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ENGR 1 > AcuteLeukemias > Flashcards

AcuteLeukemias Flashcards

1
Q

Two types of acute leukemias

A
  1. Acute myeloid leukemia (AML) 


2. Acute lymphoblastic leukemia (ALL)

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2
Q

3 different types of Acute Myeloid Leukimias (AML)

A
  1. Congenital 

  2. Therapeutic-AML 

  3. NOS
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3
Q

General signs/symptoms of Acute leukemias

A
  1. anemia: fatigue, malaise, pallor 

  2. thrombocytopenia: bruising, petichiae, hemorrhage 

  3. neutropenia: fever, recurrent infxn
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4
Q

What is the general blast marker used to diagnose Acute Leukemias?

A

CD34

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5
Q

General characteristics of AML

- severity 

- target population

- common markers

A
  • progressive 
- 90% of AML occurs in adults
    
- Common blast marker: CD34
    
- common myeloid markers: CD117, myeloperoxidase
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6
Q

General characteristics of ALL

- severity 

- target population

- common markers

A
  • disease “explodes”: rapidly fatal w/o treatment
    
- 75% of ALL occurs in children <6
    
- Common blast marker: CD34
    
- common lymphoblast marker: tdt
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7
Q

5 Different types of Congenital AML

A
  1. RUNX1-RUNX1 

  2. CBFB-MYH11 

  3. PML-RARA
    
4. RBM1-MLK1 

  4. MLL
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8
Q
  1. RUNX1-RUNX1 
2. CBFB-MYH11 
3. PML-RARA 
4. RBM1-MLK1 
5. MLL
A
  1. translocations 
2. previous chemo: alk agents, topo II inhib. 
3. previous exposure of active marrow to ioniz rad. 
4. tobacco smoke 
5. benzene exposure 
6. genetics
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9
Q

Different types of T-AML

A

(therapeutic)
1. Alkylating agent or ionizing radiation

2. Topo II inhib.

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10
Q

Different types of NOS AML

A

Ones with these mutations:


1. FLT3 
2. NPM1 
3. CEBPA

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11
Q

Different types of ALL

A
  1. B-ALL 


2. T-ALL

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12
Q

RUNX1-RUNX1 genetic translocation/mutation

A

t(8;21)

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13
Q

CBFB genetic translocation/mutation

A

t(16;16) or inv(16)

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14
Q

PML-RARA genetic translocation/mutation

A

t(15;17)

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15
Q

RBM15-MLK1 genetic translocation/mutation

A

t(1;22)

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16
Q

AML Congenital MLL genetic translocation/mutation

17
Q

T-AML genetic translocation/mutations

A

For alylating agent or radiation:

- whole/partial loss of ch 5 and/or 7

For topo II inhib

- often MLL (11q23)

18
Q

AML NOS genetic translocation/mutation

A

These mutations: 

FLT3 (ITD)

NPM1 

CEBPA

19
Q

BCR-ABL genetic translocation/mutation

A

t(9;22) p190

20
Q

ALL - B-ALL - MLLgenetic translocation/mutation

21
Q

ETV6-RUNX1 genetic translocation/mutation

22
Q

T-ALL:

- % of ALL

- common markers

A

20-25% of ALL

general blast marker: CD34 

common lymphoblast marker: tdt

t cell markers: CD3, CD7

23
Q

B-ALL: 


  • % of ALL 

  • common markers
A

80-85% of ALL

general blast marker: CD34

common lymphoblast marker: tdt 

B cell markers: CD19, CD22

- lack CD20 (of mature B cells like in Non-Hodgkin)

24
Q 
Prognosis of Congenital AML: 

1. RUNX1-RUNX1 

2. CBFB-MYH11 

4. RBM1-MLK1
 
5. MLL
A
  1. RUNX1-RUNX1 - Good 

  2. CBFB-MYH11 - Good 

  3. RBM1-MLK1 - Good 

  4. MLL - Poor
25
Q 
Prognosis of:

- T-AML 

-FLT3 

- NPM1
 
- CEBPA
A
  • T-AML: 
Very poor 
(luckily its only 10-20% of AML)
  • FLT3: very poor 

  • NPM1 : good (if FLT3 not present) 

  • CEBPA: good (if FLT3 not present)
26
Q

Alkylating agents/radiation are types of T-AML that progress to AML via which cancer?

27
Q

Prognosis of B-ALL: 

BCR-ABL 

MLL 

ETV6-RUNX1

A

BCR-ABL: worst of all ALL

MLL: poor

ETV6-RUNX1: very favorable

28
Q

Prognosis of T-ALL

A

Good 
Kids: 95% cure,
100% remission 
Adults:
50% cure,
60-80% remission

29
Q

What does RUNX1 code for?

A

alpha subunit of CBF txn factor

5

30
Q

What does CBFB code for?

A

beta subunit of CBF txn factor

31
Q

What type of cells are you likely to see in CBFB-MYH11?

A

baso-eos


- immature eosinophils w/ baso granules

32
Q

What type of cells are you likely to see in PML-RARA?

A

hypergranular cells 


multiple auer rods

33
Q

What type of cells are you likely to see in RBM15-MLK1

A

megakaryoblastic differentiation

34
Q

What type of cells are you likely to see in Congenital AML MLL?

A

monocytic differentiation

35
Q

Which AML is more likely to be seen in pts with Down Syndrome?

A

RBM15-MLK1

36
Q

Which AML is more likely to be at risk for DIC? How do you treat it?

A

PML-RARA (APL)

treat w/ ATRA

37
Q

BCR-ABL B-ALL vs MLL B-ALL ivs T-ALL in patient populations

A

BCR-ABL: more common in adults

MLL: more common in neonates/infants 

T-ALL: more common in males, adolescents/young adults

38
Q

Which cancer is more likely to present with a mediastinal mass?

ENGR 1 (29 decks)

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