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Ch16 Leukemia Flashcards

0
Q

A rapidly progressive disease characterized by an abnormal expansion of immature cells or blasts can be defined as:

A

Acute leukemia

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1
Q

What is the name of a malignant disease of hematopoietic tissue characterized by replacement of normal BM elements with abnormal (neoplastic) blood cells.?

A

Leukemia

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2
Q

Slowly progressive disorder characterized by an abnormal expansion of mature cells

A

Chronic leukemia

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3
Q

Name the 2 major cell types of leukemia

A

Myelogenous and lymphocytic

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4
Q

More than 50% of leukemia cases occur in adults:

A

Over the age of 64

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5
Q

What are the most frequently seen adult cases of leukemia

A

Acute myeloid leukemia (AML)

Chronic lymphocytic leukemia (CLL)

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6
Q

What is the most frequently seen type of children leukemia?

A

Acute lymphoblastic leukemia (ALL)

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7
Q

What is a characteristic of acute leukemia?

A

Loss of BM function as well as anemia

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8
Q

Name a characteristic of chronic leukemia

A

Increased WBC count

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9
Q

Characteristics acute and chronic leukemia share

A

Enlarged spleen ( usually more pronounced in chronic)

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10
Q

What is the current survival rate of children leukemia?

A

> 30 years

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11
Q

What seems to be the cause/origin of leukemia?

A

Altered expression of oncogenes and tumor suppressor genes

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12
Q

What is the function of oncogenes?

A

To regulate cell proliferation and differentiation

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13
Q

If malignant cells are immature leukemia is said to be:

A

Acute

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14
Q

When the malignant cells are predominately mature cells leukemia is said to be:

A

Chronic

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15
Q

The term myeloid encompasses what type of leukemia?

A

Granulocytic
Monocytic
Megakaryocytic
Erythrocytic

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16
Q

What percentage of acute leukemia is seen in children

A

75%

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17
Q

What is the most common type of leukemia in adults?

A

AML - 80%

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18
Q

Name some initial symptoms of acute leukemia

A

Weakness
Bleeding abnormalities
Flu-like symptoms

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19
Q

A tumor or mass of myeloid cells outside of the marrow defines what?

A

A myeloid or granulocytes sarcoma

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20
Q

What is primarily seen in acute monoblastic leukemia?

A

Gingival-hypertrophy and oral lesions

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21
Q

What is a hallmark of precursor T-ALL?

A

Mediastinal mass from thy mic involvement

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22
Q

Leukemia lab test help by:

A

Determine prognosis
Guide therapy
Distinguish AML and ALL

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23
Q

Primary evaluations from acute leukemia include:

A

CBC, w/ WBC differential, and peripheral blood cell evaluation
Platelet count

24
Acute leukemia lab results show:
``` Anemia - mild to severe Platelet count decreased WBC - very low to very high Blood smear - blasts or other immature cells Nucleated RBC - occasional ```
25
What follow up exam is expected to further diagnosis of leukemia?
BM aspirates
26
WHO classified acute leukemia to require a min blast of ____ in the peripheral blood
20%
27
What flow marker is present in most cases of ALL but rarely expressed in AML?
Nuclear enzyme terminal deoxynucleotidyl transferase (TdT)
28
Name lab studies that identify the specific genetic abnormalities seen in malignant blast cells
Karyotyping | Molecular genetic studies - FISH, PCR
29
Patients with 38 instead of 46 chromosomes
Hyopdiploidy- acute leukemia, poor diagnosis
30
Where are auer rods seen?
Granulocytes series, not in ALL
31
Cytoplasmic inclusions that result from an abnormal fusion of primary granules and are pathognomic for myeloifproliferation process are called what?
Auer rods
32
Sudan black B stain indicated what?
Myeloid differentiation
33
What test is used to diagnose if peroxidase Is present in the primary granules of myeloid cells
Myeloperoxidase (MPO)
34
What does Sudan black B stain?
Phospholipids Neutral fats Sterols
35
What are the 2 techniques used to detect antigens
Flow cytometry | Immunhistochemestry
36
Proteins on the cell membrane which can be used for flow cytometry and immunohistochemistry
Cell surface markers
37
Why use cell surface markers?
Used to tell cell lineage and maturation stage
38
What marker is very useful in assessing cell lineage in ALL?
Cytoplasmic markers
39
A unique nuclear enzyme (DNA polymerase) present in stem cells and precursor B and T lymphoid cells
TdT
40
Positive TdT is what leukemia?
ALL
41
What is an essential component in the evaluation of newly diagnosed leukemia?
Cytogenetic analysis of leukemic cells
42
Cytogenetic analysis of leukemic cells plays a major role in:
``` Diagnosis Subclassification Prognosis Therapy guide Monitoring effects of therapy ```
43
What chromosomal abnormalities have been associated with acute promyelocytic leukemia?
(15:17)
44
What is the difference in the classification of the acute leukemias between WHO and FAB?
Who says 20% blasts for diagnosis | FAB says 35% blasts to be AML
45
WHO classification incorporates ____ major categories for acute myeloid leukemia
5
46
What are the categories for acute myeloid leukemia?
``` Recurrent genetic abnormalities Multilineage dysplasia Myeloidysplastic syndrome AML - not otherwise categorized Ambiguous lineage ```
47
About _____ of newly diagnoses children with ALL can be cured
80%
48
WHO classifies what type of leukemia on whether the lymphoblastic leukemia is a precursor B or a precursor T cell lineage?
ALL
49
The stages of B-cell maturation can be identified by what?
TdT Surface markers Immunoglobulin
50
How are t-cells identified and subclassed?
By using immunologic reagents
51
Characteristics of Burkitts leukemia
Lack immunophenotypic characters of an early B-cell, mainly TdT is negative
52
Which type of leukemia is due Tia translocation involving a rearrangement of an oncogene between a couple different chromosomes?
Burkitts leukemia
53
What is the main goal in treating acute leukemia?
Poison and kill the dividing cells, usually by blocking DNA or RNA synthesis
54
What cytochemical stain is best for differentiating AML from ALL
Myeloperoxidase
55
How many blast cells in a bone marrow aspirates smear are necessary for a diagnosis of acute leukemia using FAB criteria?
30%
56
How many blast cells in a bone marrow aspirates smear are necessary for a diagnosis of acute leukemia using WHO criteria?
20%
57
Which cytochemical stain is useful in separating myelin last from monoblasts?
Nonspecific esterase

Hematology (10 decks)

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