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IHO Week 4 (MJ) > AML and MDS > Flashcards

AML and MDS Flashcards

1
Q

Characteristics of Acute Leukemia

A

Sudden onset
Adults or children
Rapidly fatal without treatment
Composed of immature cells (Blasts)

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2
Q

Characteristics of Chronic Leukemia

A

Slow onset
Only adults
Longer course
Composed of mature cells

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3
Q

Definition of leukemia?

A

malignant proliferation of immature myeloid or lymphoid cells in the bone marrow

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4
Q

Causes of leukemia

A

Clonal expansion

Maturation failure

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5
Q

Why is leukemia so bad?

A

It crowds out normal cells
Inhibits normal cell functions
Infiltrates other organs

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6
Q

Clinical findings in acute leukemia?

A

Sudden onset
Symptoms of bone marrow failure
Bone pain (expanding marrow)
Organ infiltration (liver, spleen, brain)

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7
Q

Signs of bone marrow failure

A

fatigue
infections
bleeding

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8
Q

lab findings in acute leukemia

A

blasts/immature cells in blood
Leukocytosis
Anemia
Thrombocytopenia

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9
Q

Acute Myeloid Leukemia

A

Malignant proliferation of myeloid blasts in blood, bone marrow
20% cutoff for diagnosis
subtypes
bad prognosis

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10
Q

What percentage of blood cells (off of total count) need to be blasts to diagnose AML?

A

20%

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11
Q

M0, M1, M2, M3

A

Involve neutrophilic series (myeloblasts, promyelocytes, etc.)

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12
Q

M4 and M5

A

involve monocytic series (monoblasts etc.)

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13
Q

M6

A

involves erythroid series (erythroblasts)

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14
Q

M7

A

involves megakaryocytic series (megakaryocytes)

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15
Q

What do you count as a blast in your 20% count?

A

anything with nucleus

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16
Q

immunophenotyping

A

flow cytometry for CD markers

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17
Q

Dysgranulopoiesis

A

Neutrophils don’t have enough lobes

Neutrophils don’t have granules in cytoplasm (instead of pink - clear or grey)

18
Q

Auer rods

A

ONLY IN MALIGNANT MYELOBLASTS

19
Q

Myeloperoxidase (MPO)

A

stains neutrophils

20
Q

Chloraceteate esterase

A

Neutrophil stain (blue)

21
Q

Non-specific esterase

A

Monocytes (red)

22
Q

AML-M0

A

Increased myeloblasts
“bland” blasts
MPO negative
Needs markers to diagnose

23
Q

AML-M1

A

Increased myeloblasts
No maturation
Auer rods
MPO positive

24
Q

AML-M2

A

Increased myeloblasts
Maturing neutrophils
t(8;21) in some cases

25
Q

AML-M3

A 
Increased PROMYELOCYTES (not blasts)
Faggot cells (many auer rods)
DIC
t(15;17) in all cases
26
Q

What is diagnostic for AML-M3

A

Faggot cells

27
Q

AML-M2 translocation

A

t(8;21)

28
Q

AML-M3 translocation

A

t(15;17)

29
Q

AML-M4 mutation?

A

inv(16)

30
Q

AML-M5

A

MONOCYTES
NSE positive
extramedullary tumor masses

31
Q

AML-M7

A

Megakaryoblasts

32
Q

AML with genetic abnormalities

A

t(8;21) better
t(15;17) better
inv(16) better

11q23 worse prognosis

33
Q

Which genetic abnormality has a worse prognosis?

A

11q23

34
Q

AML with FLT-3 mutation

A

FLT-3 is a tyrosine kinase
1/3 cases of AML
Monocytic cells
Poor prognosis

35
Q

AML with Multilineage Dysplasia

A

Elderly
Severe pancytopenia
Chromosome abnormalities (5 and 7)
Poor prognosis

36
Q

AML therapy related

A

from previous chemotherapy
2-5 years onset
VERY hard to treat

37
Q

Treatment of AML

A

Chemo

Bone marrow transplant

38
Q

Prognosis of AML

A

not great
t(8;21), inv(16)and t(15;17) are better
FLT-3, therapy worse

39
Q

Myelodysplastic Syndrome (MDS)

A

Problem: abnormal stem cells
dysmyelopoiesis
Maybe increased blasts
May evolve into acute leukemia

40
Q

Dysplasia looks like…

A

Red cells - megaloblastic nuclei, fragmentation
Neutrophils - hypogranulation, hyposegmentation
Megakaryocytes - small, non=lobulated cells

41
Q

Clinical and lab findings MDS

A

older patients
asymptomatic
BM failure
macrocytic anemia

42
Q

Treatment and prognosis of MDS

A

Low grade: support and follow

High grade: be more aggressive

IHO Week 4 (MJ) (10 decks)

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