ALL

Question 1

ALL clinical features ?

Answer 1

1-bone marrow replacement 2- general lymphadenopathy and splenomegaly 3-mass effect:presented as pain and periosteal infiltration 4-CNS symptoms if meningeal spread happen: صداع استفراغ شلل بالأعصاب 5- on in T ALL there is thymic medisteal mass : presented as obstructions in airways and larges vessels in medistum

Question 2

ALL pathogenisis?

Answer 2

1-dysregulate expression and function of transcriptional factors needed for cell differentiation ALL-B:Loss of function in PAX5 gene ALL-T:gain of function in NOTCH1 gene 2-increased tyrosine kinase activity and RAS signalling 1 ALONE is not enough to cause leukemia

Question 3

ALL tumors cells have genetic changes mention some of them.

Answer 3

1- hyperpoidy in 90% of cases

2- in B ALL: t(12.21) involving ETV6 and RUNX1 fusion gene t(9.11) involving BCR and AML

3-in T cells t(9,22)

Question 4

ALL morphology

Answer 4

-Hyper cellular Bone marrow filled with blast cells -Lymphoblast cells: N/C ratio increased Cytoplasm: scant agranular Nucleus: condensed with small nucleoli Negative for MPO Positive for PAS

Question 5

ALL prognosis?

Answer 5

Different in T and B B has worse course (leading cause Of cancer death in children) T has good prognosis in : -aged 2-10 children على الرغم انه مب مشهور عند الأطفال -in hyperloidy state - low blast count

Question 6

ALL phenotypes

Answer 6

B types: CD 10 , 19 , 20. ( indicted by 19 antibodies) T types : CD 2 to 8 ( indicted by 3) In both types: + tdt (terminal deoxynucleated transferase)

Question 7

Difference between B and T ALL ?

Answer 7

يختفلون بخمس نقاط 1- origin of cell 2-pathogenisis بالجزء الأول فقط 3- phenotyping 4-age 5-prognosis

Question 8

AML differ from ALL in which clinical feature ?

Answer 8

It has NO splenomegaly