General information

Question 1

Why is it classified as ACUTE promyelocytic leukaemia?

Answer 1

The word “acute” comes from the fact that the disease progresses rapidly and creates immature blood cells, rather than mature ones

Question 2

Explain the differentiation and lineage of myeloid stem cells and lymphoid stem cells.

Answer 2

Myeloid stem cells lead to the creation of:

• Red blood cells (erythrocytes)
• Platelets (thrombocytes)
• Myeloblasts -> Granulocytes (aka leukocytes)

Lymphoid stem cells

• B lymphocyte
• T lymphocyte
• Killler T cells

Question 3

What is a leukocyte?

List the types of leukocytes

Answer 3

Leukocytes (granulocytes are a type of leukocyte) are white blood cells (immune cells).

Types:

• Neutrophil
• Basophil
• Lymphocyte
• Monocyte
• Eosinophil

Question 4

Differentiate granulocytes from agranulocytes

Answer 4

Granulocytes have granules with enzymes in them. They are involved in the innate defense system.

Agranulocytes lack granules

Question 5

List the types of granulocytes and agranulocytes

Answer 5

Granulocytes:

• Neutrophil
• Eosinophil
• Basophil
• Mast cell

Agranulocytes:

• Lymphocyte
• Monocyte

Question 6

How common is APL? Which age group does APL affect most?

Answer 6

• Acute promyelocytic leukemia represents 10–12% of AML cases
• The median age is approximately 30–40 years

Question 7

Can APL be caused as a secondary disease?

Answer 7

Yes. It can also occur as a secondary malignancy in those that receive treatment with topoisomerase II inhibitors (such as the anthracyclines and etoposide) due to the carcinogenic effects of these agents, with patients with breast cancer representing the majority of such patients

Question 8

What are oral manifestations of APL?

Answer 8

• Infections like candidiasis
• Pallor of mucosa
• Petechiae (palate)
• Ecchymosis on tongue
• Excessive gingival bleeding
• Fever (very warm mouth when you touch)
• Gingival hyperplasia (due to leukaemic cell infiltrate)