Joes Bits

Question 1

Philadelphia positive MPN

Answer 1

CML
Chronic phase and blast phase
Tyrosine kinase inhibitors

Blast phase
> 20% myeloid blasts in BM or blood
Extramedullary proliferation of blasts
Increased lymphoblasts BM and blood

Question 2

PV

Answer 2

Increased Hb and haematocrit
Pleomorphic mature megakaryocytes
V167F mutation

Question 3

ET

Answer 3

Increased platelets
No collagen fibrosis of BM

Question 4

PMF

Answer 4

Proliferation of abnormal megakaryocytes and granulocytes
Osteosclerosis

Question 5

MDS dysplasia threshold

Answer 5

10%

Question 6

AML mutations

Answer 6

PML::RARA
RUNX1::RUNX1T1
CBF::MYH11
BCR::ABL1
CEBPA

Question 7

Flow cytometry in classification of leukaemias

Answer 7

Rapid, sensitive and specific

Blood, bone no marrow, body fluids (eg. CSF, pleural fluid), tissue specimens after processing (eg. Lymph node biopsy)

Multiple measurements can be taken on a cell at one time, can establish
Haemopoietic or not
Clonality
Lineage
Myeloid
Lymphoid (B/T/NK)

Stage of maturation
Characterisation of mature B cell neoplasms e.g. CLL, FL, MCL, HCL

Role in monitoring for minimal residual disease

Question 8

Cytogenetics (karyotyping)

Answer 8

Culture
Add colcemid
Centrifuge
Remove supernatant
Add hypertonic sol. to swell cells and disperse chromosomes
Giemsa stain
Microscope x100 -> x1000

Question 9

What does karyotyping allow us to screen?

Answer 9

Numerical abnormalities
Structural abnormalities
Diagnosis of AML
And prognosis