EXAM #3: ACUTE LEUKEMIA

Question 1

What are the myeloid cell lines?

Answer 1

Granulocytes
Monocytes
Erythrocytes
Megakaryocytes

Question 2

What are the lymphoid cell lines?

Answer 2

B-cells

T-cells

Question 3

What are the tools used to diagnose leukemia?

Answer 3

• PBS

- Bone marrow

Question 4

What patient population is AML most common in?

Answer 4

Males over 65 years-old

Question 5

What patient population is ALL most common is?

Answer 5

Children

Question 6

What is the most important genetic association with acute leukemia?

Answer 6

Trisomy 21 (Down’s Syndrome)

Question 7

What is the old name for MDS?

Answer 7

“Pre-Leukemia”

Question 8

What exposures can cause MDS?

Answer 8

1) Benzene
2) Radiation therapy
3) Tobacco
4) Chemotherapy–alkylating agents

Question 9

What patient population is CML most common in?

Answer 9

Males over 65 years-old

Question 10

What is the most common form of Leukemia in adults?

Answer 10

CLL

Question 11

What are the symptoms associated with Acute Leukemia?

Answer 11

• Fatigue
• Pallor
• Weakness
• Bone pain
• Anemia
• Neutropenia

Question 12

What is Sweet’s Syndrome?

Answer 12

Acute febrile netrophilic dermatosis

Question 13

Is organomegaly common in AML?

Answer 13

NO

Question 14

What is a Myeloid Sarcoma?

Answer 14

AML with extra-medullary disease

Question 15

What is APL?

Answer 15

Acute Progranulocytic Leukemia

Question 16

What is an Auer Rod?

Answer 16

Fused lysozomes and neutrophilic granules

Question 17

What are Auer Rods pathognomonic for?

Answer 17

AML

Question 18

What is Leukemia Cutis?

Answer 18

Leukemia in the skin (AML)

Question 19

What is pathognomonic for Acute Monocytic Leukemia?

Answer 19

Gingival hypertrophy/ hyperplasia

Question 20

How is Leukemia diagnosed?

Answer 20

BM aspiration from Posterior Iliac Crest (PIC)

Question 21

What is the trend in terms of death with AML therapy and advancing age/ ECOG score?

Answer 21

Death with therapy approaches 60% with a ECOG score of 3 and older than 69

Question 22

What has to happen to the bone marrow in treatment of AML?

Answer 22

Bone Marrow elimiation

Question 23

What is the standard induction plan for AML treatment?

Answer 23

7+3

**7x days of three chemotheraputic drugs that results in elimination of the bone marrow

Question 24

What follows up standard induction therapy for AML?

Answer 24

Consolidation therapy

Question 25

What is the exception to standard induction and consolidation therapy?

Answer 25

APL

Question 26

What are the supportive measures for AML induction?

Answer 26

1) Irradiated RBCs
2) Prophylactic antibiotics
3) Growth factors (GM-CSF)
4) HEPA rooms
5) Low microbial diets

Question 27

What is a HEPA room?

Answer 27

High positive pressure air flow rooms

Question 28

What are the side effects of tumor induction in AML?

Answer 28

Tumor-lysis syndrome (hyperuriciemia)

Question 29

What genetic translocation causes APL?

Answer 29

t(15:17)

- RARR translocation

Question 30

What is the treatment for APL?

Answer 30

ATRA i.e. all trans retinoic acid

Question 31

What are the major side effects of APL?

Answer 31

1) APL Differentiation Syndrome/ Retinoic Acid Syndrome

2) DIC

Question 32

What is the prognosis for ALL in those over 35 years-old?

Answer 32

Bad

Question 33

What group of patients with ALL normally gets a Bone Marrow Transplant?

Answer 33

Adults

Question 34

What is the presentation for CML?

Answer 34

1) Bleeding
2) Fatigue
3) Fever
4) Frequency infection
5) Weight loss
6) Anorexia
7) LUQ pain
8) Night sweats

Question 35

Who argued that specific gene translocations caused specific diseases?

Answer 35

Jane Rowley, MD

Question 36

What did Jane Rowley, MD describe?

Answer 36

t(9:22) in CML

Question 37

What did the t(9:22) translation create?

Answer 37

BCR-ABL fusion gene coding for a constitutively active tyrosine kinase

Question 38

What is the major drug used to treat CML?

Answer 38

Imatinib/ Gleevec