B3.038 - Big Case Leukemia Flashcards
APL is frequently associated with what
DIC
what is diagnostic for acute leukemia
>20% blasts in bone marrow
what are the bone marrow pathological findings of ALL and AML
increased cellularity increased blasts
what is acute leukemia
neoplasm derived from prefcursor hematopoietic cells iwht proliferation and accumulation of immature (blast )cells aka proliferation without maturation
Variably hypercellular, megakaryocytic predominancy
mild or no fibrosis
ET
Markedly hypercellular, granulocyte predominance, blasts <10%, Mild fibrosis
CML
Acute Promyelocytic Leukemia translocation
t(15;17) Disrupts retinoic acid receptor (RAR-alpha) gene
ALL favorable prognostic features
Precursor B-ALL 4-10 yo <10,000 WBC hyperdiploidy, t(12;21)
Etiologic associations of leukemias
Trisomy 21 radiation exposure to alkylating agents, topoisomerase II inhibitors, primarily AML Immunodeficiency states other stem cell hematologic disorders
Hypercellular, mostly granulocytic and megakaryocytic
Reticulin and collagenous fibrosis and osteosclerosis
PMF
what are blood pathologic findings of AML and ALL
anemia nuetropenia thrombocytopenia circulating blasts
what is the most common cancer in children
ALL
how do you diagnose AML
>20% blasts in bone marrow myeloperoxidase + TdT- CD34+ CD13+ CD33+ CD117+
can AML turn into myeloproliferative neoplasms
no
why is hyperdiploidy favorable for ALL
specific types of chromosomes get repeated that help pt
what are these
schistocytes
Markedly hypercellular with erythroid predominance, increased and clustered megakaryocytes
Decreased or absent Iron
mild to moderate fibrosis
PV
when can lymphoid neoplasms occur
any point bc lymphoid cells live a long time and change/reproduce
what does acute promyelocytic leukemia looks like
abnormal promyelocyte like cells with multiple auer rods
AML has morphologic/functional similarity to
myeloid cell lines
what is used to treat APL
All trans retinoic acid
what are these and what are they associated with
Auer rods, with AML diagnostic
what is cellularity
amount of bone marrow occupied by cells as opposed to fat
what are clinical findings of ALL
bone marrow insufficiency Bone pain Hepatosplenomegaly Lymphadenopathy
What are auer rods diagnostic for
AML
describe acute leukemias
primarily immature cells untreated will rapidly progess and be fatal in weeks to montsh
ALL/LBL epidemiology
Most common cancer of childhood mostly B cell cancer and second peak after 50
when can myeloid neoplasms occur
in the blast stage
cell division is required for what
neoplasms to be produced
ALL unfavorable prognostic features
T-ALL <2>10 y >10,000 WBCs organomegaly t(4;11), t(9;22)
what is myeloperoxidase important in
enzyme important in granulocytic function and killing bacteria
what is the goal of induction therapy and what is it
usually multi agent chemo produce complete remission
PV
describe chronic leukemias
primarily mature or maturing cells untreated will take weeks to moths to progress
how do you diagnose B-ALL
TdT+ Myeloperoxidase - CD10+ CD19+
what are unfavorable features of AML prognosis
age >60 WBC >100,000 prior myelodysplastic syndrom
auer rods are what
concentrations of pirmary granules, only in myeloid lineage blasts
what are clinical findings of AML
bone marrow insufficiency hepatosplenomegaly
ALL/LBL
B lymphoblastic leukemia/lymphoma T-lymphoblastic leukemia/lymphoma
TdT is expressed by what
immature lymphoid cells
can myeloproliferateive neoplasms turn into AML
yes
what is post induction therapy
goal is long term disease free survival
PMF
aggregates of mast cells
positive for metachromatic stains
Mastocytosis
which is worse AML or myeloproliferateive neoplasm
AML
T-ALL diagnostics
TdT+ Myeloperoxidase - CD2+ CD3+ CD5+
why dont you have lypmphadenopathy in AML
you dont have myeloid cells going to lymph nodes
AML epidemiology
incidence increases steadily through adult life
CML
Favorable features of AML prognosis
t(15;17) t(8;21)
CML
