Leukemias

Question 1

Which leukemia isn’t associated with radiation

Answer 1

CLL

Question 2

Chronic Lymphoid prolif forms…

Answer 2

CLL/Small Cell Lymphoma
Hairy Cell Leukemia
MM

Question 3

Relationship of acute/chronic to BM fxn

Answer 3

more acute = greater dysfunction

Question 4

Chronic leukemias may lead to….

Answer 4

Marrow Failure

Blast Transformation

Question 5

Appearance of BM in a leukemia

Answer 5

Muddy, red-brown to gray-white color as marrow is replaced

Question 6

Two leukemias with the most splenomegaly

Answer 6

CML, Hairy Cell

Question 7

Liver enlargement tends to be greater with ____ (lymphocytic or myelogenous)

Answer 7

Lymphocytic – localizes to portal area

Myelogenous are less and diffusely in sinusoids

Question 8

___ infiltrates the CNS + testicles

Answer 8

ALL

Question 9

____ infiltrates the gingiva

Answer 9

AML

Question 10

DIC is associated with ____

Answer 10

Acute Promyelocytic Leukemia (M3)

Question 11

Features of all acute leukemias

Answer 11

Abrupt onset
Depressed marrow fxn + Bone Pain/Tenderness
Organ infiltration w/ leukemic cells
CNS symptoms from meningeal spread (esp. from ALL)
Anemia

Question 12

Features of all chronic leukemias?

Answer 12

Depend on cell effected
Nonspecific symptoms – fatigue, weakness, weight loss
Slow Progression

Question 13

Which chronic is more likely to have blast crisis

Answer 13

CML

CLL usually won’t get there.

Question 14

Most common childhood leukemia

Answer 14

ALL

Question 15

ALL is split into morphological subtypes based on…

Answer 15

Cell Size
Nuclear Morphology
Cytoplasmic basophilia/vacuolation

Question 16

ALL L1 is….
L3 is….
Most are…

Answer 16

L1 = Small lymphocytes w/ nuclear atypia
L3 = Large w/ nuclear and cytoplasmic atypia
L1

Question 17

ALL Leukemic lymphoblasts contain large aggregates of…..

What do they lack that is in AML

Answer 17

PAS-positive material

Peroxidase-containing granules

Question 18

Important thing to stain for to distinguish ALL from AML

Answer 18

TdT

Question 19

Hyperploidy is a _______ prognostic indicator in ALL

Answer 19

good

Question 20

Clinical features more tied to ALL than AML

Answer 20

Bone Pain, Lymphadenopathy, hepatosplenomegaly

More frequently becomes meningeal

Question 21

Important details on M2 and M3 forms of AML

Answer 21

M2 - Myeloid Forms with variable maturation. auer rods. Most common.
M3 – Acute promyelocytic leukemia w/ hypergran. (RA)

Question 22

Most important clinical features of AML?

Answer 22

Thrombocytopenia – petechiae, ecchym.
DIC
Opportunistic Infections
Little organ involvement, No CNS

Question 23

CML is definitively diagnosed with

Answer 23

9, 22 translocation

This allows reduced adherence of cells to the stromal matrix

Question 24

Dominant cell line involved in CML

Answer 24

granulocytic precursors

Question 25

How to distinguish CML from acute leukocytosis

Answer 25

LAP staining (not in leukemic cells)

Question 26

Clinical features characteristic of CML?

Answer 26

Large Cell Counts
Splenomegaly
Varied mature forms of cells in the blood

Question 27

Long term effect of AML

Answer 27

Accelerated phase –> less responsive to treatment, less fxn

Blast Crisis –> AML, ALL

Question 28

Peripheral blood smear findings that are most unique to CLL

Answer 28

Smudge Cells

Question 29

Markers that should be present in CLL?

Which one would you expect that isn’t

Answer 29

CD19, 20, 5

NO TdT

Question 30

Approx 1/3 of patients with CLL have Trisomy ___

Answer 30

12

Question 31

Marker associated with Hairy Cell leukemia? Most common presenting symptom?

Answer 31

TRAP

Splenomegaly

Question 32

AML is associated with a translocation at..

Answer 32

8, 21