Acute Lymphoblastic Leukemia - Krafts Flashcards
1
Q
What is the official definition of Acute Lymphoblastic Leukemia?
A
Malignant proliferation of lymphoid blasts in blood, bone marrow
2
Q
What is ALL classified by?
A
Immunophenotype
(B vs. T)
3
Q
What age group is more common in ALL?
A
children
4
Q
What are the two types of Acute Lymphoblastic Leukemia?
A
- T-lymphoblastic leukemia
- TdT positive (only in lymphoblasts)
- T-cell Ag positive
- B-cell Ag negative
- B-lymphoblastic leukemia
- TdT positive
- T-cell Ag negative
- B-cell Ag positive (markers = 19, 20, 21)
5
Q
Which type of ALL has a worse prognosis?
A
T-lymphoblastic leukemia
6
Q
What is significant about T-lymphoblastic Leukemia?
A
- = T-lymphoblastic lymphoma
- Most common patient profile:
- Teenage male with mediastinal mass
- Usually super high WBC count
- Bad prognosis
7
Q
What are morphologic features of immature lymphocytes?
A
- Two types of blasts
- smudge cells/ghost cells
- small dark cells
- large cells with large nucleus, fine chromatin
- nucleoli sometimes present
8
Q
What is significant about B-lymphoblastic leukemia?
A
- = B-cell lymphoblastic lymphoma
- Several sub- and sub-subtypes
- TdT positive
- Rarely has Philadelphia chromosome!
- worse prognosis
9
Q
How do you tell between a B- & T-lymphoblastic leukemia?
A
Flow cytometry to see what cell markers are.
10
Q
What are the prognostic features of ALL?
A
- Immunophenotype (T is bad)
- Age (1-10 years old = good)
- babies under 1 yoa have worse prognosis
- children over 10 have worse prognosis
- WBC (<50,000 good)
- the more white cells in the blood the bigger tumor burden you have
- Cytogenetics
- hyperdiploidy = more/extra chromosomes
- better prognosis
11
Q
What is the treatment for ALL?
A
- Chemo alone
- Chemo with bone marrow transplant
- Many children are cured!
- 5 year disease free
