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TT DD ex 3 and BL ex 2 > Cancer stuffs - Acute leukemias > Flashcards

Cancer stuffs - Acute leukemias Flashcards

1
Q

Two types of acute leukemias

A
  1. Acute myeloid leukemia (AML)

2. Acute lymphoblastic leukemia (ALL)

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2
Q

3 different types of Acute Myeloid Leukimias (AML)

A
  1. Congenital
  2. Therapeutic-AML
  3. NOS
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3
Q

General signs/symptoms of Acute leukemias

A
  1. anemia: fatigue, malaise, pallor
  2. thrombocytopenia: bruising, petichiae, hemorrhage
  3. neutropenia: fever, recurrent infxn
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4
Q

What is the general blast marker used to diagnose Acute Leukemias?

A

CD34

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5
Q

General characteristics of AML

  • severity
  • target population
  • common markers
A
  • progressive
  • 90% of AML occurs in adults
  • Common blast marker: CD34
  • common myeloid markers: CD117, myeloperoxidase
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6
Q

General characteristics of ALL

  • severity
  • target population
  • common markers
A
  • disease “explodes”: rapidly fatal w/o treatment
  • 75% of ALL occurs in children <6
  • Common blast marker: CD34
  • common lymphoblast marker: tdt
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7
Q

5 Different types of Congenital AML

A
  1. RUNX1-RUNX1
  2. CBFB-MYH11
  3. PML-RARA
  4. RBM1-MLK1
  5. MLL
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8
Q

General risk factors of acute leukemias

A
  1. translocations
  2. previous chemo: alk agents, topo II inhib.
  3. previous exposure of active marrow to ioniz rad.
  4. tobacco smoke
  5. benzene exposure
  6. genetics
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9
Q

Different types of T-AML

A

(therapeutic)

  1. Alkylating agent or ionizing radiation
  2. Topo II inhib.
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10
Q

Different types of NOS AML

A

Ones with these mutations:

  1. FLT3
  2. NPM1
  3. CEBPA
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11
Q

Different types of ALL

A
  1. B-ALL

2. T-ALL

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12
Q

RUNX1-RUNX1 genetic translocation/mutation

A

t(8;21)

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13
Q

CBFB genetic translocation/mutation

A

t(16;16) or inv(16)

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14
Q

PML-RARA genetic translocation/mutation

A

t(15;17)

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15
Q

RBM15-MLK1 genetic translocation/mutation

A

t(1;22)

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16
Q

AML Congenital MLL genetic translocation/mutation

A

11q23

17
Q

T-AML genetic translocation/mutations

A

For alylating agent or radiation:
- whole/partial loss of ch 5 and/or 7

For topo II inhib
- often MLL (11q23) gene

18
Q

AML NOS genetic translocation/mutation

A

These mutations:
FLT3 (ITD)
NPM1
CEBPA

19
Q

BCR-ABL genetic translocation/mutation

A

t(9;22) p190

20
Q

ALL - B-ALL - MLLgenetic translocation/mutation

A

11q23

21
Q

ETV6-RUNX1 genetic translocation/mutation

A

t(12;21)

22
Q

T-ALL:

  • % of ALL
  • common markers
A

20-25% of ALL

general blast marker: CD34
common lymphoblast marker: tdt
t cell markers: CD3, CD7

23
Q

B-ALL:

  • % of ALL
  • common markers
A

80-85% of ALL

general blast marker: CD34
common lymphoblast marker: tdt
B cell markers: CD19, CD22
- lack CD20 (of mature B cells like in Non-Hodgkin)

24
Q

Prognosis of Congenital AML:

  1. RUNX1-RUNX1
  2. CBFB-MYH11
  3. RBM1-MLK1
  4. MLL
A
  1. RUNX1-RUNX1 - Good
  2. CBFB-MYH11 - Good
  3. RBM1-MLK1 - Good
  4. MLL - Poor
25
Q

Prognosis of:

  • T-AML
  • FLT3
  • NPM1
  • CEBPA
A
  • T-AML:
    Very poor
    (luckily its only 10-20% of AML)
  • FLT3: very poor
  • NPM1 : good (if FLT3 not present)
  • CEBPA: good (if FLT3 not present)
26
Q

Alkylating agents/radiation are types of T-AML that progress to AML via which cancer?

A

MDS

27
Q

Prognosis of B-ALL:
BCR-ABL
MLL
ETV6-RUNX1

A

BCR-ABL: worst of all ALL
MLL: poor
ETV6-RUNX1: very favorable

28
Q

Prognosis of T-ALL

A

Good
Kids: 95% cure, 100% remission
Adults: 50% cure, 60-80% remission

29
Q

What does RUNX1 code for?

A

alpha subunit of CBF txn factor

30
Q

What does CBFB code for?

A

beta subunit of CBF txn factor

31
Q

What type of cells are you likely to see in CBFB-MYH11?

A

baso-eos

- immature eosinophils w/ baso granules

32
Q

What type of cells are you likely to see in PML-RARA?

A

hypergranular cells

multiple auer rods

33
Q

What type of cells are you likely to see in RBM15-MLK1

A

megakaryoblastic differentiation

34
Q

What type of cells are you likely to see in Congenital AML MLL?

A

monocytic differentiation

35
Q

Which AML is more likely to be seen in pts with Down Syndrome?

A

RBM15-MLK1

36
Q

Which AML is more likely to be at risk for DIC? How do you treat it?

A

PML-RARA (APL)

treat w/ ATRA

37
Q

BCR-ABL B-ALL vs MLL B-ALL ivs T-ALL in patient populations

A

BCR-ABL: more common in adults
MLL: more common in neonates/infants
T-ALL: more common in males, adolescents/young adults

38
Q

Which cancer is more likely to present with a mediastinal mass?

A

T-ALL

TT DD ex 3 and BL ex 2 (21 decks)

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