Leukemias Flashcards
Which leukemia isn’t associated with radiation
CLL
Chronic Lymphoid prolif forms…
CLL/Small Cell Lymphoma
Hairy Cell Leukemia
MM
Relationship of acute/chronic to BM fxn
more acute = greater dysfunction
Chronic leukemias may lead to….
Marrow Failure
Blast Transformation
Appearance of BM in a leukemia
Muddy, red-brown to gray-white color as marrow is replaced
Two leukemias with the most splenomegaly
CML, Hairy Cell
Liver enlargement tends to be greater with ____ (lymphocytic or myelogenous)
Lymphocytic – localizes to portal area
Myelogenous are less and diffusely in sinusoids
___ infiltrates the CNS + testicles
ALL
____ infiltrates the gingiva
AML
DIC is associated with ____
Acute Promyelocytic Leukemia (M3)
Features of all acute leukemias
Abrupt onset
Depressed marrow fxn + Bone Pain/Tenderness
Organ infiltration w/ leukemic cells
CNS symptoms from meningeal spread (esp. from ALL)
Anemia
Features of all chronic leukemias?
Depend on cell effected
Nonspecific symptoms – fatigue, weakness, weight loss
Slow Progression
Which chronic is more likely to have blast crisis
CML
CLL usually won’t get there.
Most common childhood leukemia
ALL
ALL is split into morphological subtypes based on…
Cell Size
Nuclear Morphology
Cytoplasmic basophilia/vacuolation
ALL L1 is….
L3 is….
Most are…
L1 = Small lymphocytes w/ nuclear atypia
L3 = Large w/ nuclear and cytoplasmic atypia
L1
ALL Leukemic lymphoblasts contain large aggregates of…..
What do they lack that is in AML
PAS-positive material
Peroxidase-containing granules
Important thing to stain for to distinguish ALL from AML
TdT
Hyperploidy is a _______ prognostic indicator in ALL
good
Clinical features more tied to ALL than AML
Bone Pain, Lymphadenopathy, hepatosplenomegaly
More frequently becomes meningeal
Important details on M2 and M3 forms of AML
M2 - Myeloid Forms with variable maturation. auer rods. Most common.
M3 – Acute promyelocytic leukemia w/ hypergran. (RA)
Most important clinical features of AML?
Thrombocytopenia – petechiae, ecchym.
DIC
Opportunistic Infections
Little organ involvement, No CNS
CML is definitively diagnosed with
9, 22 translocation
This allows reduced adherence of cells to the stromal matrix
Dominant cell line involved in CML
granulocytic precursors
How to distinguish CML from acute leukocytosis
LAP staining (not in leukemic cells)
Clinical features characteristic of CML?
Large Cell Counts
Splenomegaly
Varied mature forms of cells in the blood
Long term effect of AML
Accelerated phase –> less responsive to treatment, less fxn
Blast Crisis –> AML, ALL
Peripheral blood smear findings that are most unique to CLL
Smudge Cells
Markers that should be present in CLL?
Which one would you expect that isn’t
CD19, 20, 5
NO TdT
Approx 1/3 of patients with CLL have Trisomy ___
12
Marker associated with Hairy Cell leukemia? Most common presenting symptom?
TRAP
Splenomegaly
AML is associated with a translocation at..
8, 21
