Acute Myeloid Leukemia

Question 1

mutations in myeloproliferative disorders

Answer 1

• TET2 for clonal dominance

- JAK/STAT for proliferation of mature peripheral blood cells

Question 2

chromosome translocation found in all CML pts

Answer 2

between q of chr 22 and q of chr 9 (leading to fusion gene between BCR on ch22 and ABL on chr9 (chr is called a philadelphia chr)

Question 3

consequence of BCR and ABL fusion

Answer 3

• ABL protein is Tyr Kinase which strongly inhibits apoptosis
• DNA binding of ABL is enhanced

Question 4

clinical sign of CML

Answer 4

leukocytosis, splenomegaly 50% of the time

Granulocytes in peripheral blood

Question 5

therapy of CML

Answer 5

imatinibmesylate

Question 6

clinical findings of AML

Answer 6

anemia (low reticlocyte count), fatigue, thrombocytopenia, leukopenia, splenomgaly

Question 7

acute pro myelocytic leukemia chromosome issue is

Answer 7

t(15,17) (q22,q12)

resulting in fusion gene RARA on chr 17 with PML gene on chr 15. This blocks differentiation of granulocytes

Question 8

presentation of acute pro myelocytic leukemia

Answer 8

Disseminated intravascular coagulation

Question 9

what are schistocytes

Answer 9

damaged erythroid cells

Question 10

mutations in AML

Answer 10

• FLT3-ITD
• NPM-1 (for regulation of p53 pathway)
• CEBP-alpha (regulates granulocyte differentiation)

Question 11

treatment of APL

Answer 11

all leukemic cells are sensitive to all trans retinoic acid