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Hematology Module 2 > Introduction to Leukocyte Neoplasms (Part 3 AML) > Flashcards

Introduction to Leukocyte Neoplasms (Part 3 AML) Flashcards

1
Q

Acute Myeloid Leukemia (AML) affects elements in what cell lineages?

A

granulocytic, monocytic, erythroid, or megakaryocytic lineages

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2
Q

Acute Myeloid Leukemia (AML) affects what age group?

A

All ages, predominated in adults around 65 years of age

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3
Q

How will someone present clinically with Acute Myeloid Leukemia (AML)?

A
  • Pallor, fatigue
  • Fever/ infection
  • Bruising/ bleeding
  • Malignant cell infiltration into other tissues
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4
Q

Acute Myeloid Leukemia (AML)

- peripheral blood

A
  • Variable leukocytosis
  • variable displasia
  • myeloblasts present in 95% of patients
  • Leukemic hiatus
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5
Q

Having many myeloblasts and some segs with no intermediate stages is known as what?

A

Leukemic Hiatus

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6
Q

Acute Myeloid Leukemia (AML)

- Bone marrow findings

A
  • Hypercellular increased blasts
  • > 20% blasts with limited maturation
  • variable dysplasia
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7
Q

Acute Myeloid Leukemia (AML)

- Immunophenotyping

A

CD34+, HLA-DR+, CD117+, CD13+, CD33+

the last two are very specific to AML

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8
Q

What six immature cells will you find in Acute Myeloid Leukemia (AML)?

A
  • Myeloblasts
  • Promyelocytes
  • Monoblasts
  • Promonocytes
  • Erythroblasts
  • Megakaryoblasts
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9
Q

Acute Myeloid Leukemia (AML) will have recurrent cytogenic abnormalities:
_______ - addition or deletion of part of - or entire- chromosome
_______ primarily translocations and inversions

A

Numerical

Structural

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10
Q

Acute Promyelocytic Leukemia (APL)

- cytogenetic abnormality

A

t(15;17)(q24;q21)

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11
Q

Acute Promyelocytic Leukemia (APL)

- two different types of APL

A
  • Typical (60-70%)

- Atypical (30-40%)

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12
Q

Of the two types of APL…which one has hyper granular promyelocytes and nuclei are often bi-lobed or kidney shaped

A

Typical

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13
Q

Of the two types of APL…which one has micro granular promyelocytes and nuclei that are predominately deeply notched/bilobed (Butterfly)

A

Atypical

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14
Q

Will Acute Promyelocytic Leukemia (APL) have Auer rods?

A

YES! They will have multiple Auer Rods (faggot cells)

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15
Q

In Acute Promyelocytic Leukemia (APL), t(15;17) creates a fusion gene. What is it?

A

PML-RARA

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16
Q

The PML-RARA fusion gene leads to what?

A

Uncontrolled proliferation and inhibition of cellular differentiation

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17
Q

Acute Promyelocytic Leukemia (APL)

- Lab Results

A
  • DIC/fibrinolysis coagulation
  • Thrombocytopenia
  • hyper or microgranular promyelocytes
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18
Q

When a slide from a patient with APL is stained with MPO, what will it look like?

A

Strongly Positive

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19
Q

Acute Promyelocytic Leukemia (APL)

- Treatment

A
  • Prescribe ATRA

- manage coagulopathy

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20
Q

AML - With Abnormal Marrow Eosinophils

- cytogenetic abnormality

A

inv(16)(p13.1;q22)

t(16;16) (p13.1;q22)

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21
Q

AML - With Abnormal Marrow Eosinophils

- age group affected

A

primarily young adults

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22
Q

AML - With Abnormal Marrow Eosinophils

- prognosis

A

favorable to average risk

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23
Q

AML - With Abnormal Marrow Eosinophils

- Peripheral Blood findings

A
  • myeloblasts (other immature myeloid cells)
  • monocytoid cells
  • thrombocytopenia
  • normal eos
24
Q

AML - With Abnormal Marrow Eosinophils

- Bone marrow findings

A
  • myeloblasts and promyelocytes (30-80%)
  • Monocytic component (>20%)
  • > 5% eosinophils (all stages of maturation)
25
Q

AML with maturation

- cytogenetic abnormality

A

t(8;21)(q22;q22)

26
Q

AML with maturation

- fusion gene

A

Runx1-Runx1T1

27
Q

AML with maturation

- age affected

A
  • 25-30 years old

- predominant in children and young adults

28
Q

AML with maturation

- prognosis

A
  • good in adults but poor in children

- response well with chemotherapy

29
Q

AML with maturation

- PB findings

A
  • Blasts with numerous azurophilic granules
  • Some may have very large granules (Pseudo-Chediak-Higashi)
  • Auer Rods likely
30
Q

AML with maturation

- BM findings

A

dysplasia in neutrophil line

monos, eos, and eryth, components not affected

31
Q

AML with Myelodysplasia-Related Changes

- wich AMLs are in this category

A
  • AML evolving from previous myelodysplastic syndrome

- AML with cytogenetic abnormalites that marrow those of MDS syndromes

32
Q

AML with Myelodysplasia-Related Changes

- age range affected

A

elderly population

33
Q

AML with Myelodysplasia-Related Changes

- Lab findings

A

presents with severe pancytopenia

34
Q

AML with Myelodysplasia-Related Changes

- prognosis

A

poor

35
Q

AML- Therapy-Related Myeloid Neoplasms

- why does it occur?

A

occurs as a result of therapy-related cytotoxic chemotherapy and/or radiation therapy

36
Q

AML- Therapy-Related Myeloid Neoplasms

  • Age affected
  • Prognosis
A
  • median age 61

- poor prognosis (<10% 5 yr survival rate)

37
Q

AML not otherwise specified (NOS)

- divisions within this category are based primarily off of what?

A

morphological and cytochemical/immunophenotypic features

38
Q

(M0) AML-NOS Minimal Differentiation

- What stains are negative?

A

MPO and most other stains are negative

39
Q

(M0) AML-NOS Minimal Differentiation

- age affected

A

infants and older adults

40
Q

(M0) AML-NOS Minimal Differentiation

- PB findings

A

Blasts: medium, round (1-2 nucleoli), fine chromatin, cytoplasm is AGRANULAR and BASOPHILIC

41
Q

(M0) AML-NOS Minimal Differentiation

  • MPX/SBB stains
  • Auer rods?
A

neg/no auer rods

42
Q

(M1) AML-NOS Without Maturation

  • Blast percentage
  • MPO/SBB stain?
  • Auer rods?
A
  • > 90% of non erythroid cells
  • MPO/SBB >3% (positive)
  • Auer rods (+/-)
43
Q

(M2) AML-NOS With Maturation

  • MPO
  • Auer Rods?
  • age affected
A
  • MPO Positive
  • Frequent Auer rods
  • all age groups
44
Q

(M4) AML -NOS Myelomonocytic

  • Peripheral blood
  • Auer rods?
A
  • Myeloblasts
  • Monocytoid cells
  • thromobcytopenia
  • Auer rods +/-
45
Q

(M4) AML -NOS Myelomonocytic

- Bone marrow

A
  • Myeloblasts >20%

- Monocyte components

46
Q

(M4) AML -NOS Myelomonocytic

- stains

A

Blasts will be positive for both myeloid and monocytic markers
(MPO+)
(ANBE +)

47
Q

(M5a) AML-NOS-Acute Monoblastic AND (M5b) Monocytic Leukemia
- problems

A
  • bleeding problems common at presentation
  • Cutaneous and gingival infiltration
  • CNS involvement common
48
Q

(M5a) AML-NOS-Acute Monoblastic AND (M5b) Monocytic Leukemia
- ANBE stain

A

ANBE- Positive

49
Q

AML-NOS Acute Erythroid Leukemia

- Two subclasses

A
  • Erythroleukemia (erythroid and myeloblasts in BM)

- Pure Erythroid leukemia (only erythroid precursors in BM)

50
Q

AML-NOS Erythroleukemia (erythroid/myeloid)

- PAS stain

A

PAS- positive in RBC precursors, Chunky

51
Q

(M7) AML-NOS- Megakaryoblastic

- PB

A
  • Micromegakaryocytes

- pleomorphic blasts, blasts with agranular cytoplasm

52
Q

(M7) AML-NOS- Megakaryoblastic

- BM and stains

A
  • usually dry tap
  • MBO/SBB- negative
  • Factor VIII stain-pos
53
Q

AML-NOS-Basopilic Leukemia

- increased what?

A

blasts and immature basos

54
Q

AML-NOS Acute Panmyelosis with Myelobibrosis (APMF)

  • clinical
  • increase in what?
A
  • bone pain and extensive myelofibrosis

- Increased blasts of all myeloid lines

55
Q

After chemotherapy patients often develop severe leukcytopenia so what do we do to concentrate the cells for a differential?

A

We make a buffy coat smear by adding EDTA-anticoag blood into a WINTROBE tube

Hematology Module 2 (14 decks)

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