ALL Flashcards
what is the primary aim of AALL1331?
evaluating blinatumomab for patients with B ALL at first relapse
What is the translocation TEL-AML1 (ETV6-RUNX1)
t(12;21)(p13;q22)
what is a diagnostic criterion of T cell ALL that can’t be present in B cell?
cytoplasmic CD3
which chemotherapy agent has been implicated in significant toxicity in children with DS ALL?
methotrexate
what is a diagnostic criterion of T cell ALL that can’t be present in B cell?
cytoplasmic CD3
which chemotherapy agent has been implicated in significant toxicity in children with DS ALL?
methotrexate
risk of leukemia in identical twins?
if one twin develops leukemia within the first 5 yrs of life, the second twin has a 20% risk of developing leukemia
immunophenotype AML
MPO, CD117, CD13, CD33
histochemical stains positive in AML
non-specific esterases
MPO
sudan black
immunophenotype AML
MPO, CD117, CD13, CD33
list 5 genetic conditions that predispose to developing leukemia
T21 Bloom Fanconi SDS DBA NF1 ataxia telangectasia SCN
factors important in pathogenesis of leukemia
- ionizing radiation
- chemical exposure
- drugs (ie, alkylators in AML)
- genetics (20% risk of identical twin developing leukemia if other twin develops before 5 yrs of age, sibs have 4x increased risk)
- chromosomal abnormalities (ie T21)
what translocation is found in the majority of burkitt’s lymphoma/leukemia
t(8;14) in 80%
between c-myc and IgH gene
what is an L3 phenotype associated with?
burkitt’s lymphoma/leukemia
what translocation is found in the majority of burkitt’s lymphoma/leukemia
t(8;14) in 80%
between c-myc and IgH gene
CNS1
no blasts on cytospin, no neurologic symptoms (regardless of CSF WBC)
CNS2 definition
< 5 WBC on CSF + cytospin positive for blasts
CNS1
no blasts on cytospin, no neurologic symptoms (regardless of CSF WBC)
what type of leukemia is myeloperoxidase positive?
AML
most common cytogenetic abnormalities in B precursor ALL
- hyperdiploid (> 50 chromosomes, 25%)
- ETV6-RUNX1 t(12;21) 25%
- MLL rearrangements t(4;11) t(9;11) 8%
- Ph-like (15-20%)
- ERG deletion (7%)
- E2A-PBX1 t(1;19) 5%
x-ray finding associated with ALL
transverse metaphyseal bands, growth arrest lines, osteolytic lesions, osteopenia
what is the steinherz/bleyer algorithm?
helps to determine if a traumatic tap should be classified as CNS3.
If CSF WBC/CSF RBC is > 2x more than blood WBC/blood RBC
BCR-ABL1 translocation
t(9;22)(q34;q11)
what is the steinherz/bleyer algorithm?
helps to determine if a traumatic tap should be classified as CNS3.
If CSF WBC/CSF RBC is > 2x more than blood WBC/blood RBC.
BCR-ABL1 translocation
t(9;22)
MLL rearrangement
t(v;11q23)
hypodiploidy definition
< 44 chromosomes
hyperdiploidy definition
> 50 chromosomes
hypodiploidy definition
< 44 chromosomes
size of protein product from BCR-ABL translocation CML
210 kDa
What are the implications of a traumatic diagnostic LP?
upgrade to CNS2
use steinherz/bleyer algorithm to determine whether it should be considered CNS3
CSF WBC / CSF RBC > 2X blood WBC / blood RBC
what is the absence of CD10 in precursor B cell ALL associated with?
MLL (KMT2A) rearrangements - specifically t(4;11) and a poor outcome
What are the implications of a traumatic diagnostic LP?
upgrade to CNS2
use steinherz/bleyer algorithm to determine whether it should be considered CNS3
CSF WBC / CSF RBC > 2X blood WBC / blood RBC
what is the absence of CD10 in precursor B cell ALL associated with?
MLL (KMT2A) rearrangements - specifically t(4;11) and a poor outcome
what translocation is associated with cytoplasmic Ig?
t(1;19) TCF3-PBX1 (formerly known as E2A-PBX1)
characteristics of Burkitt leukemia
- surface Ig expression
- FAB L3 morphology
- MYC translocation
T cell antigens
cytoplasmic CD3
CD7
CD2 or CD5
What is the immunophenotype for T cell ALL
CD3, TdT, CD7
What is immunophenotype for B lineage ALL
Combination of at least two of CD19, cCD79a or cCD22
