Acute myeloid leukemia

Question 1

What are the difference between chronic and acute leukaemias?

Answer 1

Chronic leukaemia: Cells are fairly mature perform some normal functions but cell number are abnormal: Symptoms are relatively mild.

Acute leukaemia: Cells are immature, cannot perform normal functions: Symptoms are far more severe

Question 2

How many cases of AML are there and who does it effect most?

Answer 2

3/4 per 100,000

Rare in children, common in adults

Question 3

What % of cases are chromosomally abnormal?

Answer 3

60%

Question 4

What are you use karyotype analysis for?

Answer 4

Clonal expansion

Question 5

How does a clonal cell compete better in an environment than normal cells?

Answer 5

Grows and divides better (mechnaisms?)
Competes of nutrients in the bone marrow in the 3D space much better

Question 6

What are the 7 different AML

Answer 6

AML with MDS related changes
Myeloid prliferations relating to down syndrome
AML-NOS
Myeloid sarcoma
Blastic plamacytoid dendritic cell neoplasm
Therapy related AML
AML with recurrent genetic abnormalities.

Question 7

Describe AML with MDS related changes

Answer 7

Acute Leukaemia that is caused when Myeodysplastic syndrome (a pre-cancerous disorder) progresses and gets wrose and eventually have enough blasts in peripheral blood (20% of more), disease transforms into AML.

Poor prognosis

Question 8

Describe Therapy related AML

Answer 8

Being treated (for example lymphoma or MPN, MDS) and receiving chemo, the chemotherapy which is genotoxic. Can introduce mutations, those mutations intended to kill cell. if cell manages to repair the mutation however incorrectly, can cause a mutation which results in another cancer.

Question 9

What do genotoxic agent do

Answer 9

They disrupt the DNA in all cells. hopefully impact growth and proliferation of rapibly dividing cells.

Will also affect normally dividing cells.

Question 10

Genetics and cytogenetics

Answer 10

Can further characterise.
Monitor for clonal expansion and clonal evolution.
Also detect prognostically significant markers of disease.

Question 11

State a recurrent genetic abnormality

Answer 11

t(8;21)(q22;q22)

Question 12

t(8;21)(q22;q22)

Answer 12

Fuses two genes together - RUNX1-RUNX1T1

Sufficient to cause AML.

Question 13

Is AML always cause by the same translocation?

Answer 13

No, not all translocations

Also inversion
inv(16)(p13.1q22) CBFB-MYH11

Question 14

ANother translocation causing AML

Answer 14

t(15;17)(q22;q21) PML-RARA