Leukemias Flashcards
Acute leukemia
Abnormal proliferstion of precursors
Chronic leukemia
Abnormal proliferation of mature cells
L stands for
Lymphoblasts
M Stands for
Myeloid line of stem cells
Most of our lymphocytes are
B cells
AML
Acute myelobkastic leukemia, bunch of myelobkasts precursors
Myelogenous or myelobkastic
Mature myeloid cells proliferating
ALL
Acute, in bone marrow or precursors, abnormal of lymphoblasts, all that exists I. Bone marrow are lymphoblasts. No room for myeloid line to proliferate. So deficiency in myeloid cells, some red blood cells but so squeezed that get liched off on way out of bone which look like tear drop.
Thrombocytopenia shows as
Superficial bleeding, increased bleeding tume
ALL occurs in
Children
AML
Myeloid are abnormally proliferating, crows out bc so li has off as exiting so tear drops cells, those myeloid blasts NEVER differentiate into normal cells so you get petechial bleeding.
Fever, night sweats, petechial bleeding, bone pain, hepatisplenomegaly, enlarged Ln
Leukemia patients
Greater than 30% lymphoblasts in blood, children
ALL
Chrom deletion or somatic hyoermutation, scant cytoplasms, hepatosplenomegaly, Lymohocytosis (lots of lymphocytes), 20-30% have thrombocytopenia,, male adults (average age of Dx is 70 years old)
CLL
AML
Acute, bone marrow, myelobkastic proliferate, the myeloblasts differentiate into something that proliferates. Ex, an erythroblasts proliferates. auer rods are pathognomonic. Echymosis, petechial. Greater than 30% myelobkasts. Occurs in adults (average age is 67) range is from 0 to elderly.
CML
Myelogenous line is abnormally proliferating, Philadelphia chromosome, hypecelukar marriw, elevated eosinophils and basophils, massively increased WBC count (more than 200k), mature myeloid are seen in periphery, average age is 60-65
Auer rods
AML
Azurophikic granular material forming elongated needles in cytoplasm of leukemia blasts
Auer rods in AML
Sudan strains for
Fat
Sudan black stains positive in
Myeloblasts for AML
Translocation for AML variant M3
Translocation 15;17
Blast cells are seen in
ALL
Most common pediatric malignancy
ALL
TDT, Cd10 and CD19
B- ALL
Cd1a, cd2, cd3, cd4, cd5, cd7 y cd8
T-ALL
ALL stain positive for
PAS, stains the carbohydrate macromolecules
SVC Syndrome
Enlarged head, flushing, vision issues, could have upper extremity edema if it is at the brachicephalic junction.
Stridor
Louder and high pitched than whiz. Sounds like a whistle. When you breath in.
Inspiratory whiz
Airway compromise.
Why does AML carry a worse prognosis than ALL?
Because person can not generate neutrophils or macrophages
Methotrexate is used for which one? ALL or AML?
ALL
Monocytes, macrophages, neutrophils proliferate
CML
CML originate in the ———— and not in the ———
Periphery, bone marrow
Blast crisis
Reverts back to being acute leukemia so you’d see greater than 20% blasts in blood and it can be myelobkasts or lymphoblasts and that can lead to bone pain.
Greater than 30% myeloblasts
Acute leukemia
Smudge cells
Fragile lymphocytes, with no cell membrane and no nuclear structure, seen in CLL
Seen in over the age of 50. Average age of presentation is 70
CLL
CLL
Best prognosis because lymphocytes are functional produce antibodies even though*
Not at normal amount, but well enough.
If WBC in CLL becomes too great, then risk of
Thrombosis because it clogs vessels.
If WBC in CLL becomes too great, then risk of ?
Thrombosis because it clogs vessels.
Guy in 40s, lymph nodes enlarged. It was huge, and Inside, it was Completely black.
No Sx other than that enlarged LN.
Metastatic melanoma from bottom of his foot - acrolentifinous melanoma
Most common type of melanoma
Superficial spreading
Reed sternberg cells
Hodkin’s lymphoma
Cd15 y cd30 positive, muktinucleated cells, cd20 y cd45 negative
Reed sternberg cells, Hodkin’s lymphoma
Hodkin’s age of appearance
Bimodal distrobution: 16-44 y more than 55
Hodkin’s with Mst RS cells
Mixed cellularity, seen in EBV, HIV and elderly population
Overexpression of bcl2 antiapoptotic gene
Follicular lymphoma, t(14;18)
Tingible bodily macrophages, a macrophage with a dead tumor cells inside gives the look of a starry sky
Burkitt
Children with chronic malaria can suffer from this lymphoma
Burkitt
Seen in Africa, big mass in jaw, also distan ileum, cecum, ovaries, kidney
Burkitt
Can present as a Bowel obstruction in AIDS patient early on in AIDS.
Burkitt
Hemorrhagic cystitis caused by
Cyclophosphamide
Cyclophosphamide gets metabolized into ——- which damages the epithelium.
Acroline, which damages the epithelium. causing cystitis
To prevent toxicity of cyclophosphamide give
MESNA
Bone marrow proliferation can cause primary ——-
Polycythemia Vera
Headache, hypertension, hyoercoagulable, vertigo, itchy after hot shower - mast cell degranulation causes pruritis
Polycythemia Vera
How to treat polycythemia Vera?
Phlebotomy
All cell lines depleted
Aplastic anemia
Drugs that cause aplastic anemia
Chloramphenicol, AZT, benzene, vinbkastine
Destruction and subsequent scarring of the bone marrow
Myelofibrosis
Citrate, found in blood in transfusion, binds to —— in the blood and causes ——
Calcium, hypocalcemia
Mephalam
Treats multiple myeloma Alkylation agents
PSA
Cancer antigen, prostate
CEA antigen
Colon, liver
AFP antigen
Yolk sac cancers
S-100
Melanoma