Cytogenetics In ALL

Question 1

Numeric abnormalities

T/F: Hyperdiploidy with >50 chromosomes confers the worst prognosis

Answer 1

False —> most favorable

Question 2

T/F: Hyperdiploidy with a chromosomal number between 47- 50 confers intermediate prognosis and is associated with T-ALL.

Answer 2

True

Question 3

Diploidy (normal) with 46 chromosomes is associated with intermediate prognosis for ALL patients

Answer 3

True

Question 4

Hypodiploidy confers the best prognosis, most of these patients have 45
chromosomes (chromosome 21 is commonly lost).

Answer 4

False —> worst, chromosome 20

Question 5

Any case of ALL with a reciprocal translocation has a ___ prognosis with the exception of t (__; __)

Answer 5

Bad, 12; 21

Question 6

Describe pseudodiploidy. Good or bad prognosis?

Answer 6

Normal number of chromosomes but with structural anomaly. Bad prognosis.

Question 7

T/F: there’s a chance for curing ALL patients with reciprocal translocation (form of gene rearrangement)

Answer 7

False —> we don’t speak of a cure

Question 8

In CML, ____ ____ positivity goes with a good prognosis.

Answer 8

Philadelphia chromosome

Question 9

Identify the translocation:
Mostly associated with pro-B ALL
Associated with leukocytosis, splenomegaly and patients with congenital acute leukemia
Poor prognosis

Answer 9

t 4; 11

Question 10

Identify the translocation:
Associated with precursor B-cell immunophenotype and older age
Characterized by leukocytosis and L2 morphology

Answer 10

t 9; 22

Question 11

T/F: FISH a cytogenetic technique used to detect and localize the presence or absence of specific DNA sequences on chromosomes

Answer 11

True

Question 12

T/F: FISH and PCR are used to detect abnormalities that cannot be detected with regular cytogenetic studies like in the case of t (9; 22)

Answer 12

False —> t (12; 21)

Question 13

T 8;14 T 8; 22 and T 2; 8 are associated with cases of ___ and ___ morphology, as well as translocation involving the ___ oncogene

Answer 13

B-ALL, L3, c-myc

Question 14

What cell type are T 11; 14 and T 1; 14 associated with?

Answer 14

T cells

Question 15

ALL in infants is clinically aggressive, frequently presenting with:

Answer 15

CNS leukemia, massive hepatosplenomegaly and high leukocyte levels

Question 16

T/F: if the P.B. count of WBC is > or equal to 50,000/mm3 it indicates bad prognosis with heavy infiltration, but of the P.B count of WBC is < 20,000/mm3 = good prognosis

Answer 16

True: higher leukocyte count, worse prognosis

Question 17

T/F: When a patient has CALLA +ve blasts and all other criteria are favorable, one can speak of cure by chemotherapy alone

Answer 17

True

Question 18

T/F: this is the following overall order of favorable prognosis:
CALL (pre pre B), pre-B ALL, pro B-ALL, T-ALL and B-ALL

Answer 18

True

Question 19

Order the morphologic subgroups associated with best to worst prognosis

Answer 19

L1, L2, L3

Question 20

Does platelet count affect prognosis?

Answer 20

Yes, thrombocytopenia is associates with poor prognosis

Question 21

T/F: Periodic acid-Schiff stain (PAS) positive case is associated with a poor prognosis

Answer 21

False —> good prognosis

Question 22

Molecular complete remission means?

Answer 22

No evidence of leukemia cells in the bone marrow is found, even when using very sensitive lab tests, such as PCR

Question 23

Describe: minimal residual disease

Answer 23

A term used after treatment when leukemia cells can’t be found in the bone marrow using standard lab tests (such as looking at cells under a microscope), but they can still be detected with more sensitive tests (such as flow cytometry or PCR). Patients with MRD after treatment are more likely to have the leukemia relapse

Question 24

T/F: for a patient to be in relapse, more than 5% of the bone marrow must be made up of blast cells

Answer 24

True

Question 25

Identify the translocation:
Associated with Pre-B ALL and negative CD10 expression
Presence of heavy chains
Bad prognosis

Answer 25

t (1; 19)