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Oncology Exam 2 > AML/ALL Other > Flashcards

AML/ALL Other Flashcards

1
Q

What is the most common cause of cancer in children?

A

Acute leukemia

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2
Q

T/F complete remission is higher in adult patients with acute leukemias than children

A

False!

>85% CR in children/young adults

65-85% in adults

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3
Q

Does AML or ALL have more estimated new cases?

A

AML

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4
Q

Does AML or ALL have more estimated deaths?

A

AML

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5
Q

T/F in acute leukemia cells continue to differentiate

A

False!

Do not continue to differentiate

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6
Q

T/F ALL has a higher survival rate in pediatrics and adults compared to AML

A

TRUE!

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7
Q

Etiology of acute leukemias

A

- most times don’t know!

  • Genetic conditions
  • Socioeconomic
  • Immunologic factors
  • Environmental exposure
  • Toxins (
  • Family history (high birth rate?)
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8
Q

What is the median age of diagnosis of ALL?

A

10 years

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9
Q

What is the median age of AML?

A

67 years

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10
Q

T/F leukemia is more common in females

A

False!

Males

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11
Q

T/F ALL has a higher incidence in caucasians

A

True

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12
Q

In acute leukemia diagnosis what blast % will they have?

What is a normal blast %?

A

>20% - leukemia

<5% - normal

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13
Q

S/S of acute leukemia

A
  • anemia
  • thrombocytopenia
  • neutorpenia
  • CNS (seizures, HA, visual disturbances)
  • gingival hyperplasia
  • bone pain
  • extra-medullary disease (leukemia cutis, chloromas)
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14
Q

S/S of anemia in acute leukemia

A

fatigue

malaise

CNS

cardiac

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15
Q

S/S of thrombocytopenia in acute leukemia

A

bleeding

bruising

petechiae

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16
Q

S/S of neutropenia in acute leukemia

A

infection

fever

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17
Q

What labs should you get to diagnose acute leukemia?

A
  • CBC with differential
  • Uric acid, K, P, SCr
  • Peripheral blood smear (blasts)
  • Coagulation studies
  • Bone marrow biopsy
  • Cytogenetic analysis
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18
Q

What is the main goal of treatment in acute leukemia?

A

Cure!

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19
Q

What are the 3 things needed to achieve complete remission in acute leukemias?

A
  1. < 5% blasts in bone marrow
  2. Recovery of platelets to > 100,000
  3. Recovery of ANC >1500
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20
Q

What are all the goals of treatment for acute leukemias

A
  1. cure
  2. rapidly achieve CR
  3. maintain CR- prevent recurrence
  4. minimize toxicity
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21
Q

What is treatment based on in AML?

A

risk of relapse

22
Q

T/F if you have features associated with a good response in AML you would give a more intensive chemotherapy regimen

A

False!

good response: less chemo

poor response: more chemo

23
Q

Goal of remission induction in AML

A

attain complete remission

  • restore normal hematopoesis
24
Q

How do you look for residual disease after induction in AML?

A

look at bone marrow

empty: no further treatment

25
Q

What is pancytopenia comprised of?

A
  1. neutropenia: ~30 days
  2. anemia
  3. thrombocytopenia
26
Q

T/F you premedicate with gemtuzumab

A

True!

APAP, benadryl, methylpred

  • risk of infusion reaction
27
Q

What is Vyxeos?

A

liposomal cytarabine + daunorubicin

28
Q

Which drug contains copper and monitor for toxicity?

What is it used to treat?

A

Vyxeos for AML

29
Q

What drug class do you use to treat > 60 year olds with AML?

A

hypomethylating agents

30
Q

What are the 2 hypomethylating agents used to treat AML?

A

Decitabine

Azacitidine

31
Q

What is venetoclax target?

A

BCL-2 protein

32
Q

Goal of consolidation in AML

A

achieve durable remission

33
Q

In AML who do you use HSCT for?

A

poor-risk cytogenetics if chance of cure

relapse

34
Q

T/F the risk of AML relapse is related to duration of 1st remission

A

true

35
Q

T/F APL has a poor prognosis

A

False!

Good prognosis!

36
Q

What is APL characterized by?

A

severe coagulopathies

37
Q

S/S of APL differentiation syndrome

A

fever

respiratory distress

interstitial pulm infiltrates

pleural effusions

weight gain

DEATH

38
Q

How can you prevent or treat APL differentiation syndrome?

A

Dexamethasone

39
Q

What do you monitor when taking arsenic (ATO)?

A

K and Mg

  • risk of QT prolongation
40
Q

T/F B cell ALL is less common than T cell ALL

A

False

B cell more common

41
Q

T/F CNS involvement is more common in AML than ALL

A

False!

More common in ALL

42
Q

What are the risk features associated with relapse in ALL?

A
  • WBC > 50,000
  • chromosome abnormalities (Ph+, t(4;11)
  • < 1 yo; > 10 yo
  • extra-medullary involvement
  • no remission within 4 weeks of tx
  • male
43
Q

Which drugs are used intrathecally for CNS issues in ALL?

A

MTX

Cytarabine

Hydrocortisone

**NOT vincristine**

44
Q

T/F you only do CNS prophylaxis in ALL treatment during induction

A

False

Due during remission induction and consolidation/intensification

45
Q

Goal of induction in ALL

A

reduce tumor burden

46
Q

Goal of consolidation in ALL

A

eliminate leukemic cells remaining after induction

47
Q

Goal of maintenance therapy in ALL

A

prevent disease relapse after post remission induction and consolidation

48
Q

What are CALGB 811 and Hyper-CVAD used for?

A

ALL

49
Q

T/F CART can be used in ALL

A

True

50
Q

What is used in standard induction in pediatric ALL?

A

Vincristine

Prednisone/dexameth

asparginase/PEG/asp

51
Q

What is added to high risk induction in pediatric ALL?

A

daunorubicin

Oncology Exam 2 (5 decks)

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