Leukemia Flashcards
EBV causes
Burrkett’s leukemia/lymphoma
HTLV1 causes
Adult T cell leukemia
Pulmonary leukostasis is more common in
AML
Coagulopathy is common in which AML?
AML M5 + AML M3
RES infiltration is common in
ALL
Gum hypertrophy is common in
AML M5
Sweet’s syndrome and chloroma
AML
- 15 to 20 micro m.
- fine chromatin.
- predominant nucleoli 1-4.
- moderate basophilic cytoplasm.
- Auer rods may present.
Myeloblast
- 10 to 15 micro m.
- condensed chromatin.
- scanty cytoplasm.
- inconspicuous nucleoli 1-2.
- auer rods are absent.
Lymphoblast
Neutrophil primary granules are stained in?
Myeloperoxidase (MPO) (myeloblasts strong +ve, monoblasts faint +ve)
Phospholipids are stained in?
Sudan black B (SBB)
Cellular enzymes are stained in ?
Specific esterase (myeloblasts strong +ve)
M2 , M3 ,M4eo
Favorable prognosis
M0, M1, M5, M6, M7
Unfavorable prognosis
t(8,21), t(15,17), inv(16), normal CG
Favorable prognosis
t(9,22), -5, -7, +8. Complex CG
Unfavorable prognosis
Adverse prognostic factors in ALL: ( high risk)
t(9,22).
t(4,11).
trisomy 8.
Hypodiploidy
Postremission therapy aimed at destroying clinically occult disease.
Remission consolidation (intensification) therapy
Low dose of chemotherapy aimed at preventing the reemergence of leukemia.
Maintenance (continuation) therapy
Initial chemotherapy treatment aimed at achieving a complete remission.
Remission induction therapy
Complete remission of leukemia
■ Disappearance of leukemia after treatment with full regeneration of normal hematopoiesis.
■ <5% blasts in a normocellular bone marrow.
■ Return of peripheral blood count to normal:
■ Neutrophils count > 1500/µL. ■ Platelets count >100,000/µL. ■ hemoglobin level >10 gm/dL.
■ Disappearance of sings and symptoms.
Persistent leukemia, not detectable by light microscopy.
Minimal residual disease
Leukemia that does not enter CR.
Refractory Leukemia
WBC> 100 000
AML
WBC> 200 000
ALL
Cytoreduction Tx for AML
Hydroxyurea
Cytoreduction Tx for ALL
Steroids
Allopurinol + Rasburicase
Used to treat Tumor Lysis Syndrome
FFP + cryoprecipitate are used to treat
DIC coagulopathy In Leukemic patients
Acute leukemia associated with CNS disease at presentation?
ALL
Aim is to reconstitute normal hematopoiesis and to prevent GVL effect.
Allogeneic SCT
high-dose ara-C is used in?
Remission consolidation therapy (post remission)
ATRA (all trans retinoic acid) is used to treat?
AML M3
Used to treat AML M3, and can result in differentiation syndrome?
ATRA (all trans retinoic acid)
Which of the following is NOT done to manage differentiation syndrome resulted from ATRA Tx?
- Hold ATRA.
- Stop ATRA.
- Give dexamethasone.
- Give diuretics.
Stop ATRA
Induces apoptosis in the leukemic cells
Arsenic trioxide (ATO) *induces cardiotoxicity + neurotoxicity
Hyper CVAD drugs used to treat
ALL
For relapsed or patients with high risk to develop leukemia
Allogeneic SCT
Leukemia mainly seen in children
ALL
Leukemia mainly seen in elderly
CLL
The most common malignancy in childhood?
ALL
Which of the following is specific manifestation of AML?
- Gumhypertrophy.
- violaceous skin deposits.
- Testicular enlargement.
- mediastinal mass (SVCO).
A and B
- Testicular enlargement.
- mediastinal mass (SVCO). Both are specific for?
ALL
DIC is specific for which leukemia?
AML