Intro to Leukemia and Cytochemical stains Flashcards
Define Leukemia. what does it do to other cells?
malignancy/cancer of blood cells in BM/Blood
Crowds out other cells
What are some common physical presents in pt with leukemia? Common symptoms?
infections/bruising/bleeding issues
Symptoms: purple patches, weakness, anemia..etc
What is the etiology of leukemia?
Idiopathic cause, some contributing factors could be chem toxins, hereditary, age, radiation..etc
What are some characteristics of Acute leukemia?
malignant proliferation
arrested maturation
hiatus development
What are some characteristics of Chronic Leukemia?
uncontrolled proliferation
normal maturation
Increased WBC/Marked
T/F: in acute leukemia PLTs are normal to decreased, but in Chronic they are normal to increased
True
What does
ALL
AML
CML
CLL
stand for
acute lymphoblastic anemia
acute myelocytic leukemia
chronic myelocytic anemia
chronic lymphocytic leukemia
What is the current treatment goal of leukemias? What are some ways this is achieved?
goal is remission, but possibility of it coming back
Treatment: BM transplant, chemo, radiation..etc
T/F cytochemical stains are useful in diagnosis of acute leukemia but flow cytometry is gold standard
true
Describe myeloperoxidase (MPO) and how it would stain
AML
ALL
peroxidase in granules
myelocytic series (strong positive)
monocytic (weak pos)
AML - positive
ALL - Negative
T/F in myeloperoxidase, peroxidase and H202 don’t oxidize substrate/precipitate
false they do oxidize them and that causes them to stain
T/F myeloid leukemia has >90% blasts MPO positive and sometimes >5% blasts may be positive
false. >80% blasts are MPO positive but sometimes only <5% are MPO positive, consider only the BLASTS
Describe esterases:
Specific esterase
Non specific esterase
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
Adding NaF (sodium fluoride) to esterase stain does what?
sodium fluoride inhibits monocytic cells but myelocytic cells remain stained
Describe combined esterase stains and how they stain cells
myeloblasts stain red (granules)
monoblasts stain black
What is LAP and what cells is it found in?
Leukocyte alkaline phosphate is an enzyme found in secondary granules of neutrophils
alk phos precipitates as colors in cells
T/F: you would use a LAP when a shift to the left is present
true
When is LAP decreased?
decreased in malignant granulocytes like CML, sideroblastic anemias or myeloprolif disorders
T/F: Neuts in a leukomoid reaction decrease the LAP
false, they increase it
Describe TRAP (tartrate resistant acid phosphatase) and what cells it is present in
acid phosphotase is present in all nonerythroid cells, precipitates red
T/F: all NORMAL isoenzymes of acid phos are not inactivated by tactic acid and will stain
false: all normal isoenzymes of acid phos are inactivated by tartic acid and will NOT stain
Will hairy cell leukemia isoenzyme #5 stain with TRAP?
yes, it is resistant to tartric acid and will stain
describe terminal deoxy. transferase TdT and what cells it is specific for
specific cell markers (enzymes) in lymphocytic precursors
pos in acute lymphocytic leukemias
T/F: TdT is not observed in AML
false it is observed in AML
