Leukaemia Flashcards
leukaemia defination ?
- it is a neoplastic disorder
- characterized by
- uncontrolled abnormal proliferation of Haemopoirtic cells
- progresively increasing infiltration of bOne marrow
- which refelcts the Peripheral blood
L classification ?
- acute myeloblastic L
- chronic lymphoblastic L
- MIXED phenotypic AL
- acute myelocytic / granulocytic L
- chronic lymphocytic L
ALL classification ??
- small homogenous lymphoblast
- large h l
- heterogenous l
L1 - L2 - L3
AML classification ?
- 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
which Acute L in children ??
lymphoblastic
which acute L in adult ??
myeloblastic
Blast cell >30% = ??
AL
BLAST cell = 20%
> 5%
myeloblastic syndrome
which L is less aggressive?
chronic L
DIFFICULt to cure / less respinsivee to therapeutic intervention which L ?N
chronic L
WHAT is Blast cell ??
early bone marrow Haemopoietic cells - found in AL
Slower progression which L ?
Chronic L
CBC of AML ?
- Hb% -
- PCV -
- RBC count -
- WBC count = high/normal with blast cell = Gross leukocytosis
- platelet count -
Bone marromarrow of AML ??
- cellularity = hypercellular
- M/E ratio = +
- erythropoiesis = -
- granulopoiesis = immature blast cells
- megalaryopoiesis = -
PBF of AML ?
- 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
*
cytochemical stains of AML ?
- sudan black B +
- myeloperoxidase +
- periodic acid schiff -
- non-specific esterase +
immunophenotyping of AML ?
CD13
CD33
CBC & PBF of ALL ?
Same as AML
Bone marrow of ALL ?
same as AML
Cytochemical stains of ALL ?
Opposite to AML
main diagnostic criteria for acute L ?
- anemia
- thrombocytopenia
- presence of blast cells
- with/without leukocytosis
cytoplasm of myeloblast special feature ?
auer rods ?
what is auer rods ?
large crystalline cytoplasmic inclusion bodies found in myeloblastic cells
what is faggots ?
multiple auer rods
origin of auer rods ?
fusion of azurophil granules
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 = +
why anemia & thrombocytopenia in acute L ?
normal HSC are replaced by infiltrating neoplastic cells
AML & ALL ??
100%
- AML = adult
- prominent cell = myeloblast
- more common
- auer rods = +
- smears cell = -
- cytochemical stain = all
- response to therapy is low
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
CBC of CML ?
- Hb% -
- RBC -
- WBC= gross leukocytosis with left shift
- Platelet = chronic phase + late phase -
BM of CML ?
- C= hypercellular
- M/E = +
- E= -
- G= myelocyte & myeloblast
- M = +/depressed
chromosomal study of CML ?
Philadelphia c
Lab Dx of CLL ?
same as CML
biochemical examination of CML ?
- = V-B12 , uric acid , LDH
- = LAP score leukocyte alkaline phosphate
which chromosome abnormal in Philadelphia
22
M/A of Philadelphia C ?
Reciprocal translocation between C- 22 & 9
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
consequences of Philadelphia C ?
C-abl DNA are joined to DNA of C-22 = oncogene producntion = alerted structure & fucntion
Phases of CML?
- chronic phase
- accelerated phase
- blastic phase
cause of death in CML ?
- blastic crisis
- secodary infection
- myelofibrosis
Blastic crsis means ??
transformation to acute L
what is Chloroma ?
localized sub-periosteal leukaemic tumor masses
AML-CML/CGL
Blast cells count in Blastic crisis ?
-. myeloblast = 70-80%
lymphopblast = 20-30%
Blood picture of blastic crisis ?
- Hb% -
- Plateelt - =thrombocytopenia
- Basophill = +
- blast cells
types of Leukaemoid reaction ?
- myeloid LR
- lymphatic LR
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 ……
MLR ?/
- acute haemolysis
- infection
- pneumonia
- meningitis
- septicemia
- miliary TB
Lymphatic Leukaemoid reaction >??
- CMV
- Infectious mononucleosis
- pertusis
- measles
- wouphing cough
- miliary TB
413
what is leuco-erythroblastic Blood picture ??
presence of immature myeloid + nucleated red cells in the peripheral blood
causes of L-E blood picture ?
- secondary carcinoma of bone
- multiple myeloma
- myelofibrosis
- marble bone diseases
- Thalassemia
- lymphoma
- haemolytic anaemia
Pancytopenia + L-E-Blood picture ?
- lymphoma
- myelofibrosis
- metasttatic carcinoma of BM
Sub-leukaemic L ????
- total WBC count in peripheral blood is not increased - few blast cells are presnet ???
- but BM shows a picture of L
No blast cells in PBF is called ??
Aleukaemic L
what is myelodysplastic syndrome ?
it is a heterogenous group og L related condition characterized by various combination of A+ N+thrombocytopenia
Hallmark of myelodysplastic syndrome ?
apoptosis in peripheral blood
CBC of Myelodysplastic s ?
same as AML