Lymphoid Neoplasms I Flashcards
What is another name of
- Chronic Lymphocytic Leukemia
- Acute Lymphoblastic Leukemia
- Chronic Lymphocytic Leukemia = Small Lymphocytic Lymphoma
* Acute Lymphoblastic Leukemia = Lymphoblastic Lymphoma
What is the most common malignancy of childhood?What is its etiology?
ALL - Most common malignancy of childhood but incidence also increases after 50 y.Etiologic associations
- Ionizing radiation
- Immunodeficiency states Trisomy 21 (Later than the age of 5…L for ALL)
Explain ALL.
- Most frequently occurs in children; less common in adults (worse prognosis).
- T-cell ALL can present as mediastinal mass (presenting as Superior Vena Cava-like syndrome).
- Associated with Down syndrome.
- Peripheral blood and bone marrow have increased lymphoblasts.
- TdT+ (marker of pre-T and pre-B cells), CD10+ (marker of pre-B cells).
- Most responsive to therapy.
- May spread to CNS and testes.
- t(12;21) = better prognosis.
What kind of precursor cellsare more likely to be found that cause ALL?
B cell precursors cause ALL by far majority than T cell precursors.
What are ALL clinical features?What do we see in peripheral smear and bone marrow?
- Anemia
- Weakness
- Fatigue
- Pallor
- Fever
- Bone pain
- Thrombocytopenia - Bleeding
- Hepatosplenomegaly
- Lymphadenopathy
In peripheral smaer we see leukoblastocytosis with blasts or normal WBCs with blasts and bone marrow is hypercellular with sheets of blast cells.
What are the immunophenotypic findings in ALL?
Precursor B-ALL (85%) CD10+, CD19+, TdT+, sIg-
Precursor T-ALL (15%) CD2+, CD3+, CD5+, CD7+, TdT+
* May co-express CD4 and CD8
What genetics determine the prognosis of ALL?
ALL israpidly fatal, if untreated. With chemotherapy, 95% remission rate and 75-85% cure rate if favorable prognostic features
What are some of the other clinical features that make ALL prognosis better or worse?
