MDS and MPN

Question 1

2 features of MDS

Answer 1

Ineffective hematopoiesis

Increased risk of AML transformation

Question 2

3 diagnostic criteria

Answer 2

Dysplastic morphology
Increased myeloblasts (under 20%)
Clonal cytogentic abnormality

Question 3

Causes of MDS

Answer 3

Chemotherapy
Virus
Drug
B12/folate deficiency

Question 4

Low grade MDS

Answer 4

Myeloblasts under 5% marrow and 2% blood
RCUD: one lineage, 5 year prognosis
RCMD: multiple lineage, 2.5 year prognosis

Question 5

High grade MDS

Answer 5

Myeloblasts 5-19% marrow, 3-19% blood
RAEM-1: 5-9% blasts marrow, 2-4% blood, 1.3 yrs
RAEM-2: 10-19% marrow, 5-19% blood, 9 months

Question 6

3 negative end points of MPN

Answer 6

Transformation to leukemia
MDS from ineffective hematopoiesis
Marrow fibrosis causing marrow failure

Question 7

CML

Answer 7

High PMN count
Hypercellular marrow from granulocytic hyperplasia
Small megakaryocytes
No marrow dysplasia
BCR-ABL1

Question 8

PV

Answer 8

Increased RBC with high PMNs and platelets
Trilineage hyperlasia with abnromal megakaryocytes
JAK2 in 50%

Question 9

PMF

Answer 9

High granulocytes and megakaryocytes
Hypercellular first then myelofibrosis
JAK2 in 50%

Question 10

ET

Answer 10

High platelets
Very abnormal megakaryocytes in marrow
No granuloctyic hyperplasia
50% JAK2

Question 11

3 locations of PV thrombosis

Answer 11

Splenic vein
Mesenteric vein
Portal vein

Question 12

Leukoerythroblastosis

Answer 12

Increased immature granulocytes and RBCs

Dacrocytes - tear drop shaped RBC