MDS - Usera Flashcards
MDS is characterized by one or more peripheral blood (blanks) and with (blank) in one or more myeloid lines
cytopenias; dysplasia
T/F: there is an inevitable risk of developing leukemia from MDS
false
what is the poster child for MDS?
older male; 70
In MDS, what is the state of the blood and cellular maturation?
cyotpenic with variable maturation
In MPD, what is the state of the blood and cellular maturation?
cythemic with distinct maturation
in Acute leukemia, what is the state of the blood and cellular maturation?
variable blood state with no maturation
What are the IPSS thresholds for Hemoglobin, ANC and platelets for MDS?
Hgb: <100`
Are there blasts in the periph. blood in refractory anemia?
no
<5% blasts, and dysplastic erythroid cells describes:
refractory anemia
GREATER THAN 15% ringed sideroblasts, <5% blasts, and dysplastic erythroid cells describes:
refractory anemia with ringed sideroblasts (RARS)
The red cell population in RARS can be described as;
dimorphic
(blank) bodies are seen in the peripheral blood of RARS
Pappenheimer
Which two types of MDS are the most stable?
RA and RARS
Refractory anemia with excess blasts has (blank)cytopenia
pancytopenia
Auer rods immediately classifies the disorder as RAEB (1/2)
2
<5% blasts and no Auer rods is RAEB (1/2)
1
5-19% blasts and/or Auer rods is RAEB (1/2)
2
No Auer rods, <5% blasts, and normal to increased platelets is what special genetic type of MDS?
5q- syndrome
Which has the best prognosis: RA RARS RAEB 1 RAEB 2 5q- syndrome
5q- syndrome
Clonal cytogenetic abnormalities are present in (blank) percent of MDS cases
50
Initiating stimuli for MDS invovles (blank) damage
genetic
benzene exposure, cigarettes, family Hx of heme neoplasms lead to de novo (blank)
MDS
What are the three heritble syndromes that lead to MDS?
Fanconi’s Anemia
Schwachman-Diamond syndrome
Diamond-Blackfan syndrome
FDS: fuck dysplastic syndromes
Describe the general clinical appearance of someone with MDS?
Fatigue and weakness Palor Ecchymoses Hemorrhage Infection
Anisocytosis and poikilocytosis indicate what about RBC morphology?
Aniso=different in size
Poikilo= different in shape
RBCS in MDS have an MCV >110fL, indicating:
macrocytosis
MDS presents with anemia, meaning the Hgb will be below:
10
Basophilic stippling, Howell-Joly bodies, membrane abnormlities, and the presence of a nucleus (when there shouldn’t be one) are abnormalities found in what cell line in MDS?
RBCs
what shape do the macrocytes take in MDS?
oval
MDS presents with a cytopenia of what RBC maturation stage?
reticulocytopenia
Canon-ball nucleus is a finding of fucked up (blank) cells
nucleated RBCs that definitely should not be there
T/F: left shifted granulocytes are always present in MDS
false; sometimes only
Describe the granulation of neutrophils in MDS?
Agranular or hypogranular
Pseudo-Pelgeroid, hypersegmented, or ringed nuclei are found in (blank) cells in MDS
granulocytes
T/F: MDS can present with both leukopenia and neutropenia
true
In MDS are platelets larger or smaller than their normal size?
FUCKING GIANT
t/f: mds can lead to both thrombocytopenia and thrombocytosis
true
When we say “FUCKING GIANT” platelets, how big are talkin’?
the size of a goddamned RBC
<20% myeloblasts in the bone marrow is diagnostic for (blank), while 20 and above is diagnostic for (blank)
MDS; myelogenous leukemia
T/F: In MDS, the bone marrrow can be normal, hypo, or hyper cellular
true
T/F: it is common to have dysplasia in all myeloid lines in MDS
true
The fuck is karyorrhexis and when do you see it?
destructive fragmentation of the nucleus of a dying cell whereby its chromatin is distributed irregularly throughout the cytoplasm. See that shit in dyserythropoesis
Describe the nuclear findings of dyserythropoesis?
Karyorrhexis, irregular staining, ringed sideroblasts, nuclear budding, nuclear fragmentation, multinucleation
Describe the cytoplasmic findings of dyserythropoesis?
Vacuolization, basophilic stippling, ringed sideroblasts
In the bone marrow during dyserythropoesis, describe the size of the erythroid precursors?
Giant, just like everything else
Describe the bone marrow findings of dysgranulopoesis?
Basically everything in both directions from normal:
hypo/hypersegmentation of nuclues
Hypo or agranular
Absent secondary granules
T/F: megakaryocytes can be up, down, or normal in MDS
true
The fuck is a micromegakaryocyte and where the fuck do you find it?
in the bone marrow in MDS; its a dysplastic finding
Hyperchromatic nuclear staining happens in what cell lineage in MDS?
megakaryocytes
T/F: reticulocytopenia is found in the peripheral blood of all types of MDS
true
T/F: oval macrocytes are found in the peripheral blood of all types of MDS
true
In what two types of MDS do you see nomral WBCs and platelets with blasts less than 1% of peripheral blood?
RA and RARS
Describe the differences in blast percentages in both the peripheral blood and bone marrow for RAEB 1 and 2
RAEB1:
peripheral: 5
bone marrow: 10-19
RAEB (1/2) correlates with a higher risk of leukemia
RAEB 2
Which RAEB prognosis correlates with blast percentage?
RAEB 1
In what forms of MDS do you see monoctyes <1000/uL?
RAEB 1 and 2
In which RAEB are ringed sideroblasts present?
RAEB 1
MDS may follow what two types of treatment?
chemo or radiation
T/F: therapy related MDS has a favorable prognosis and resolves after finishing treatment
false; UNFAVORABLE prognosis with high risk of leukemia
which two chromosomes are involved in MDS?
5 and 7
Complex karyotypes involving >(blank) csome abnormalities are associated with a worse MDS prognosis
3
Median survival worsens with increasing (blank) percentage and (blank) dysplasia
increasing blast percentage; trilineage dysplasia
What percent of MDS pts undergo transformation to leukemia?
10-40%
What IPSS MDS category is this?
5-10% marrow blasts.
variable karyotype
2-3 peripheral cytopenias
0.5
What IPSS MDS category is this?
<5% marrow blasts
normal, or Y-isolated karyotype, isolated 5q- or del20q
0-1 peripheral cytopenia
0
What IPSS MDS category is this?
Abnormal csome 7 or more than 3 karytype abnormalities
1
What IPSS MDS category is this?
11-20% marrow blasts
1.5
What IPSS MDS category is this?
21-30% marrow blasts
2
What two growth factors are given to treat MDS?
GM-CSF, EPO
Chemo is given as Tx for a (better/worse) prognosis of MDS
worse
T/F: bone marrow transplant is an Tx for MDS
true
What type of chemo drugs do you give for MDS?
hypomethylating agents like 5-azacytidine and decitabine