ALL Flashcards
Genetic predisposition for ALL
Downs- < 3 tend to get megakaryoblastic leuk
Ataxia- due to mut in ATM gene
Nijmegen breakage syndrome
Bloom
Flow associations w genetic abn
Cd 15 33 65
Cd 13 55
All re arrangement of MLL gene
ETV-runx1 gene
Hyperdiploidy
Good
may reflect an increased cellular accumulation of methotrexate and
its polyglutamates, an increased sensitivity to therapeutic antimetabolites, and a marked propensity of these cells to undergo apoptosis.
Hypodiploidy
Badass
Cd 10- is which b
Po b
CD10+ Ve
Early pre b
CD10+_ % cIG +
Pre b
Genetic alterations in ph like ALL
Crlf2 re arrangements Abl class tyrosine genes Jak2 and EPOR mutations, jak stat and ras
What is pH like ALL
Lacks BCR able
GEP similar to ph ALL
Alteration in lymphoid transcription genes
Targets used for MRD monitoring
leukemia-associated immunophenotype (LAIP)on multiparametric flow cytometry
leukemia-specific rearrangements of immunoglobulin and T-cellreceptor (IG/TR) genes
fusion gene transcripts by real-time
quantitative polymerase chain reaction (RT-qPCR).
Cause of false neg MRD
Clonal IG/TR rearrangements
are not directly related to the oncogenic process and can undergo
clonal evolution in immature leukemic blasts with still active IG/TR
recombination machinery, which might lead to the loss of leukemia-
specific IG/TR sequence
Early precursor T cell leaukaemia
primitive T-precursor phenotype, expression of multiple early myeloid antigens, complex cytogenetics without regularly recurring aberrations, a different gene expression signature, reduced frequency of acknowledged genetic aberrations of T-ALL and the presence of FLT3 mutations
Cd 58 +Ve
Useful if positive as differentiates from haematogones
High risk ALL kids
Bcr-abl or MLL (4:11)
Poor perd reponse at day 8
Failure to achieve cr by day 33 or high MRD(>5x10-4) at d79
