Intro to acute Leukaemia

Question 1

Difference b.w Acute myleoid leukaemia (AML) & Acute Leukaemia (AL)

Answer 1

AML is a subcategoy of myeloid neoplasms and AL

Question 2

Classifications of AML w/ recurrent genetic abnormalities

Answer 2

• No previous treatment (chemo, radio)
• Detect specific genetic abnormality defines of AML
• NOT need >20% blast for dx

Question 3

Classifications of AML NOS (not otherwise specified) w/ recurrent genetic abnormalities

Answer 3

• No previous therapy (chemo, radio)
• No recurrent genetic abnormalities
• No myeloidsyplasia

Question 4

what’s minimal residual disease concept?

Answer 4

• small amounts of remaining neoplastic cells

Question 5

Dx this? if you get:

• Positive cytochemical staining for sudan black B, myeloperoxidase
• immunophenotype hyper granular

Answer 5

• Acute promyelocytic leukaemia
• mature myeloid type
  (if phenotype was microgranular = immature phenotype)

Question 6

Pathophysiology of acute promyelocytic leukaemia (APL)

Answer 6

• t(15:17) [translocation of 15 & 17]
  = fusion gene PML-RARalpha = acts as an altered reitnoic acid receptor
  => oncogenic signaling
  => inc undifferentiated promyelocytes

Question 7

Distinguish the morphology of

1. AML w/ min. diff.
2. AML acute monoblastic & monocytic leukaemia
3. Pure erythroif leukaemia

Answer 7

1. medium size, HIgh N:C rati, 1-2 nucleoli, basophilic cytoplasm
2. predominantly monoblast

Question 8

Dx this? & further test

• medium size,
• HIgh N:C rati, 1-2 nucleoli,
• basophilic cytoplasm

Answer 8

Dx: AML w/ min. diff.

Tests
Cytochem.
Cytogenetics = on specific chromo abnormalitlies
Immunophenotype: HLA-DR+, CD13+

Question 9

Dx this? & further test

predominantly monoblast, promyelocyte & monocytes

Answer 9

dx: AML acute monoblastic & monocytic leukaemia

• Cytogenetics: non-specific chromosome abnormalities
• Immunophenotype: CD13+, CD33+
• Cytochem: alpha-naphtyl acetate esterase strongly Positive

Question 10

Dx this?

• medium size,
• HIgh N:C rati, 1-2 nucleoli,
• basophilic cytoplasm
• FINE CHROMATIN

Answer 10

Dx: Pure erythroid leukaemia

• Cytochemistry: positive for glycophorin A , PAS
• Immunophenotype HLA-DR-