelodysplastic syndrome D) All of the above E) Answers B & C
E) Answers B and C
smoking is associated with chronic monocytic leukemia
What are some main causes of acute leukemia?
- Idiopathic (vast majority)
- Prior chemotherapy/radiotherapy
- Chemical exposure (benzene)
- Myelodysplastic syndromes
- Myeloproliferative diseases
- Down’s syndrome
- Fragile chromosome syndromes (Fanconi’s anemia)
- Aplastic anemia and PNH
T or F. Acute leukemias are aggressive diseases that can rapidly cause death if not treated
T.
Where does the malignant transformation occur in acute leukemias?
in hematopoietic stem cells or early progenitors
Genetic damage leads to:
(1) increased rate of proliferation
(2) reduced apoptosis
(3) block in cellular differentiation.
Collectively these events result in accumulation of early BM hematopoietic cells known as ‘blast’ cells
What is acute leukemia defined as?
20+% blasts in blood or BM (less than 20%= MDS)
Can also be diagnosed with less than 20% if cytogenetic abnormalities are present
How is AML differentiated from ALL?
Most useful: Immunological markers (flow cytometry).
Morphologically, presence of auer rods is diagnostic of AML.
Chromosomes and genetic analysis can be useful
What are some myeloid antigens used to ID AML?
-Myeloid antigens include MPO, CD33, CD13, HLA-DR
What are some lymphoid antigens used to ID ALL?
-Lymphoid antigens include TdT, CD10, CD19, CD20
