Leukaemia Flashcards
1
Q
leukaemia defination ?
A
- it is a neoplastic disorder
- characterized by
- uncontrolled abnormal proliferation of Haemopoirtic cells
- progresively increasing infiltration of bOne marrow
- which refelcts the Peripheral blood
2
Q
L classification ?
A
- acute myeloblastic L
- chronic lymphoblastic L
- MIXED phenotypic AL
- acute myelocytic / granulocytic L
- chronic lymphocytic L
3
Q
ALL classification ??
A
- small homogenous lymphoblast
- large h l
- heterogenous l
L1 - L2 - L3
3
Q
AML classification ?
A
- minimal differentiated AML
- ML without maturation
- ML with maturation
- hypergranular pro-myelocytic L
- myelo-monocytic L
- monocytic L
- Erythro-L
- Megakaryo-Blastic L
FAB classification
M0 - M7
4
Q
which Acute L in children ??
A
lymphoblastic
4
Q
which acute L in adult ??
A
myeloblastic
5
Q
Blast cell >30% = ??
A
AL
5
Q
BLAST cell = 20%
> 5%
<30%
A
myelodysplastic syndrome
6
Q
which L is less aggressive?
A
chronic L
6
Q
DIFFICULt to cure / less respinsivee to therapeutic intervention which L ?N
A
chronic L
7
Q
WHAT is Blast cell ??
A
early bone marrow Haemopoietic cells - found in AL
7
Q
Slower progression which L ?
A
Chronic L
8
Q
CBC of AML ?
A
- Hb% -
- PCV -
- RBC count -
- WBC count = high/normal with blast cell = Gross leukocytosis
- platelet count -
8
Q
Bone marromarrow of AML ??
A
- cellularity = hypercellular
- M/E ratio = +
- erythropoiesis = -
- granulopoiesis = immature blast cells
- megalaryopoiesis = -
8
Q
PBF of AML ?
A
- RBC = Normochromic normocytic anisocytosis poikilocytosis macrocytes - mild polychromasia
- platelet = (-)
- WBC = immature blast cells + Auer bodies + smear cells + gross leukocytosis with left shift + prominent cell - Myeloblast
*
9
Q
cytochemical stains of AML ?
A
- sudan black B +
- myeloperoxidase +
- periodic acid schiff -
- non-specific esterase +
10
Q
immunophenotyping of AML ?
A
CD13
CD33
11
Q
CBC & PBF of ALL ?
A
Same as AML
12
Q
Bone marrow of ALL ?
A
same as AML
13
Q
Cytochemical stains of ALL ?
A
Opposite to AML
14
Q
main diagnostic criteria for acute L ?
A
- anemia
- thrombocytopenia
- presence of blast cells
- with/without leukocytosis
15
Q
cytoplasm of myeloblast special feature ?
A
auer rods ?
16
Q
what is auer rods ?
A
large crystalline cytoplasmic inclusion bodies found in myeloblastic cells
17
Q
what is faggots ?
A
multiple auer rods
18
origin of auer rods ?
fusion of azurophil granules
19
Myeloblast vs Lymphoblast ?
| just Myeloblast porbo then ulta for L
* size= larger
* cytoplasm = more- granular
* nucleoli = more
* N/C ratio =not so high
* chromatin = loose
* auer body = +
20
why anemia & thrombocytopenia in acute L ?
normal HSC are replaced by infiltrating neoplastic cells
21
AML & ALL ??
| 100%
1. AML = adult
2. prominent cell = myeloblast
3. more common
4. auer rods = +
5. smears cell = -
6. cytochemical stain = all
7. response to therapy is low
22
PBF of CML ?
* RBC - N-N-A-P-polychromasi - basophilic stippling
* Platelet = chroni + late stage -
* WBC = leukocytosis & markdly shift to left , myelocyte , metamyelocytes , E+B = ++++ Eosinoiphilia
22
CBC of CML ?
* Hb% -
* RBC -
* WBC= gross leukocytosis with left shift
* Platelet = chronic phase + late phase -
23
BM of CML ?
* C= hypercellular
* M/E = +
* E= -
* G= myelocyte & myeloblast
* M = +/depressed
24
chromosomal study of CML ?
Philadelphia c
25
Lab Dx of CLL ?
same as CML
25
biochemical examination of CML ?
* + = V-B12 , uric acid , LDH
* - = LAP score leukocyte alkaline phosphate
26
which chromosome abnormal in Philadelphia
22
27
M/A of Philadelphia C ?
Reciprocal translocation between C- 22 & 9
28
transfer portion of chromosome of 22 & 9 ??/
C-abl = abelson cellular protooncogen of C-9 is transferred to Break point cluster region of C-22
long aarm of C-22 is transferred to short arm of c-9
29
consequences of Philadelphia C ?
C-abl DNA are joined to DNA of C-22 = oncogene producntion = alerted structure & fucntion
30
Phases of CML?
1. chronic phase
2. accelerated phase
3. blastic phase
30
cause of death in CML ?
1. blastic crisis
2. secodary infection
3. myelofibrosis
31
Blastic crsis means ??
transformation to acute L
32
what is Chloroma ?
localized sub-periosteal leukaemic tumor masses
| AML-CML/CGL
32
Blast cells count in Blastic crisis ?
-. myeloblast = 70-80%
lymphopblast = 20-30%
33
Blood picture of blastic crisis ?
* Hb% -
* Plateelt - =thrombocytopenia
* Basophill = +
* + blast cells
34
types of Leukaemoid reaction ?
1. myeloid LR
2. lymphatic LR
35
What is Leukaemoid reaction ??
it is a occurance of peripheral blood picture resembling that of L in a subject who does not have L
but BM = shows normal picture ......
35
MLR ?/
1. acute haemolysis
2. infection
3. pneumonia
4. meningitis
5. septicemia
6. miliary TB
36
Lymphatic Leukaemoid reaction >??
* CMV
* Infectious mononucleosis
* pertusis
* measles
* wouphing cough
* miliary TB
| 413
37
what is leuco-erythroblastic Blood picture ??
presence of immature myeloid + nucleated red cells in the peripheral blood
38
causes of L-E blood picture ?
1. secondary carcinoma of bone
2. multiple myeloma
3. myelofibrosis
4. marble bone diseases
5. Thalassemia
6. lymphoma
7. haemolytic anaemia
39
Pancytopenia + L-E-Blood picture ?
1. lymphoma
2. myelofibrosis
3. metasttatic carcinoma of BM
40
Sub-leukaemic L ????
* total WBC count in peripheral blood is not increased - few blast cells are presnet ???
* but BM shows a picture of L
40
No blast cells in PBF is called ??
Aleukaemic L
41
what is myelodysplastic syndrome ?
it is a heterogenous group og L related condition characterized by various combination of A+ N+thrombocytopenia
42
Hallmark of myelodysplastic syndrome ?
apoptosis in peripheral blood
43
CBC of Myelodysplastic s ?
same as AML
