Lymphoblastic Leukemias

Question 1

Do we differentiate between lymphoid proliferation in the bone marrow vs. lymph nodes?

Answer 1

not anymore - so lymphoblastic leukemia and lymphoblstic lymphoma is the same thing at this point

Question 2

How are the acute lymphoblastic leukemias classified?

Answer 2

immunophenotpe: B or T

Question 3

Who gets the acute lymphoblastic leukemias?

Answer 3

waay more common in children - and they have a better prognosis (really quite good actually)

Question 4

What enzyme do we use to tell if there’s a lymphoblastic process going on? Will it differentiate T and B?

Answer 4

TdT - they’ll both have it

Question 5

What’s the most common presentation of T lymphoblastic leukemia?

Answer 5

Teenage male with mediastinal mass (T for teenage and T for thymus)

Question 6

Is the WBC usually hihg or low in T lymphoblastic leukemia?

Answer 6

way up

Question 7

T lymphoblastic leukemia - better or worse prognosis than B lymphoblastic?

Answer 7

worse

Question 8

What chromsomal abnormality is rarely, but sometimes seen in B lymphoblastic leukemia? Why is that surprising?

Answer 8

the philadelphia chromosone: translocation of 9 and 22

it’s unusual because you usually see that in CML, which is a totally unrelated disease

Question 9

WHat’s the treatment for ALL?

Answer 9

chemo and bone marrow transplant - many children are cured

Question 10

WIth the cytogenetics, what unsual finding leads to a better prognosis, strangely enough?

Answer 10

hyperdiploidy in the tumor cells has a better prognosis. we don’t know why

Question 11

What age range has the best prognosis for ALL>

Answer 11

1-10 years old

Question 12

What do you want the WBC count below for the best prognosis?

Answer 12

lower than 10,000