Leukemias Flashcards
Which of the following is true concerning chronic lymphocytic leukemia in dogs and humans? a. Dogs most commonly have B cell leukemia while humans most commonly have T cell leukemia b. T cell leukemia is most common in both species c. B cell leukemia is most common in both species d. Dogs most commonly have T cell leukemia while humans most commonly have B cell leukemia
d.
Which of the following is least commonly reported in dogs? a. acute myeloblastic leukemia (M1 and M2) b. acute myelomonocytic leukemia (M4) c. promyelocytic leukemia (M3) d. megakaryoblastic leukemia (M7)
c. The other three are relatively common (for myeloid leukemias, anyway) in dogs, while M3 has not been reported.
Mutations in which of the following genes have been reported in dogs with acute myeloid leukemia? i. FLT3 ii. C-Kit iii. RAS iv. JAK2 a. i and ii b. i, ii, and iii c. i, ii, iii, and iv d. ii and iii
b. JAK2 mutation has been reported in a dog with primary polycythemia (polycythemia vera) and JAK2 mutations are also identified in 90% of humans with the disease.
In humans with CML, the “Philadelphia Chromosome” results from a translocation between chromosomes 9 and 22, and causes a BCR-ABL mutation. In dogs, the analogous chromosome rearrangement is: a. 8 and 11 b. 9 and 11 c. 8 and 26 d. 9 and 26
d.
Identify what markers are used for cytochemical staining or immunophenotyping of megakaryocytes when evaluating blood and bone marrow smears for the diagnosis of AML vs lymphocytic leukemia. i. Acetylcholinesterase ii. Von Willibrand’s factor iii. Platelet glycoproteins iv. Vimentin v. Cytokeratin A. i, ii, iii B. iv C. v D. all of the above E. iv, v
a.
A blood smear and bone marrow differential count is performed. The erythroid cells are less than 50% of all nucleated cells and the blast cells are greater than 30%. Out of the options below, what is the most likely diagnosis? A. Erythroleukemia (M6) B. Chronic myeloid leukemia C. Acute myeloid leukemia or Acute undifferentiated leukemia D. Essential thrombocythemia E. Chronic lymphocytic leukemia
c. If erythroid cells are less than 50% of ANC and the blast cells are greater than 30%, a dx of AML or AUL is made. If erythroid cells are greater than 50% of ANC and the blast cells are greater than 30%, a dx of erythroleukemia (M6) is made. If rubriblasts are a significant proportion of the blast cells, a dx of M6Er, or erytholeukemia with erythoid predominance, can be made. *** It should be noted that in human AML classification system, the blast threshold has been lowered to 20% and similar recommendations are being made for AML in dogs and cats.
What drug has been reported to be the most effective agent for treating CML during the chronic phase? A. Elspar B. Mixtoxantrone C. Methotrexate D. Cisplatin E. Hydroxyurea
e. CML is best managed with chemotherapy to control the proliferation of abnormal cell line and improve the quality of life. Hydroxyurea is the most effective agent for treating CML during the chronic phase. The initial dose is 20-25 mg/kg twice daily.
Which of the following mutations have been documented in dogs with acute myelogenous leukemia? i. FLT3 ii. JAK2 iii. RAS iv. RON v. C-KIT a. I, ii, iii b. ii, iii, iv c. I, iii, iv d. I, iii, v e. ii, iv, v
d.
A 10-year-old, castrated male, Staffordshire terrier presents with a history of anemia, thrombocytopenia, and lethargy. On the complete blood count, there are 45,000 circulating blast cells. Flow cytometry is performed and diagnoses a CD34+CD11b+CD3-MPO+CD79a-. What is the diagnosis? a. acute myeloid leukemia b. acute lymphoblastic leukemia c. mastocytosis d. chronic myelogenous leukemia e. megakaryoblastic leukemia
a. CD11b – myeloid line MPO – myeloid line
Which of the following chemotherapy agents would be suspected to improve survival of dogs with acute lymphocytic leukemia based on improvement in human survival? a. 6-thioguanine b. cytosine arabinoside c. hydroxyurea d. CCNU e. cyclophosphamide
b.
A 6 year old MI German Shepherd Dog presents with a 3 month history of increased PCV, lethargy, and hyporexia. On presentation to you the HCT is 75%. No other clinically significant blood work abnormalities are noted on minimum data base. On physical exam his mucous membranes are bright pink to red in color, but he appears adequately hydrated. Thoracic radiographs and abdominal ultrasound are unremarkable. Bone marrow aspiration shows a normal M:E ratio. What is the best treatment recommendation? i. IV fluids ii. phlebotomy iii. cyclophosphamide iv. hydroxyurea v. blood transfusion A. i only B. i, ii, iii C. i, ii, iv D. v only
C. Would also want to echo and make sure that no heart probs, or check EPO levels.
Which of the following is a specific marker for basophils? A. CD34 B. CD41 C. Omega exonuclease D. Chloracetate esterase
c. CD34 – marker for acute lymphoid leukemia and AML CD41 – megakaryoblasts Chloracetate esterase – neutrophils and basophils
