Heme2b

Question 1

What is APL?

Answer 1

Acute Promyelocytic Leukemia. Translocation of retinoic acid receptor-alpha from chromosome 17 to chromosome 15.

Question 2

How can we treat APL?

Answer 2

ATRA (all trans-retinoic acid).

Question 3

What are Auer rods? When are they found?

Answer 3

Auer Rods are found in AML. They are peroxidase-positive cytoplasmic inclusions.

Question 4

Why must you Dx APL quickly?

Answer 4

DIC

Question 5

What FAB designation does APL have?

Answer 5

M3

Question 6

How do we treat APL?

Answer 6

ATRA + ATO. Maintenance with pulse ATRA.

Relapse = ATO

Question 7

How do we treat CBF AML?

Answer 7

Ind: Cytarabine

Con: High Dose Cytarabine

Relapse: Alll-BMT

Question 8

Tell me about the patient, genetics and comments for Burkitt Lymphoma.

Answer 8

P: young adults, adolescents
G: t(8;14), c-myc (8) and heavy chain Ig (14)
C: EBV assoc., jaw lesions, endemic in Africa

Question 9

Tell me about the patient, genetics and comments for Diffuse Large B-Cell Lymphoma.

Answer 9

P: older adults, 20% children
G: t(11;14)
C: most common type of non-Hodgkin lymphoma in adults.

Question 10

Tell me about the patient, genetics and comments for Mantle Cell Lymphoma.

Answer 10

P: older males
G: t(11;14), cylcin-D1 (11), heavy chain Ig (14)
C: CD5+

Question 11

Tell me about the patient, genetics and comments for Follicular Lymphoma.

Answer 11

P: adults
G: t(14;18), heavy chain (14), bcl-2 (18)
C: indolent course; blc-2 inhibits apoptosis, “waxing/waning” lymphadenopathy.

Question 12

Hodgkins vs. Non-Hodgkins: localized nodes.

Answer 12

Hodgkins

Question 13

Hodgkins vs. Non-Hodgkins: Reed Sternberg Cells.

Answer 13

Hodgkins

Question 14

Hodgkins vs. Non-Hodgkins: 50% association with EBV.

Answer 14

Hodgkins

Question 15

Hodgkins vs. Non-Hodgkins: HIV association.

Answer 15

Non-Hodgkins

Question 16

Hodgkins vs. Non-Hodgkins: “B” signs.

Answer 16

Hodgkins (fever, night sweats, weight loss)

Question 17

Hodgkins vs. Non-Hodgkins: majority B-Cells.

Answer 17

Non-Hodgkins

Question 18

Hodgkins vs. Non-Hodgkins: 20-40y/o

Answer 18

Non-Hodgkins

Question 19

Hodgkins vs. Non-Hodgkins: bi-modal, youg and >50y/o

Answer 19

Hodgkins

Question 20

What is the pneumonic “CRAB” and what does it refer to?

Answer 20

Calcium is up
Renal failure
Anemia
Bone lesion

This refers to Multiple Myeloma.

Question 21

What disease has to do with a monoclonal M protein spike?

Answer 21

Multiple Myeloma.

Question 22

What are the M spike and plasma cell values for MGUS, smoldering multiple myeloma and multiple myeloma?

Answer 22

MGUS*: = 3g M spike OR >= 10% PC
MM: M spike +, >= 10% PC, and CRAB(+)

*CRAB(-)