Leukemia Flashcards
what cells are derived from the Myeloblast
- erythrocyte
- Thrombocyte
- Monocyte
- Neutrophil
- Basophil
- Eosinophil
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What can cause elevated neutrophils
bacterial infections
What can cause elevated immature neutrophils (bands)
- acute bacterial infections
- sepsis
What can cause elevated lymphcytes
viral infections
What can cause the presence of atypical lymphcytes
epstein-barr virus
What is the most common acute leukemia in adults
acute Myelogenous leukemia
what lab values would lead you to suspect acute Myelogenous leukemia
- peripheral blood is always abnormal
- accumulation of leukemic blasts
- reduced production of normal cells
- neutrophils
- erythrocytes
- platelets
what are two important causes of acute Myelogenous leukemia
- chemical exposure
- Myelodysplastic syndrome (MDS): malignant hematologic disease
AML signs and symptoms arrives from which three cells being affected
- RBC-> anemia
- Neutropenia
- thrombocytopenia
AML prognosis
- favorable if younger than 60 yo
- unfavorable if older than 60 yo or evolved from MDS
what is expected on peripheral smear in acute Myelogenous leukemia
Auer rods
what needs to be found in bone marrow biopsy for diagnosis of AML
Blasts > or = 20% of sample
What is Myelodysplastic syndrome
- ineffective hematopoiesis
- see cytopenias
- more common in those > 60 y.o.
What is tumor lysis syndrome
- emergeny!-> associated with high mortality
- initiation of cytotoxic therapy or can occur spontaneously
- massive tumor cell lysis: release of cellular contents
tumor lysis syndrome is manifested by what 4 symptoms
- Hyperkalemia
- Hyperphosphatemia
- Hypocalcemia
- Hypouricemia
treatment of tumor lysis syndrome
- prevention
- fluids
- frequent monitoring of
- K
- phosphorus
- uric acid
- calcium
risk factor for chronic myeloid leukemia
ionizing radiation
90% of chronic myeloid leukemia is due to what genetic abnormality
- philadelphia chromosome
- translocation of chromosomes 9 and 22
what are B symptoms
- fever
- drenching night swights
- weight loss
presentation
- fatigue
- malaise
- abdominal fullness
- splenomegaly
- B symptoms
chronic myeloid leukemia
chronic myeloid leukemia presents in what 3 phases
- chronic
- accelerated
- blast
chronic phase of chronic myeloid leukemia
- 80% patient diagnosed in this phase
- asymptomatic
- WBC > 100,000
- <10% blood or bone marrow cells are blasts
- typically lasts 5-6 yrs
accelerated phase of chronic myeloid leukemia
- 10-19% blood or BM cells are blasts
- symptomatic
- anemia
- fatigue
- malaise
- flu-like symptoms
blast crisis stage of chronic myeloid leukemia
- 20% or more of blood or bone marrow cells are blasts
- symptomatic
- splenomegally
- fatigue
- fever
how is chronic myeloid leukemia diagnosed
- bone marrow biopsy
- identification of Philadelphia chromosome
treatment of chronic myeloid leukemia
- tyrosine kinase inhibitors
- gleevac=imatinib
complications of chronic myeloid leukemia
- hyperleukocytosis
- wbc > 100,000/mcl
- emergency!
- decreased tissue perfusion
- may require leukapheresis
- hyperviscosity syndrome
what is the most common cancer in children and teens
acute lymphocytic leukemia
In acute lymphocytic leukemia, is cure rate more favorable in children or adults
children
acute lymphocytic leukemia laboratory findings
- blasts in peripheral blood
- cytopenia
- neutropenia
- anemia
- thrombocytopenia
- elevated LDH
what is expected to be found in peripheral smear of acute lymphocytic leukemia patients
lymphoblasts
how is acute lymphocytic leukemia diagnosed
- peripheral smear
- bone marrow biopsy
precursor B-cell acute lymphocytic leukemia has what prognosis
- 70-80% cases of childhoos ALL
- favorable!
- 90% enter remission
T cell acute lymphocytic leukemia
- older age, male predominance
- hyperleukocytosis at dx
- tend to have more problems than B-cell ALL
what is Mature B-cell acute lymphocytic leukemia? Prognosis?
- Burkitt cell leukemia/lyphoma
- favorable prognosis
acute lymphocytic leukemia treatment
- induction chemotherapy
- monoclonal antibodies
what is the most prevalent leukemia in adults in western countries
chronic lymphocytic leukemia
what malignancy has the highest inheritability
chronic lymphocytic leukemia
what is chronic lymphocytic leukemia
- accumulation of incompetent lymphocytes in blood, bone marrow, and lymph nodes
chronic lymphocytic leukemia clinical features
- bone marrow failure
- anemia
- thrombocytopenia
- neutropenia
- organomegaly in advanced disease
- lymphadenopathy
- splenomegaly
- hepatomegaly
presentation
- anemia
- B symptoms
- atypical infections
- death due to
- infection
- bleeding
- cachexia
chronic lymphocytic leukemia
how is chronic lymphocytic leukemia diagnosed
- bone marrow biopsy
- lymph node biopsy
treatment of chronic lymphocytic leukemia
- Rituximab and other monoclonal antibodies