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HEMATOLOGY 2🙏 > French SUBGROUP - American - British (FAB) classification AML > Flashcards

French SUBGROUP - American - British (FAB) classification AML Flashcards

1
Q

M0

A

AML, Minimally Differentiated

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2
Q

● Blasts having CD13, CD33, CD34 and CD117
● No Evidence of Cellular Maturation of Blasts

A

M0 (AML, Minimally Differentiated)

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3
Q

● Auer Rods (-), Myeloperoxidase (-), Sudan Black B (-)
● Less than 5% of All AML

A

M0 (AML, Minimally Differentiated)

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4
Q

Patients are usually infants or older adults

A

M0 (AML, Minimally Differentiated)

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5
Q

M1

A

(AML, Without Maturation)

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6
Q

● Blasts having CD13, CD33, CD34 and CD117 similar with those of M0
● 90% of Cells in BM are BLASTS
● Found in All Age Groups with Highest Incidence in Adults

A

M1 (AML, Without Maturation)

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7
Q

● Has No Male or Female Predominance

A

M1

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8
Q

● Nuclear:Cytoplasmic Maturational Asynchrony
○ Morphologically - Nucleus appears more immature than Cytoplasm
○ Functionally - Leukemic Blasts exhibits Phagocytosis w/c is a property only of a Mature WBC

A

M1 (AML, Without Maturation)

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9
Q

● Auer Rods (+), Myeloperoxidase (+), Sudan Black B (+)
● Chloroacetate Esterase (+), Acetate Esterase (-)

A

M1 (AML, Without Maturation)

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10
Q

● Greater than 20% Type I and II Blasts in Bone Marrow
○ At least 10% Granulocyte @ Various Stages of Maturation

● Distinguished from M1 by Presence of Granulocytic Cells At or Beyond the Promyelocytic Stage of Maturation

A

M2 (AML, With Maturation)

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11
Q

● CharacteristicGINGIVALBLEEDING
● Pseudo-Pelger-Huet (+) - Rod-Shaped or Dumbbell-Shaped or Nonsegmented Nuclei

A

M2 (AML, With Maturation)

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12
Q

● Hypogranular Neutrophils (+) - Leads to Deficient Phagocytosis,
Deficient Microbial Killing and Deficient Chemotaxis

A

M2 (AML, With Maturation)

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13
Q

● Auer Rods (+), MPO (+) and SBB (+)
● Aspects of Dysplasia are present

A

M2 (AML, With Maturation)

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14
Q

● AKA Hypergranular Promyelocytic Leukemia
● Found in all age groups similar to M1 and M2
● Greater Predilection for Males
● Frequently more associated with DIC

A

M3 (Acute Promyelocytic Leukemia)

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15
Q

● Abnormal Promyelocytes with Heavy Granulation
● Presents with Leukopenia
● Auer Rods (+) and Intensely Positive for MPO and SBB
● Faggot Cells (+)
● Reniform or Bilobed Nuclei

A

M3 (Acute Promyelocytic Leukemia)

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16
Q

M3

A

(Acute Promyelocytic Leukemia)

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17
Q

(Acute Promyelocytic Leukemia)

A

M3

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18
Q

Subunit of M3

A

M3m (Microgranular Promyelocytic Leukemia)

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19
Q

● numerous granules present but can only be detected by electron microscopy hence the term “MICROGRANULAR”
● Has Worse Prognosis than M3 due to Initial High Blast Counts

A

M3m (Microgranular Promyelocytic Leukemia)

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20
Q

Caused by a Chromosomal Translocation t(15;17)

A

M3m (Microgranular Promyelocytic Leukemia)

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21
Q

M4

A

(Acute Myelomonocytic Leukemia)

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22
Q

● AKA Naegeli Monocytic Leukemia
● Positive for Myeloid Antigens - CD13 and CD33
● Positive for Monocytic Antigens - CD4, 11b, 11c, 14, 36, 64

A

M4 (Acute Myelomonocytic Leukemia)

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23
Q

● Auer Rods (+), MPO (+), SBB (+), Specific and Non-Specific Esterases (+)

● Lysozyme - Muramidase > Contained in Larger Amounts in Monocytes > Excreted in Large Amounts in Urine when there is M4 Leukemia

A

M4 (Acute Myelomonocytic Leukemia)

24
Q

○ Serum or Urine Lysozyme = Diagnostically Important for——- Leukemia
○ 3x the Upper Limit is Significant
● Caused by a Problem in Chromosome 16

A

M4 (Acute Myelomonocytic Leukemia)

25
Q

M4 (Acute Myelomonocytic Leukemia) sub unit?

A

M4eo (Acute Myelomonocytic Leukemia w/ Eosinophilia)

26
Q

● IncreasedMarrowEosinophils
● Cells exhibit Large Basophilic Granules mixed with Smaller Eosinophilic Granules

A

M4eo (Acute Myelomonocytic Leukemia w/ Eosinophilia)

27
Q

●Uniquely exhibits Distinct Chloroacetate Esterase and
PAS (+) which differentiates it from normal eosinophil

A

M4eo (acute myelomonocytic leukemia with eosinophilia )

28
Q

M5

A

Acute Monocytic Leukemia

29
Q

M5 Acute Monocytic Leukemia sub unit

A

M5a (Acute Monocytic Leukemia, Poorly Differentiated)

M5b (Acute Monocytic Leukemia, Well Differentiated)

30
Q

● AKASchillingLeukemia

● Presents w/ Highest Incidence of Organomegaly and Organ
Involvement of all AMLs

● Greater than 80% of Marrow Cells are Monoblasts, Promonocytes or Monocytes

A

M5 (Acute Monocytic Leukemia)

31
Q

● Auer Rods (+), MPO (-), SBB (-), Specific Esterase (-)

● Associated with problems in Chromosome 11, t(9;11)

● Divided into M5a (Poorly Differentiated) and M5b
(Well Differentiated)

A

M5 (Acute Monocytic Leukemia)

32
Q

M5a

A

Acute Monocytic Leukemia, Poorly Differentiated

33
Q

● Characterized by Large Blast Cells with Delicate, Lacy Chromatin in both blood and bone marrow

○ 1-3 Large, Prominent Vesicular Nucleoli are present
○ Voluminous Cytoplasm with 1 or More Pseudopods

A

M5a
(Acute Monocytic Leukemia, Poorly Differentiated)

34
Q

More than 80% of Monocytic Compartment Predominance are Blasts

A

M5a
(Acute Monocytic Leukemia, Poorly Differentiated)

35
Q

M5b Acute Monocytic Leukemia, Well Differentiated

A

● Characterized by Presence of ALL STAGES OF MONOCYTE DEVELOPMENT (Monoblasts, Promonocytes and Monocytes)

● Predominant Cell in BM Promonocyte

36
Q

● Associated with DIFFUSE ERYTHEMATOUS SKIN RASH (differentiates it from M5a clinically)

A

M5b Acute Monocytic Leukemia, Well Differentiated

37
Q

M6

A

(Acute Erythroleukemia)

38
Q

● DiGuglielmo’s syndrome
● Variable WBC Count and Pancytopenia occurs
● Presence of Numerous Nucleated RBCs

A

M6 (Acute Erythroleukemia)

39
Q

-Mixed Populations of Hypochromic and Normochromic RBCs
-Leukemia frequently progresses to M1, M2 or M4 Leukemia M6 -Erythroblasts = Alpha-Naphthyl Acetate Esterase (+)

A

M6 (Acute Erythroleukemia)

40
Q

Auer Rods (+)
Defect in Chromosome 5 and 7

A

M6 (Acute Erythroleukemia)

41
Q

M7

A

(Acute Megakaryocytic Leukemia)

42
Q

Distinct Feature of M7

A

Myelosclerosis

43
Q

Previously Classified as Undifferentiated Leukemia since
MPO (-), SBB (-) and Esterase (-)

A

M7 (Acute Megakaryocytic Leukemia)

44
Q

Alpha-Naphthyl Acetate Esterase (+),
Alpha-Naphthyl Butyrate Esterase (-)
- Unique Cytochemistry for Megakaryoblasts

A

M7 (Acute Megakaryocytic Leukemia)

45
Q

● PAS (+)
● CD41, CD42b and CD61
● Defect in Chromosome 21

A

M7 (Acute Megakaryocytic Leukemia)

46
Q

Treatment for AML

A

● Chemotherapy
● Radiation Therapy
● Immunotherapy

47
Q

Chronic granulocytic leukemia

A

Chronic myelogenous leukemia

48
Q

An MPN that originates in the abnormal pluripotent bone marrow stem cell and is consistently associated with the BCR-ABL(1) fusion gene located in the Philadelphia chromosome

A

Chronic myelogenous leukemia CML

49
Q

Chronic myelogenous leukemia (CML) findings

A

Increase WBC
PMNs
MATURE WBC

50
Q

Chromosome 9 and 22
translocation

A

Philadelphia chromosome ( CML)

51
Q

Translocation of c-abl, from chromosome 9 to location of bcr on chromosome 22 to form fusion gene bcr-abl

A

active tyrosine kinase

52
Q

• Splenomegaly
• Constitutional symptoms
- fatigue, malaise, LG fever, weight loss, excess sweating
• Anemia
• Bleeding
• pruritis

A

CML: Chronic myelogenous leukemia

53
Q

• Investigation

  • leukopenia
  • basophila
  • low RBC ct.

• Diagnosis
- evidence of BCR-ABL fusion product or presence of Philadelphia chromosome

A

CML: Chronic myelogenous leukemia

54
Q

-excessive leukocytic response in the peripheral blood

-a result of severe infection, inflammation, metabolic disease or malignancy

A

Leukemoid reaction

55
Q

-used to distinguish LR (leukemoid revtion) from CML
-Uses KAPLOW’s METHOD

A

Leukocyte (neutrophil) Alkaline Phosphatase(LAP) test

56
Q

Normal Kaplow’s score

A

❖20 – 100

HEMATOLOGY 2🙏 (12 decks)

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