Lec 13 Intro to WBC Flashcards
What are the origin myeloid malignancies?
involve cells of myeloid lineage [granulocytes, monocytes/ macrophages, erythrocytes, megakaryocytes/ platelets]
What is an acute leukemia?
leukemia with rapid onset; rapidly progressive and fatal
cells are not well differentiated or mature
What is a chronic leukemia?
leukemia with insidious onset
cells are mature and well differentiated
In leukemia are the malignant cells in the bone marrow or peripheral blood?
both!
What does it mean to have extramedullary disease?
leukemic cells infiltrate CNS, skin, liver, splee, lymph nodes
What characterizes acute leukemias?
clonal [from single transformed cell], characterized by impaired differentiation of hematopoietic cells; failure of apoptosis
have leukemic stem cells with self renewal capacity
What mech causes resistance to chemotherapy + relapse in leukemia?
evolution of sub-clones with additional mutations
What are some signs of acute leukemia?
anemia, hemorrhage, infection b/c the normal hematopoietic cells are crowded out by the accumulation of immature poorly functioning leukemic cells
What is acute myelogenous leukemia?
acute leukemia from myeloid lineage
What is median age of AML?
70 years old
What is acute lymphocytic leukemia [ALL]?
leukemia characterized by lymphoid lineage markers
Who gets ALL?
can be seen in chidlhood but can occur at any age
What are risk factors for acute leukemia?
- benzene exposure
- ionizing radiation
- prior exposure to chemo
What are some inherited risks for acute leukemia?
- down’s syndrome
- fanconi anemia
- bloom’s syndrome
What types of mutations associated with acute leukemias?
- structural chromosomal abnormalities [deletions, translocations], somatic mutations
How many subtypes of AML and ALL are there?
8 types of AML
3 types of ALL
What is a leukemia vs lymphoma?
leukemia = malignant cells in blood and marrow and can invade other organs
lymphoma = malignant cells confined to nodes/spleen; can sometimes invade blood and marrow and other organs
What are some underlying causes that can lead to secondary acute myelogenous leukemia?
- aplastic anemia
- paroxysmal nocturnal hemoglobinuria
- myelodysplasia
What is definition of acute leukemia?
> 30% blasts in blood or bone marrow
What is the strongest predictor of response to induction and survival?
cytogenetics
M2 AML is associated wtih what chromosomal translocation? What kind of prognosis?
(8;21) pretty good prognosis
What do you see on labs in acute leukemia?
- 50% normal or low WBC
- neutropenia
- hyperleukocytosis
- thrombocytopenia
- anemia
What chromosomal abnormality in M3 type of AML?
chromosome translocation (15;17)
What do you see on smear in M3 AML?
auer rods = cytoplasmic inclusions
lots of circulating myeloblasts
What is a possible complication of M3 AML?
development of DIC
How do you treat M3 AML?
all-trans retinoic acid [vit A] –> induces differentiation of myeloblasts