Chronic Leukemias

Question 1

Two Types of Chronic Leukemias

Answer 1

1. Chronic Lymphocytic Leukemia
2. Chronic Myeloid Leukemia

Question 2

Chronic Myeloid Leukemia Definition

Answer 2

clonal expansions of myeloid cells in bone marrow, blood, or tissues

Question 3

CML Translocation

Answer 3

• Translocation occurs between Chromosome 9 (ABL) and Chromosome 22 (BCR)

Question 4

Translocation of t(9;22)

Answer 4

• piece of Chromosome 9 breaks off and attaches itself to chromosome 22
• shortening of Chromosome 22

Question 5

Philadelphia Chromosome

Answer 5

• translocation results in a shorter chromosome 22
• t(9;22) results in activation of ABL - tyrosine kinase

Question 6

ABL Tyrosine Kinase

Answer 6

activation results in abnormal cell divisions and inhibits apoptosis

OVERPRODUCTION OF MYELOID CELLS

Question 7

CML Diagnosis

Answer 7

FISH “Fluorescence In Situ Hybriziation

Question 8

CML Symptoms

Answer 8

• Leukocytosis
• Normocrhomic Anemia
  -Hypercellularity in Bone Marrow
• Splenomegaly due to spleen trying to deal with overproduction in vascular

Question 9

Treatment of CML

Answer 9

Tyrosine Kinase Inhibitor - Gleevec

Question 10

CLL Typical Treatment

Answer 10

Rituximab (Anti-CD20)

Question 11

Rituximab

Answer 11

Binds to CD20 on B cells and allows for stimulation of the immune system to recognize the marked B cells as targets for destruction
- Apoptosis, Complement-Dependent Cytotoxicity

Question 12

Idelalisib and Ibrutinib

Answer 12

B cells constantly have to be stimulated for survival
- blocking of signaling leading to death of B cells

Question 13

CAR-T

Answer 13

• take out T cells from patient
• add specific CAR ‘modification’ that allows T cells to attack cancer cels