Leukaemia

Question 1

Outline the types of tumors

Answer 1

Neoplasm = abnormal new growth
Benign= remain localized, do not metastasize
Malignant = metastasize through lymphatic channels/blood to lymph nodes and other tissues
Primary = growing at anatomical site where progression began
Metastatic = forming at a site which derive from a tumor located elsewhere

Question 2

What are the 3 types of cancer?

Answer 2

Carcinomas (90% of cancers, epithelial cells)
Sarcomas (rare, connective tissues)
Leukemias and lymphomas (11% of tumors, blood forming cells and immune system cells respectively)

Question 3

What are two types of cancer genes?

Answer 3

Proto-oncogenes (over 100)
Tumor suppressor genes (12 known)

Question 4

compare leukemia to lymphoma

Answer 4

Leukemia = neoplasms originating from hematopoietic stem cells in bone marrow

Lymphoma = neoplasm originating from lymphocytes, largely restricted to lymphoid organs

Question 5

What are the four main types of leukemia?

Answer 5

Acute lymphoblastic
Acute myeloid
Chronic lymphocytic
Chronic myeloid

Question 6

Outline acute leukemias

Answer 6

An uncontrolled proliferation of poorly differentiated blast cells

In ALL, predominant cell = lymphoblast
In AML, further subdivided

Question 7

What are Auer rods?

Answer 7

Large, crystalline cytoplasmic inclusion bodies found in AML

Question 8

Outline acute leukemias

Answer 8

Replacement of bone marrow with blast cells causes anemia, increasing infection susceptibility and bleeding.

ALL most common in children
AML most common in adults

Question 9

What are the types of AML?

Answer 9

M0-M5 = immature forms of WBCs
M6 = immature forms of erythrocytes
M7 = immature forms of cells that make platelets

Question 10

What stains are commonly used to classify AML type?

Answer 10

Enzymatic:
Esterase
Phosphatase
Myeloperoxidase

Non-enzymatic:
Sudan black B
Periodic acid Schiff
Toluidine bkue
Perls stain

Question 11

What is chloroacetate esterase used for?

Answer 11

Determining whether a cell is a part of the granulocytic cell line (such as neutrophils etc)

Question 12

What are the three types of ALL?

Answer 12

L1 = small, monomorphic
L2 = large, heterogeneous
L3 = Burkitt-cell type

Question 13

Outline ALL

Answer 13

Accumulation of lymphoblasts in bone marrow, some cases initiated by genetic mutations occurring in utero

Most common in children

Question 14

Outline CML

Answer 14

A malignant proliferation of granulocytes in bone marrow and other haemopoietic organs, usually characterised by the chromosomal marker “*Philadelphia chromosome** in haemopoietic cells

Question 15

Give features of CML

Answer 15

Thrombocytosis in early stages
Larger platelets with reduced function
Hypercellularity of marrow
Biochemical abnormalities
Philadelphia chromosome

Question 16

Outline CLL

Answer 16

Generally a disease of the elderly
Anaemia is not an obvious symptom
Smear cells are common (fragile cells disrupted when making a blood film)
90% is mature B cells
When it rarely is T cells, tends to be more aggressive