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Hematology/Immunology Part 2 > Leukemia > Flashcards

Leukemia Flashcards

1
Q

What are the two main types of leukemia based on cell type?

A

Myelogenous and Lymphocytic

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2
Q

What is the most common type of acute leukemia in adults?

A

Acute Myeloid Leukemia (AML)

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3
Q

At what median age is Acute Myeloid Leukemia (AML) most commonly diagnosed?

A

65 years

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4
Q

What is the primary cause of the symptoms in Acute Myeloid Leukemia (AML)?

A

Normal bone marrow cells being replaced by leukemia cells

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5
Q

What are Auer rods pathognomonic of?

A

Myeloblasts

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6
Q

What is the significance of finding blasts in the peripheral blood?

A

It is not a normal finding and warrants further workup or referral.

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7
Q

What is required for the diagnosis of Acute Myeloid Leukemia (AML)?

A

Bone Marrow Biopsy

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8
Q

How is leukemia classified?

A

According to cell type and whether it is acute or chronic

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9
Q

What age is considered a good risk feature for Acute Myeloid Leukemia (AML)?

A

< 40 years of age

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10
Q

What is a poor risk feature related to age for AML?

A

> 60 years of age

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11
Q

What are the two classification systems for Acute Myeloid Leukemia (AML)?

A

International Consensus Classification (ICC) and World Health Organization 5 (WHO)

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12
Q

What WBC count is considered a good risk feature for AML?

A

< 10,000

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13
Q

What are the primary characteristics used to classify Acute Myeloid Leukemia (AML)?

A

Molecular and cytogenetic characteristics

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14
Q

What WBC count is considered a poor risk feature for AML?

A

> 100,000

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15
Q

What is the primary driver of Acute Myeloid Leukemia (AML)?

A

Acquired genetic and epigenetic changes to myeloid cells and the bone marrow microenvironment

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16
Q

What platelet count is considered a poor risk feature for AML?

A

< 30,000

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17
Q

What is a good risk feature related to the type of leukemia for AML?

A

De Novo

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18
Q

What is the typical percentage of myeloid blasts in blood or bone marrow for AML diagnosis?

A

Greater than 10%

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19
Q

What is a poor risk feature related to the type of leukemia for AML?

A

Secondary leukemia

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20
Q

What are some common signs and symptoms of Acute Myeloid Leukemia (AML)?

A

Fatigue, anemia, thrombocytopenia, neutropenia, leukostasis, dyspnea, chest pain, headache, altered mentation, hepatosplenomegaly, bone pain, fever

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21
Q

What is a good risk feature related to LDH levels for AML?

A

Normal LDH

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22
Q

What is a poor risk feature related to drug resistance for AML?

A

Multi-drug resistance phenotype – MDR1 gene

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23
Q

What are some causes of leukemia?

A

DeNovo (unknown), secondary to MDS, myeloproliferative disorders, aplastic anemia, prior chemotherapy or radiation, toxic exposure, inherited syndromes or diseases

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24
Q

What is a poor risk feature related to disease status after initial therapy for AML?

A

Residual disease after initial induction therapy

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25
Q

What is the method used to diagnose AML?

A

Bone Marrow Biopsy

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26
Q

What are some inherited syndromes or diseases that increase the risk of leukemia?

A

Down Syndrome, Klinefelter, Fanconi Anemia

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27
Q

What does ‘p’ stand for in cytogenetics?

A

Short arm

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28
Q

What is the difference between acute and chronic leukemia?

A

Acute leukemia develops quickly and requires immediate treatment, while chronic leukemia progresses more slowly.

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29
Q

What are common signs and symptoms of Acute Lymphoblastic Leukemia (ALL)?

A

Fever, infection, bleeding, bone pain, headache, pancytopenia, night sweats

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30
Q

What is the primary characteristic of blasts in leukemia?

A

They are abnormal and immature cells.

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31
Q

What does ‘q’ stand for in cytogenetics?

A

Long arm

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32
Q

What does ‘inv’ stand for in cytogenetics?

A

Inversion

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33
Q

What physical exam findings are associated with ALL?

A

Hepatomegaly, splenomegaly, lymphadenopathy, testicular enlargement, neurologic abnormalities

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34
Q

What does ‘del’ stand for in cytogenetics?

A

Deletion

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35
Q

What is the primary goal of treatment for Chronic Myeloid Leukemia (CML)?

A

To reduce or eliminate cells with the Philadelphia chromosome.

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36
Q

What is the effect of genetic alterations in acute leukemia?

A

Differentiation arrest and/or excessive proliferation of abnormal immature cells, leading to decreased normal blood cell production.

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37
Q

What does ‘t’ stand for in cytogenetics?

A

Translocation

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38
Q

What percentage of children with leukemia have at least one of the following: palpable liver, palpable spleen, pallor, fever, or bruising?

A

50%

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39
Q

What is the relationship between atomic bomb survivors and leukemia?

A

Increased risks of Myeloid Leukemia

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40
Q

What is expected to occur within 3 months of CML treatment?

A

Hematologic remission with normal CBC and bone marrow, and a normal physical exam.

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41
Q

What does BMBx show in the diagnosis of ALL?

A

Infiltration of lymphoblasts

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42
Q

What cytogenetic abnormality is considered favorable in AML?

A

t(8;21) (q22;q22)

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43
Q

What is expected to occur within 3-6 months of CML treatment?

A

Cytogenetic remission with no evidence of the Philadelphia chromosome.

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44
Q

How are leukemia cells in ALL classified?

A

According to immunophenotype via Flow Cytometry

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45
Q

What are some secondary causes of Acute Myeloid Leukemia (AML)?

A

Secondary to MDS, myeloproliferative disorders, aplastic anemia, prior chemotherapy or radiation, toxic exposure

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46
Q

What cytogenetic abnormality is considered unfavorable in AML?

A

del 7q

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47
Q

What is the desired outcome within 12 months of CML treatment?

A

Molecular remission with a negative BCR/ABL mutation analysis by quantitative PCR.

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48
Q

What does CD stand for in the context of ALL?

A

Cluster of differentiation

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49
Q

What cytogenetic abnormality is considered intermediate in AML?

A

Abnormalities not otherwise specified

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50
Q

What is the role of alkylating agents in leukemia?

A

They can cause therapy-related AML.

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51
Q

Why is CML treatment usually not emergent?

A

Because the majority of circulating cells are mature myeloid cells.

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52
Q

What percentage of AML patients have normal cytogenetics?

A

Almost half

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53
Q

What is the significance of hepatosplenomegaly in AML?

A

It indicates the enlargement of the liver and spleen due to leukemia.

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54
Q

Why are chromosomal abnormalities significant in childhood ALL?

A

They help with risk group stratification and guide therapy.

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55
Q

What can further differentiate the intermediate risk category in AML?

A

Molecular profiling

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56
Q

What are cytogenetic abnormalities?

A

Chromosomal aberrations

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57
Q

What is the overall cure rate for children with ALL?

A

90%

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58
Q

How long can treatment for ALL last?

A

2-3 years

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59
Q

What is the primary treatment urgency for Acute Myeloid Leukemia (AML)?

A

Immediate treatment is required due to rapid disease progression.

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60
Q

How has the annual mortality rate for CML changed with Tyrosine Kinase Inhibitors (TKIs)?

A

It has been reduced from 10-20% to about 2%.

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61
Q

What are molecular abnormalities?

A

Gene mutations

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62
Q

What are the phases of ALL treatment?

A

Induction, intensified consolidation, maintenance, CNS prophylaxis during induction and consolidation

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63
Q

What do TKIs inhibit in CML treatment?

A

BCR-ABL tyrosine kinase.

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64
Q

What mutation is associated with shorter remission duration in AML?

A

FLT-3

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65
Q

What is the primary abnormality in the blood of AML patients?

A

Large numbers of immature/abnormal myeloid cells (blasts)

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66
Q

What is the effect of AML on normal blood cell production?

A

Decreased normal blood cell production

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67
Q

Why is CNS prophylaxis important in ALL treatment?

A

Without it, relapse significantly increases at 1 year.

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68
Q

Name a 1st generation TKI used in CML treatment.

A

Imatinib mesylate (Gleevec).

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69
Q

What is the primary diagnostic tool for AML?

A

Bone Marrow Biopsy

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70
Q

What methods are used for CNS prophylaxis in ALL?

A

Intrathecal chemotherapy, Omaya reservoir, lumbar puncture

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71
Q

Name two 2nd generation TKIs used in CML treatment.

A

Dasatinib (Sprycel) and nilotinib (Tasigna).

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72
Q

What is the primary characteristic of Auer rods?

A

They are pathognomonic of myeloblasts.

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73
Q

What were the relapse rates for CNS involvement in ALL before routine CNS therapy?

A

Up to 80%

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74
Q

What is the primary focus of the ICC and WHO classification systems for AML?

A

Molecular and cytogenetic characteristics

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75
Q

What is the prognosis for CML patients who achieve hematologic, cytogenetic, and molecular remission?

A

Excellent, with 100% remaining progression-free at 8 years.

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76
Q

What mutation improves CR rate and overall survival in AML?

A

NPM1

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77
Q

What is the first phase of intensive chemotherapy for AML?

A

Induction chemotherapy

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78
Q

What is the goal of consolidation chemotherapy in AML?

A

To produce and maintain a Complete Remission (CR)

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79
Q

What is a high-risk treatment option for AML relapse?

A

Stem cell transplantation

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80
Q

What are some long-term effects of ALL treatment?

A

Neurodevelopmental impairment, growth retardation, cardiotoxicity, risk for second malignancies, impaired glucose and insulin metabolism, infertility

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81
Q

What factors contribute to a worse prognosis in CML patients?

A

Failure to achieve remission targets, loss of cytogenetic or molecular response, or development of new mutations or cytogenetic abnormalities.

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82
Q

What is a common side effect of AML chemotherapy?

A

Pancytopenia

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83
Q

What is the primary abnormality in the bone marrow of AML patients?

A

Uncontrolled proliferation of myeloid precursors

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84
Q

What are the remission rates for adult ALL?

A

80-90%

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85
Q

What is a major cause of treatment failure in CML?

A

Poor compliance with taking the medication.

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86
Q

What is Leukemia Cutis?

A

Local or disseminated skin infiltration by leukemia cells

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87
Q

What is the primary cause of dyspnea in AML patients?

A

Leukostasis

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88
Q

What percentage of adult ALL patients have the Philadelphia Chromosome?

A

20-30%

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89
Q

What often causes relapses during TKI treatment in CML?

A

Development of a new mutation in the BCR-ABL gene.

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90
Q

What is Myeloid Sarcoma also known as?

A

Granulocytic sarcoma

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91
Q

What is the primary cause of bone pain in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

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92
Q

What is recommended for all patients with Ph-positive ALL who achieve complete remission after induction?

A

Allogeneic Stem Cell Transplant (SCT)

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93
Q

What is the primary cause of fever in AML patients?

A

Infection due to neutropenia

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94
Q

What is the most common childhood cancer?

A

Acute Lymphoblastic Leukemia (ALL)

95
Q

How often should CML patients taking TKIs be monitored with a quantitative PCR assay?

A

Approximately every 3 months.

96
Q

What is a risk factor for ALL?

A

Genetic and immunodeficiency syndromes

97
Q

What is the primary cause of altered mentation in AML patients?

A

Leukostasis

98
Q

What should be considered for CML patients who do not achieve a good molecular response or who progress following therapy?

A

Allogeneic stem cell transplantation.

99
Q

What is a common symptom of ALL?

A

Fever

100
Q

What characterizes Chronic Myeloid Leukemia (CML)?

A

Slow-growing, increased proliferation of mature myeloid cells, more functional cells

101
Q

What is the primary cause of chest pain in AML patients?

A

Leukostasis

102
Q

What physical exam finding is common in children with leukemia?

A

Hepatomegaly

103
Q

What can stem cell transplant offer to CML patients?

A

A cure.

104
Q

What percentage of adult leukemia cases does CML account for?

A

15%

105
Q

What is the median age at diagnosis for CML?

A

55-65 years

106
Q

What is the primary cause of hepatosplenomegaly in AML patients?

A

Infiltration of leukemia cells into the liver and spleen

107
Q

What is the most common chronic leukemia?

A

Chronic Lymphocytic Leukemia (CLL).

108
Q

What has happened to the mortality rate of CML?

A

It has been greatly reduced.

109
Q

What is the primary cause of thrombocytopenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

110
Q

What is the treatment for Myeloid Sarcoma?

A

Similar to AML, may benefit from radiation

111
Q

What is the hallmark of CML?

A

Philadelphia Chromosome

112
Q

What is the difference between CLL and Small Cell Lymphocytic Lymphoma (SLL)?

A

CLL is in the blood and bone marrow, SLL is in the lymph nodes.

113
Q

What is the distribution pattern of ALL?

A

Bimodal distribution around 2-5 years of age and then again around 50 years of age

114
Q

What is the Philadelphia Chromosome?

A

Translocation between the long arms of chromosomes 9 and 22

115
Q

What is the mean age at diagnosis for CLL?

A

72 years old.

116
Q

What is the primary cause of anemia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

117
Q

What is the significance of cytogenetics in AML?

A

Important prognostically at diagnosis and at time of relapse

118
Q

What is the male to female ratio for CLL?

A

2:1.

119
Q

What genes fuse to form the BCR-ABL gene in CML?

A

BCR and ABL

120
Q

What characterizes CLL?

A

Proliferation and accumulation of mature-appearing but non-functioning B lymphocytes in blood and/or lymphoid tissue.

121
Q

What does the BCR-ABL gene cause cells to produce?

A

An abnormal enzyme: BCR-ABL tyrosine kinase

122
Q

What is the 7 + 3 regimen in AML treatment?

A

Ara-C (cytarabine) for 7 days with an Anthracycline (Idarubicin or Daunorubicin) for 3 days

123
Q

What is the primary cause of fatigue in AML patients?

A

Anemia

124
Q

What is the primary cause of neutropenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

125
Q

What is the primary cause of leukostasis in AML patients?

A

High number of abnormal white blood cells

126
Q

What is the 5-year survival rate for CLL?

A

Over 80%.

127
Q

What is the 1 + 5 regimen in AML treatment?

A

Ara-C with Mitoxantrone on day 1 and day 5

128
Q

What is the most likely time for AML relapse after induction chemotherapy?

A

Within the first two years

129
Q

What are the three phases of CML?

A

Chronic phase, accelerated phase, blast phase

130
Q

What percentage of CLL/SLL patients are asymptomatic at diagnosis?

A

25%.

131
Q

What percentage of CML patients are diagnosed in the chronic phase?

A

85%

132
Q

What is the primary cause of dyspnea in AML patients?

A

Leukostasis

133
Q

What is the method to confirm Leukemia Cutis?

A

Skin biopsy

134
Q

What are the ‘B’ symptoms associated with CLL/SLL?

A

Fatigue, drenching night sweats, weight loss, frequent and/or persistent infections.

135
Q

What is the primary cause of chest pain in AML patients?

A

Leukostasis

136
Q

What characterizes the blast phase of CML?

A

20-30% blast in bone marrow or blood, difficult to control

137
Q

What is the primary cause of headache in AML patients?

A

Leukostasis

138
Q

What is the common site for Myeloid Sarcoma?

A

Skin and soft tissues

139
Q

What is a common finding in 80% of CLL/SLL patients?

A

Painless lymphadenopathy.

140
Q

What is a key diagnostic feature of CLL on a peripheral smear?

A

Smudge cells.

141
Q

What are common signs and symptoms of CML?

A

Usually asymptomatic, fatigue, weight loss, early satiety, poor appetite, low-grade fevers, excessive sweating

142
Q

What is the primary cause of altered mentation in AML patients?

A

Leukostasis

143
Q

What is the common age group for pediatric ALL?

A

2-5 years of age

144
Q

What is the primary cause of hepatosplenomegaly in AML patients?

A

Infiltration of leukemia cells into the liver and spleen

145
Q

What markers are identified in CLL/SLL through peripheral blood flow cytometry?

A

CD5, CD19, CD20, CD23.

146
Q

What physical exam findings are associated with CML?

A

Hepatomegaly, splenomegaly, petechiae, ecchymoses, pallor

147
Q

What is the common age group for adult ALL?

A

Around 50 years of age

148
Q

What is the primary cause of bone pain in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

149
Q

Is a bone marrow biopsy required for CLL diagnosis?

A

No, it is not required.

150
Q

What is the common site for ALL spread?

A

CNS (brain, spinal fluid, spinal cord)

151
Q

What is the most common finding in a CBC with differential for CML?

A

Leukocytosis (>150,000)

152
Q

What is the primary cause of fever in AML patients?

A

Infection due to neutropenia

153
Q

When is a lymph node biopsy required for SLL?

A

If peripheral flow cytometry is negative.

154
Q

What is a common physical exam finding in children with leukemia?

A

Splenomegaly

155
Q

What other blood abnormalities are found in CML?

A

Thrombocytosis, anemia

156
Q

What is a common symptom of ALL related to the blood?

A

Bleeding

157
Q

What are smudge cells?

A

Remnants of fragile lymphocytes distorted during slide preparation.

158
Q

What is a common symptom of ALL related to the bones?

A

Bone pain

159
Q

What is the primary cause of thrombocytopenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

160
Q

When is treatment indicated for CLL/SLL?

A

Advanced stage, high tumor burden, severe ‘B’ symptoms, repeated infections.

161
Q

What does a bone marrow aspiration and biopsy show in CML?

A

Hypercellular with increased myeloid cell line

162
Q

What is a common symptom of ALL related to the head?

A

Headache

163
Q

What is the primary cause of anemia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

164
Q

What is a common symptom of ALL related to the immune system?

A

Infection

165
Q

What tests detect the Philadelphia chromosome in CML?

A

Cytogenetics, molecular tests like PCR or FISH

166
Q

What is the primary cause of fatigue in AML patients?

A

Anemia

167
Q

What are the treatment options for CLL/SLL?

A

Observation, chemotherapy, immunotherapy/biologic therapy, stem cell transplant.

168
Q

What can stem cell transplant offer to CLL/SLL patients?

A

A potential cure.

169
Q

What is a common symptom of ALL related to the skin?

A

Night Sweats

170
Q

What is the goal of CML treatment?

A

To reduce/eliminate the cells with the Philadelphia chromosome

171
Q

What is the primary cause of neutropenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

172
Q

What is expected within 3 months of CML treatment?

A

Hematologic remission: normal CBC & bone marrow, normal physical exam

173
Q

What is a common physical exam finding in children with leukemia related to the lymphatic system?

A

Lymphadenopathy

174
Q

What is the primary cause of leukostasis in AML patients?

A

High number of abnormal white blood cells

175
Q

What is the primary cause of dyspnea in AML patients?

A

Leukostasis

176
Q

What is a common physical exam finding in children with leukemia related to the testes?

A

Testicular Enlargement

177
Q

What is expected within 3-6 months of CML treatment?

A

Cytogenetic remission: no evidence of Philadelphia chromosome

178
Q

What is the primary cause of chest pain in AML patients?

A

Leukostasis

179
Q

What is the desired outcome within 12 months of CML treatment?

A

Molecular remission: negative BCR/ABL mutation analysis by quantitative PCR

180
Q

What is a common physical exam finding in children with leukemia related to the nervous system?

A

Neurologic abnormalities

181
Q

What is the primary cause of headache in AML patients?

A

Leukostasis

182
Q

What percentage of children with leukemia have at least one of the following: palpable liver, palpable spleen, pallor, fever, or bruising?

A

50%

183
Q

What is the primary cause of altered mentation in AML patients?

A

Leukostasis

184
Q

What is the primary cause of hepatosplenomegaly in AML patients?

A

Infiltration of leukemia cells into the liver and spleen

185
Q

What is the primary cause of bone pain in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

186
Q

What is the primary cause of fever in AML patients?

A

Infection due to neutropenia

187
Q

What is the primary cause of thrombocytopenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

188
Q

What is the primary cause of anemia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

189
Q

What is the primary cause of fatigue in AML patients?

A

Anemia

190
Q

What is the primary cause of neutropenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

191
Q

What is the primary cause of leukostasis in AML patients?

A

High number of abnormal white blood cells

192
Q

What is the primary cause of dyspnea in AML patients?

A

Leukostasis

193
Q

What is the primary cause of chest pain in AML patients?

A

Leukostasis

194
Q

What is the primary cause of headache in AML patients?

A

Leukostasis

195
Q

What is the primary cause of altered mentation in AML patients?

A

Leukostasis

196
Q

What is the primary cause of hepatosplenomegaly in AML patients?

A

Infiltration of leukemia cells into the liver and spleen

197
Q

What is the primary cause of bone pain in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

198
Q

What is the primary cause of fever in AML patients?

A

Infection due to neutropenia

199
Q

What is the primary cause of thrombocytopenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

200
Q

What is the primary cause of anemia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

201
Q

What is the primary cause of fatigue in AML patients?

A

Anemia

202
Q

What is the primary cause of neutropenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

203
Q

What is the primary cause of leukostasis in AML patients?

A

High number of abnormal white blood cells

204
Q

What is the primary cause of dyspnea in AML patients?

A

Leukostasis

205
Q

What is the primary cause of chest pain in AML patients?

A

Leukostasis

206
Q

What is the primary cause of headache in AML patients?

A

Leukostasis

207
Q

What is the primary cause of altered mentation in AML patients?

A

Leukostasis

208
Q

What is the primary cause of hepatosplenomegaly in AML patients?

A

Infiltration of leukemia cells into the liver and spleen

209
Q

What is the primary cause of bone pain in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

210
Q

What is the primary cause of fever in AML patients?

A

Infection due to neutropenia

211
Q

What is the primary cause of thrombocytopenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

212
Q

What is the primary cause of anemia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

213
Q

What is the primary cause of fatigue in AML patients?

A

Anemia

214
Q

What is the primary cause of neutropenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

215
Q

What is the primary cause of leukostasis in AML patients?

A

High number of abnormal white blood cells

216
Q

What is the primary cause of dyspnea in AML patients?

A

Leukostasis

217
Q

What is the primary cause of chest pain in AML patients?

A

Leukostasis

218
Q

What is the primary cause of headache in AML patients?

A

Leukostasis

219
Q

What is the primary cause of altered mentation in AML patients?

A

Leukostasis

220
Q

What is the primary cause of hepatosplenomegaly in AML patients?

A

Infiltration of leukemia cells into the liver and spleen

221
Q

What is the primary cause of bone pain in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

222
Q

What is the primary cause of fever in AML patients?

A

Infection due to neutropenia

223
Q

What is the primary cause of thrombocytopenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

224
Q

What is the primary cause of anemia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

225
Q

What is the primary cause of fatigue in AML patients?

A

Anemia

226
Q

What is the primary cause of neutropenia in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

227
Q

What is the primary cause of leukostasis in AML patients?

A

High number of abnormal white blood cells

228
Q

What is the primary cause of dyspnea in AML patients?

A

Leukostasis

229
Q

What is the primary cause of chest pain in AML patients?

A

Leukostasis

230
Q

What is the primary cause of headache in AML patients?

A

Leukostasis

231
Q

What is the primary cause of altered mentation in AML patients?

A

Leukostasis

232
Q

What is the primary cause of hepatosplenomegaly in AML patients?

A

Infiltration of leukemia cells into the liver and spleen

233
Q

What is the primary cause of bone pain in AML patients?

A

Replacement of normal bone marrow cells by leukemia cells

234
Q

What is the primary cause of fever in AML patients?

A

Infection due to neutropenia

Hematology/Immunology Part 2 (9 decks)

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