ALL - Acute Lymphoblastic Leukemia Flashcards
What MUST you know about acute lymphoblastic leukemia?
- Malignant proliferation of lymphoid blasts in blood, bone marrow
- Classified by immunophenotype (B vs. T)
- More common in children
- Prognosis often good!
How is ALL classified? What immunophenotype has a better prognosis?
- T-lymphoblastic leukemia
- B-lymphoblastic leukemia
- Better prognosis for B-lymphoblastic leukemia than T!!
What cells are malignant in acute lymphoblastic leukemia?
Lymphoid stem cells!
If a kid has leukemia. . .
. . .assume ALL until proven otherwise. (adults with ALL do a lot worse!)
What are common CD B-cell markers?
CD19, CD20, CD21
Where is TdT present?
Only on lymphoblasts!
What cell markers are on T-lymphoblastic leukemia?
TdT, T-cell Ag
What cell markers are on B-lymphoblastic leukemia?
TdT, B-cell Ag
What MUST you know about T-lymphoblastic leukemia?
= T-lymphoblastic lymphoma
- Teenage male with mediastinal mass
- WBC usually VERY HIGH
- Bad prognosis
What should a smudge or ghost cell in a slide make you think of?
Lymphoid lineage leukemia
What does a T-lymphoblastic leukemia look like?
- Many blast cells in the picture
- Some smudge/ghost cells
What do you need to know about B-Lymphoblastic Leukemia?
= B cell lymphoblastic lymphoma
- Several sub- and sub- subtypes
- TdT +
- Rarely, Ph + ! (Philidelphia chromosome - seen in chronic myeloid leukemia)
What is B lymphoblastic leukemia most common in?
CHILDREN
What factors help with the prognosis of ALL?
- Immunophenotype (T is bad)
- Age (1-10 good)
- WBC (
What is the treatment for ALL?
- Chemo +/- bone marrow transplant
- Many children are cured! (5 years without disease)
