Childhood Cancer: Leukemia Flashcards
What are the two types of blood stem cells?
1) Myeloid stem cells
2) Lymphoid stem cells
Which type of blood stem cells are “all about survival” (make RBC’s and platelets)?
Myeloid
Which type of blood stem cells make B, T, and Natural Killer cells?
Lymphoids
What are the types of white blood cells and from which stem cells do they derive from?
1) Granulocytes (eosinophils, basophils, neutrophils): from myeloblasts (a myeloid stem cell)
2) B cells: from lymphoblasts (a lymphoid stem cell)
3) T cells: from lymphoblasts
4) Natural killer cells (from lymphoblasts)
What type of leukemia affects myeloblast cells?
Acute myeloblastic leukemia
How does myeloblastic leukemia kill?
It overproduces myeloblastic cells, squeezing out RBC’s
What type of leukemia affects lymphoblasts?
Acute lymphoblastic leukemia
How does ALL kill?
Overproduces lymphoblasts in the bone marrow that never mature into B or T cells; they eventually squeeze out RBCs (causing suffocation).
What are the key features of ALL from lymphoblast slides?
1) Bright purple
2) Can barely see the cytosol
What are the key features of AML from myeloblast slides?
1) Big, purple nuclei with a lot of cytosol wrapping around them.
What is the treatment for ALL?
1) Chemotherapy until remission (Induction, Consolidation, Maintenance)
2) BMT if there is a severe relapse (kids usually don’t need a BMT transplant)
True or false: ALL is less common and harder to treat than AML.
False; AML is less common and harder to treat than ALL.
What is the cure rate of ALL?
98%
True or false: radiation is used to treat ALL.
False (radiation is targeted)
What is the treatment for AML?
1) Chemotherapy until remission
2) BMT (kids usually don’t need BMT)
What is the most common age group for ALL?
3-5 y/o
What is the most common age group for AML?
All ages
What is the long-term remission rate for AML?
60-70%
True or false: ALL is most common in white boys (3-5 y/o).
True
What are the symptoms of leukemia?
1) Fatigue
2) Pale skin
3) Infections and fever
4) Easy bleeding or bruising
5) Bone or joint pain
6) Swelling of abdomen
7) Loss of appetite/weight-loss
8) Swollen lymph nodes
9) Coughing and trouble breathing
10) Swelling of face and arms
11) Rashes and gum problems
What are the steps in diagnosing leukemia?
1) Blood count
2) If increased WBC’s, wait 2 weeks, then do a second blood count.
3) If increased WBC’s again, tap and culture the marrow, looking for either lymphoblasts or myeloblasts dominating
Which ALL risk group is most sensitive to chemotherapy? Where does their leukemia originate?
Standard risk group (ages 0-10); originates in B-Cell lymphoblasts
What characterizes the ALL high risk group?
1) Over 10 y/o
2) have leukocytes in CSF
3) Originates in B and T cell lymphoblasts
4) Increased risk of relapse
What are the three phases of treatment for both AML and ALL?
1) Induction: initial 1 mo of treatment (massive kill-off)
2) Consolidation: 1-2 mo; really intense dose (“the hammer”); longer and more intense than induction, tries to kill off everything left behind
3) Maintenance: 1-2 years long, out-patient, steady treatment
What is the purpose of the induction phase of treatment?
Send leukemia into remission (massive kill-off)
What is the purpose of the consolidation phase of treatment?
To kill off everything left behind and prevent treatment resistant cancer from arising
