EXAM #3: ACUTE LEUKEMIA Flashcards
What are the myeloid cell lines?
Granulocytes
Monocytes
Erythrocytes
Megakaryocytes
What are the lymphoid cell lines?
B-cells
T-cells
What are the tools used to diagnose leukemia?
- PBS
- Bone marrow
What patient population is AML most common in?
Males over 65 years-old
What patient population is ALL most common is?
Children
What is the most important genetic association with acute leukemia?
Trisomy 21 (Down’s Syndrome)
What is the old name for MDS?
“Pre-Leukemia”
What exposures can cause MDS?
1) Benzene
2) Radiation therapy
3) Tobacco
4) Chemotherapy–alkylating agents
What patient population is CML most common in?
Males over 65 years-old
What is the most common form of Leukemia in adults?
CLL
What are the symptoms associated with Acute Leukemia?
- Fatigue
- Pallor
- Weakness
- Bone pain
- Anemia
- Neutropenia
What is Sweet’s Syndrome?
Acute febrile netrophilic dermatosis
Is organomegaly common in AML?
NO
What is a Myeloid Sarcoma?
AML with extra-medullary disease
What is APL?
Acute Progranulocytic Leukemia
What is an Auer Rod?
Fused lysozomes and neutrophilic granules
What are Auer Rods pathognomonic for?
AML
What is Leukemia Cutis?
Leukemia in the skin (AML)
What is pathognomonic for Acute Monocytic Leukemia?
Gingival hypertrophy/ hyperplasia
How is Leukemia diagnosed?
BM aspiration from Posterior Iliac Crest (PIC)
What is the trend in terms of death with AML therapy and advancing age/ ECOG score?
Death with therapy approaches 60% with a ECOG score of 3 and older than 69
What has to happen to the bone marrow in treatment of AML?
Bone Marrow elimiation
What is the standard induction plan for AML treatment?
7+3
**7x days of three chemotheraputic drugs that results in elimination of the bone marrow
What follows up standard induction therapy for AML?
Consolidation therapy
What is the exception to standard induction and consolidation therapy?
APL
What are the supportive measures for AML induction?
1) Irradiated RBCs
2) Prophylactic antibiotics
3) Growth factors (GM-CSF)
4) HEPA rooms
5) Low microbial diets
What is a HEPA room?
High positive pressure air flow rooms
What are the side effects of tumor induction in AML?
Tumor-lysis syndrome (hyperuriciemia)
What genetic translocation causes APL?
t(15:17)
- RARR translocation
What is the treatment for APL?
ATRA i.e. all trans retinoic acid
What are the major side effects of APL?
1) APL Differentiation Syndrome/ Retinoic Acid Syndrome
2) DIC
What is the prognosis for ALL in those over 35 years-old?
Bad
What group of patients with ALL normally gets a Bone Marrow Transplant?
Adults
What is the presentation for CML?
1) Bleeding
2) Fatigue
3) Fever
4) Frequency infection
5) Weight loss
6) Anorexia
7) LUQ pain
8) Night sweats
Who argued that specific gene translocations caused specific diseases?
Jane Rowley, MD
What did Jane Rowley, MD describe?
t(9:22) in CML
What did the t(9:22) translation create?
BCR-ABL fusion gene coding for a constitutively active tyrosine kinase
What is the major drug used to treat CML?
Imatinib/ Gleevec
