Intro to Leukemia and Cytochemical stains

Question 1

Define Leukemia. what does it do to other cells?

Answer 1

malignancy/cancer of blood cells in BM/Blood
Crowds out other cells

Question 2

What are some common physical presents in pt with leukemia? Common symptoms?

Answer 2

infections/bruising/bleeding issues
Symptoms: purple patches, weakness, anemia..etc

Question 3

What is the etiology of leukemia?

Answer 3

Idiopathic cause, some contributing factors could be chem toxins, hereditary, age, radiation..etc

Question 4

What are some characteristics of Acute leukemia?

Answer 4

malignant proliferation
arrested maturation
hiatus development

Question 5

What are some characteristics of Chronic Leukemia?

Answer 5

uncontrolled proliferation
normal maturation
Increased WBC/Marked

Question 6

T/F: in acute leukemia PLTs are normal to decreased, but in Chronic they are normal to increased

Answer 6

True

Question 7

What does
ALL
AML
CML
CLL
stand for

Answer 7

acute lymphoblastic anemia
acute myelocytic leukemia
chronic myelocytic anemia
chronic lymphocytic leukemia

Question 8

What is the current treatment goal of leukemias? What are some ways this is achieved?

Answer 8

goal is remission, but possibility of it coming back
Treatment: BM transplant, chemo, radiation..etc

Question 9

T/F cytochemical stains are useful in diagnosis of acute leukemia but flow cytometry is gold standard

Answer 9

true

Question 10

Describe myeloperoxidase (MPO) and how it would stain
AML
ALL

Answer 10

peroxidase in granules
myelocytic series (strong positive)
monocytic (weak pos)

AML - positive
ALL - Negative

Question 11

T/F in myeloperoxidase, peroxidase and H202 don’t oxidize substrate/precipitate

Answer 11

false they do oxidize them and that causes them to stain

Question 12

T/F myeloid leukemia has >90% blasts MPO positive and sometimes >5% blasts may be positive

Answer 12

false. >80% blasts are MPO positive but sometimes only <5% are MPO positive, consider only the BLASTS

Question 13

Describe esterases:
Specific esterase
Non specific esterase

Answer 13

specific esterase uses chloroacetate stains MYELOCYTIC (granulocytic esterase)

Non specific esterase uses alpha napthyl acetate and stains
Monocytic cells - strong pos
Myelocytic cells - weak pos

Question 14

Adding NaF (sodium fluoride) to esterase stain does what?

Answer 14

sodium fluoride inhibits monocytic cells but myelocytic cells remain stained

Question 15

Describe combined esterase stains and how they stain cells

Answer 15

myeloblasts stain red (granules)
monoblasts stain black

Question 16

What is LAP and what cells is it found in?

Answer 16

Leukocyte alkaline phosphate is an enzyme found in secondary granules of neutrophils
alk phos precipitates as colors in cells

Question 17

T/F: you would use a LAP when a shift to the left is present

Answer 17

true

Question 18

When is LAP decreased?

Answer 18

decreased in malignant granulocytes like CML, sideroblastic anemias or myeloprolif disorders

Question 19

T/F: Neuts in a leukomoid reaction decrease the LAP

Answer 19

false, they increase it

Question 20

Describe TRAP (tartrate resistant acid phosphatase) and what cells it is present in

Answer 20

acid phosphotase is present in all nonerythroid cells, precipitates red

Question 21

T/F: all NORMAL isoenzymes of acid phos are not inactivated by tactic acid and will stain

Answer 21

false: all normal isoenzymes of acid phos are inactivated by tartic acid and will NOT stain

Question 22

Will hairy cell leukemia isoenzyme #5 stain with TRAP?

Answer 22

yes, it is resistant to tartric acid and will stain

Question 23

describe terminal deoxy. transferase TdT and what cells it is specific for

Answer 23

specific cell markers (enzymes) in lymphocytic precursors
pos in acute lymphocytic leukemias

Question 24

T/F: TdT is not observed in AML

Answer 24

false it is observed in AML