Cytogenetics In ALL Flashcards
Numeric abnormalities
T/F: Hyperdiploidy with >50 chromosomes confers the worst prognosis
False —> most favorable
T/F: Hyperdiploidy with a chromosomal number between 47- 50 confers intermediate prognosis and is associated with T-ALL.
True
Diploidy (normal) with 46 chromosomes is associated with intermediate prognosis for ALL patients
True
Hypodiploidy confers the best prognosis, most of these patients have 45
chromosomes (chromosome 21 is commonly lost).
False —> worst, chromosome 20
Any case of ALL with a reciprocal translocation has a ___ prognosis with the exception of t (__; __)
Bad, 12; 21
Describe pseudodiploidy. Good or bad prognosis?
Normal number of chromosomes but with structural anomaly. Bad prognosis.
T/F: there’s a chance for curing ALL patients with reciprocal translocation (form of gene rearrangement)
False —> we don’t speak of a cure
In CML, ____ ____ positivity goes with a good prognosis.
Philadelphia chromosome
Identify the translocation:
Mostly associated with pro-B ALL
Associated with leukocytosis, splenomegaly and patients with congenital acute leukemia
Poor prognosis
t 4; 11
Identify the translocation:
Associated with precursor B-cell immunophenotype and older age
Characterized by leukocytosis and L2 morphology
t 9; 22
T/F: FISH a cytogenetic technique used to detect and localize the presence or absence of specific DNA sequences on chromosomes
True
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)
False —> t (12; 21)
T 8;14 T 8; 22 and T 2; 8 are associated with cases of ___ and ___ morphology, as well as translocation involving the ___ oncogene
B-ALL, L3, c-myc
What cell type are T 11; 14 and T 1; 14 associated with?
T cells
ALL in infants is clinically aggressive, frequently presenting with:
CNS leukemia, massive hepatosplenomegaly and high leukocyte levels
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
True: higher leukocyte count, worse prognosis
T/F: When a patient has CALLA +ve blasts and all other criteria are favorable, one can speak of cure by chemotherapy alone
True
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
True
Order the morphologic subgroups associated with best to worst prognosis
L1, L2, L3
Does platelet count affect prognosis?
Yes, thrombocytopenia is associates with poor prognosis
T/F: Periodic acid-Schiff stain (PAS) positive case is associated with a poor prognosis
False —> good prognosis
Molecular complete remission means?
No evidence of leukemia cells in the bone marrow is found, even when using very sensitive lab tests, such as PCR
Describe: minimal residual disease
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
T/F: for a patient to be in relapse, more than 5% of the bone marrow must be made up of blast cells
True
Identify the translocation:
Associated with Pre-B ALL and negative CD10 expression
Presence of heavy chains
Bad prognosis
t (1; 19)
