MTAP W3 (Hematology W15: Acute Leukemia) Flashcards
1
Q
LEUKEMIA WAS FIRST DISCOVERED BY
A
VIRCHOW
2
Q
WBC WITH SPECIFIC GRANULES
A
GRANULOCYTES
1.NEUTROPHILS
2. EOSINOPHILS
3. BASOPHILS
3
Q
WBC WITH GRANULES BUT NOT TOTALLY VISIBLE
A
AGRANULOCYTES
1. LYMPHOCYTES
2. MONOCYTES
4
Q
GRANULOCYTE
GRANULES CONTAIN BASIC PROTEINS THAT STAIN WITH ACID STAINS
A
EOSINOPHIL
5
Q
GRANULOCYTE
GRANULES CONTAIN ACIDIC PROTEINS THAT STAIN WITH BASIC STAINS
A
BASOPHIL
6
Q
GRANULOCYTE
WITH GRANULES THAT REACT TO BOTH ACID AND BASIC STAIN= PINK TO LAVANDER COLOR
A
NEUTROPHILS
7
Q
RELATIONSHIP BETWEEN GRANULES AND STAINS ARE - PROPORTIONAL
A
INVERSELY
8
Q
- CLASSIFICATION
NEUTROPHIL ARE CLASSIFIED ACC TO THEIR GRANULATION
A
SCHILLING’S
9
Q
- CLASSIFICATION
NEUTROPHIL ARE CLASSIFIED ACC TO THEIR AGE, NUMBER OF LOBULATION/SEGMENTATION
A
ARNETH’S
10
Q
NORMAL RANGE OF LOBULES
A
2-5
11
Q
Categorized as monocyte and
lymphocytes
These cells have a non-segmented nuclei
but round ,oval, indented, or folded.
A
Agranulocytes / Mononuclear cells
12
Q
WBC with phagocytic function(3)
A
- Monocyte
- neutrophils
- eosinophils
- basophils
(BMEN- boy and men)
13
Q
WBC known as immune cells
/immunocytes
A
Lymphocytes (B and T cells)
14
Q
Polymorphonuclear WBCS
A
granulocytes (NEB)
15
Q
- LEUKOCYTES
CELL: LARGE
NUCLEOLI: PRESENT
CHROMATIN: FINE AND DELICATE
NUCLEUS: NOT SEGMENTED
CYTOPLASM: DARK BLUE (RICH IN RNA)
N:C RATIO: HIGH
A
IMMATURE CELLS
16
Q
- LEUKOCYTES
CELL: SMALL
NUCLEOLI: ABSENT
CHROMATIN: COARSE AND CLUMPED
NUCLEUS: SEGMENTED
CYTOPLASM: LIGHT BLUE (LESS IN RNA)
N:C RATIO: LOW
A
MATURE CELLS
17
Q
NC RATIO IS - PROPORTIONAL TO SIZE
A
DIRECTLY
18
Q
Enlargement of the liver, spleen and lymph nodes may occur more predominantly in - LEUKEMIA
A
CHRONIC
19
Q
Bone pain from a large
leukemia cell mass in the bone marrow is typical in the
- LEUKEMIA
A
ACUTE
20
Q
Overproduction of various types of immature leukocytes in the
bone marrow and/ or peripheral blood
A
ACUTE LEUKEMIA
21
Q
Overproduction of various types of mature leukocytes in the
bone marrow and/ or peripheral blood
A
CHRONIC LEUKEMIA
22
Q
for malignancy that starts in the
lymph system, mainly the lymph nodes
A
LYMPHOMA
23
Q
A form of cancer of the plasma cells. In - , the cells overgrow, forming a mass
or tumor that is located in the bone marrow.
A
MYELOMA
24
Q
LEUKEMIA CLASSIFICATIONS
Based on numbers of
WBC present in peripheral blood
WBC count >15.0 x 109/L
A
LEUKEMIC LEUKEMIA
25
LEUKEMIA CLASSIFICATIONS
Based on numbers of
WBC present in peripheral blood
WBC count <15.0 x 109/L
WITH immature or abnormal forms of WBCs present in
peripheral blood
SUBLEUKEMIC LEUKEMIA
26
LEUKEMIA CLASSIFICATIONS
Based on numbers of
WBC present in peripheral blood
WBC count <15.0 x 109/L
WITH NO immature or abnormal forms of WBCs present in
peripheral blood
ALEUKEMIC LEUKEMIA
27
LEUKEMIA CLASSIFICATIONS
Based on numbers of
WBC present in peripheral blood
WBC count <15.0 x 109/L
WITH NO immature or abnormal forms of WBCs present in
peripheral blood
ALEUKEMIC LEUKEMIA
28
LEUKEMIA CLASSIFICATIONS
Based on duration of
untreated disease
rapidly progressive
disease that lasts several days to 6 mos
Treatable
ACUTE LEUKEMIA
29
LEUKEMIA CLASSIFICATIONS
Based on duration of
untreated disease
2 to 6 mos
SUBACUTE LEUKEMIA
30
LEUKEMIA CLASSIFICATIONS
Based on duration of
untreated disease
most patients live a minimum of 1 or 2 years or more
CHRONIC LEUKEMIA
31
LEUKEMIA CLASSIFICATIONS
Based on type of WBC
Involved
predominance of
immature (blast) WBC
ACUTE LEUKEMIA
32
LEUKEMIA CLASSIFICATIONS
Based on type of WBC
Involved
predominance of
mature/old WBC
CHRONIC LEUKEMIA
33
LEUKEMIA CLASSIFICATIONS
Based on cell lineage
Granulocytic, monocytic, erythrocytic, megakaryocytic cell lines.
MYELOID LEUKEMIA
34
LEUKEMIA CLASSIFICATIONS
Based on cell lineage
T and B lymphocytes
LYMPHOCYTIC LEUKEMIA
35
- LEUKEMIA
AGE: 1ST DECADE
ONSET: SUDDEN
SURVIVAL: WEEKS-MONTHS
WBC: INC, N, DEC
DIFFERENTIAL: BLASTS PRESENT
ACUTE LEUKEMIA
36
- LEUKEMIA
AGE: ADULTS
ONSET: INSIDIOUS
SURVIVAL: MONTHS-YEARS
WBC: INCREASED >50,000!
DIFFERENTIAL: MATURE CELLS
CHRONIC LEUKEMIA
37
ACUTE LEUKEMIA IN CHILDREN
ALL
38
ACUTE LEUKEMIA IN ADULTS
AML
39
CHRONIC LEUKEMIA IN CHILDREN
CML
40
CHRONIC LEUKEMIA IN ADULTS
CLL
41
LEUKEMIA: CLINICAL MANIFESTATIONS AND LABORATORY FINDINGS
1. ANEMIA
2. THROMBOCYTOPENIA
3. NEUTROPENIA
4. VARIABLE LEUKOCYTE
MARROW CELLULARITY: 70%
ACUTE LEUKEMIA
42
LEUKEMIA: CLINICAL MANIFESTATIONS AND LABORATORY FINDINGS
ACUTE LEUKEMIA
MARROW BLASTS BASED ON WHO
>20%
43
LEUKEMIA: CLINICAL MANIFESTATIONS AND LABORATORY FINDINGS
ACUTE LEUKEMIA
MARROW BLASTS BASED ON FAB
>30%
44
LEUKEMIA: CLINICAL MANIFESTATIONS AND LABORATORY FINDINGS
1. ANEMIA
2. THROMBOCYTOSIS
3. LEUKOCYTOSIS
MARROW CELLULARITY: 70%
CHRONIC LEUKEMIA
45
LEUKEMIA: CLINICAL MANIFESTATIONS AND LABORATORY FINDINGS
Unexplained weight loss or night sweats
ACUTE LEUKEMIA
46
LEUKEMIA: CLINICAL MANIFESTATIONS AND LABORATORY FINDINGS
Splenomegaly, hepatomegaly, lymphadenopathy
CHRONIC LEUKEMIA
47
LEUKEMIA: PREDOMINANT CELL TYPE
Immature/blast cells predominate.
ACUTE
48
LEUKEMIA: PREDOMINANT CELL TYPE
mature cells predominate.
CHRONIC
49
LEUKEMIA: PREDOMINANT CELL TYPE
myeloblasts
AML/ ACUTE MYELOID LEUKEMIA
50
LEUKEMIA: PREDOMINANT CELL TYPE
lymphoblasts
ALL/ ACUTE LYMPHOID LEUKEMIA
51
LEUKEMIA: PREDOMINANT CELL TYPE
has granulocytes
CML
52
LEUKEMIA: PREDOMINANT CELL TYPE
has lymphocytes
CLL
53
LONG TERM USE OF - LEADS TO APLASTIC ANEMIA
CHLORAMPHENICOL
54
ETIOLOGY: VIRUSES
1.EBV
2.HIV
3.HTLV
55
DIAGNOSTIC CHROMOSOME FOR ACUTE PROMYELOCYTIC LEUKEMIA
t (15;17)
56
SAMPLE FOR LEUKEMIA: ASPIRATE/BM BIOPSY
- MOST COMMONLY USED SITE
POSTERIOR SUPERIOR ILIAC CREST
57
NORMAL M:E RATIO
3:4-4:1
58
ORGANIZATIONS THAT CLASSIFY LEUKEMIA
First system, still used by some
Subdivide leukemia according to cellular morphology, and cytochemical staining results.
FRECH AMERICAN BRITISH
59
ORGANIZATIONS THAT CLASSIFY LEUKEMIA
FAB USES: (2)
1. CELLULAR MORPHOOLOGY
2. CYTOCHEMICAL STAINING
'CC'
60
FAB
Classified acute leukemia as presence of -% blast in the peripheral blood and bone marrow.
≥30%
61
ORGANIZATIONS THAT CLASSIFY LEUKEMIA
Widely used to classify leukemia. It is now the standard
classification in diagnosing leukemia
WHO
62
ORGANIZATIONS THAT CLASSIFY LEUKEMIA
WHO USES: (5) 2+3 NEW
1. IMMUNOPHENOTYPING/ FLOW CYTOMETRY
2. CYTOGENETIC ABNORMALITIES
3. CLINICAL SYNDROME
'CIC' 'CCICC'
63
WHO
Classified acute leukemia as presence of -% blast in the peripheral blood and bone marrow.
20%
64
FAB CLASSIFICATION OF LEUKEMIA
ACUTE LYMPHOBLASTIC
L1
65
FAB CLASSIFICATION OF LEUKEMIA
LYMPHOBLASTIC
L2
66
FAB CLASSIFICATION OF LEUKEMIA
BURKITT-TYPE
L3
67
FAB CLASSIFICATION OF LEUKEMIA
ACUTE MYELOID LEUKEMIA, MINIMIMALLY DIFFERENTIATED
M0
68
FAB CLASSIFICATION OF LEUKEMIA
ACUTE MYELOID LEUKEMIA, WITHOUT MATURATION
M1
69
FAB CLASSIFICATION OF LEUKEMIA
ACUTE MYELOID LEUKEMIA, WITH MATURATION
M2
70
FAB CLASSIFICATION OF LEUKEMIA
ACUTE PROMYELOCYTIC LEUKEMIA
M3
71
FAB CLASSIFICATION OF LEUKEMIA
ACUTE MYELOMONOCYTIC LEUKEMIA
M4
72
FAB CLASSIFICATION OF LEUKEMIA
ACUTE MYELOMONOCYTIC LEUKEMIA WITH EOSINOPHILIA
M4EO
73
FAB CLASSIFICATION OF LEUKEMIA
ACUTE MONOCYTIC LEUKEMIA, POORLY DIFFERENTIATED
M5A
74
FAB CLASSIFICATION OF LEUKEMIA
ACUTE MONOCYTIC LEUKEMIA, WELL DIFFERENTIATED
M5B
75
FAB CLASSIFICATION OF LEUKEMIA
ACUTE ERYTHROLEUKEMIA
M6
76
FAB CLASSIFICATION OF LEUKEMIA
ACUTE MEGAKARYOCYTIC LEUKEMIA
M7
77
FAB CLASSIFICATION OF LEUKEMIA
UNDIFFERENTIATED BLAST, AML
M0
78
FAB CLASSIFICATION OF LEUKEMIA
ITHOUT FURTHER MATURATION OF MYELOID CELLS
M1
79
FAB CLASSIFICATION OF LEUKEMIA
MYELOID CELLS DEMONSTRATE MATURATION
M2
80
FAB CLASSIFICATION OF LEUKEMIA
PROMYELOCYTE PREDOMINATE
M3
81
FAB CLASSIFICATION OF LEUKEMIA
BOTH MYELOID AND MONOCYTIC CELLS
M4
82
FAB CLASSIFICATION OF LEUKEMIA
MOST CELLS ARE MONOCYTIC
M5
83
FAB CLASSIFICATION OF LEUKEMIA
PROLIFERATION OF BOTH ERYTHROID AND GRANULOCYTIC PRECURSOR
M6
84
FAB CLASSIFICATION OF LEUKEMIA
LARGE AND SMALL MEGAKARYOBLAST
M7
85
FAB CLASSIFICATION OF LEUKEMIA
SMALL CELLS, REGULAR NUCLEAR SHAPE
L1 HOMOGENOUS
86
FAB CLASSIFICATION OF LEUKEMIA
LARGE CELLS, IRREGULAR NUCLEAR SHAPE
L2 HETEROGENOUS
87
FAB CLASSIFICATION OF LEUKEMIA
LARGE CELLS, ROUND/OVAL NUCLEAR SHAPE + VACUOLE
\\S
L3 BURKITT LYMPHOMA
88
WHO CLASSIFICATION OF LEUKEMIA
AML (4)
1. AML T8;21
2. AML INV16, T16;16
3. AML T9:11
4. APL T15:17
89
LESS COMMON FINDINGS PHYSICAL EXAM FOR LEUKEMIA
GI HEMMORHAGE
HEMATURIA
90
CLINICAL SIGNS AND SYMPTOMS
BONE AND JOINT PAIN
ALL
91
LEUKEMIA CLASSIFICATION
PREDOMINANCE OF BLAST CELLS
CLOSE TO 100% LYMPHOBLAST, LYMPHOCYTES AND SMUDGE CELLS
ALL
92
THESE ARE FOUNF IN MYELOID LEUKEMIA
AUER RODS
93
LEUKEMIA CLASSIFICATION
MOST COMMON CHILDHOOD ALL WITH BEST PROGNOSIS
FAB L1
94
LEUKEMIA CLASSIFICATION
LYMPHOBLAST LARGE, HOMOGENOUS
FAB L1
95
LEUKEMIA CLASSIFICATION
LYMPHOBLAST LARGE, HETEROGENOUS
CLEFTED NUCLEOLI
FAB L2
96
LEUKEMIA CLASSIFICATION
ADULT TYPE ALL
FAB L2
97
LEUKEMIA CLASSIFICATION
LYMPHOBLAST LARGE, HOMOGENOUS AND VACUOLATED
FAB L3
98
LEUKEMIA CLASSIFICATION
POOR PROGNOSIS OF ALL
FAB L3
99
IMMUNOPHENOTYPE
CD2,CD3,CD4,CD5,CD7,CD8
T-ALL
100
IMMUNOPHENOTYPE
CD34,CD19,CD22
B-ALL
101
IMMUNOPHENOTYPE
MARKER FOUND IN SIGNIFICANT NUMBER IN PX WITH CHILDHOOD ALL (L1)
T12;21
102
The diagnosis of ALL cannot be made with complete certainty until - procedures have been performed
CYTOCHEMICAL STAINING
103
to distinguish the lymphoblasts and lymphocytes from positively reacting cells of AML.
CYTOCHEMICAL STAINING
104
ALL BLASTS ARE - FOR SBB,PNA
NEGATIVE
105
ACP REACTION IS POSITIVE IN PX WHOSE ALL IS OF T-LYMPHOCYTE
HAIRY CELL LEUKEMIA
106
is an intracellular DNA polymerase that is present in T and B lymphoblasts.
Terminal deoxynucleotidly transferase (TdT)
107
TdT is weakly positive in - cells.
pre-B cells
108
TdT is strongly positive in 60% to 85% of -
T-cell thymocytes
109
ALL based upon immunologic membrane surface
markers
which is also CD10, is the most common subtype.
COMMON ALL ANTIGEN (CALLA)
110
This subtype is the most common form of ALL in children and morphologically, lymphocytes are of the FAB classification of L1.
COMMON ALL ANTIGEN (CALLA)
111
ALL based upon immunologic membrane surface
markers
- is a proliferation of
lymphocytes that type negative for T-cell, B-cell, and CALLA surface antigens.
NULL CELL ALL
112
ALL based upon immunologic membrane surface
markers
This functional subtype occurs mainly in boys
markers such as CD2 (using sheep RBC; i.e., E rosettes); TdT; and CD1.
T -CELL ALL
113
ALL based upon immunologic membrane surface
markers
is the rarest of subtypes, and it corresponds to the FAB classification Burkitt’s Type L3.
B- CELL ALL
114
This disorder is thought to be a memory-cell leukemia.
B- CELL ALL
115
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
Blasts exhibit myeloid markers CD13,
CD33, and CD34 but stain negatively
with the usual cytochemical stains,
myeloperoxidase.
FAB M0
116
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
It shows 90% or more marrow
myeloblasts; may have Auer rods
(fused primary granules)
FAB M1(AML without maturation)
117
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
May have Auer rods; chromosome
abnormality t (8;21)
CD 13, CD33 positive
FAB M2 (AML with maturation)
118
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
are SBB, MPO, and specific esterase positive.
FAB M1, M2, M3
119
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
promyelocyte with bundles of
Auer rods/faggot cells
APL; FAB M3
acute promyelocytic leukemia
120
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
CD13, CD33 positive
t(15:17)
APL; FAB M3
acute promyelocytic leukemia
120
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
Characterized by s = 20% (WHO) or >30% (FAB)
marrow myeloblasts with >20% cells of
monocytic origin; may have Auer rods
AMML; FAB M4
acute myelomonocytic leukemia
121
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
CD13 and CD33 positive (myeloid) and CD14
positive (monocytes)
AMML; FAB M4
acute myelomonocytic leukemia
122
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
Characterized by s = 20% (WHO) or >30% (FAB)
marrow monoblast
AMoL; FAB M5
acute monocytic leukemia
123
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
AMoL; FAB M5
seen in children (UNDIFFERENTIATED)
M5a
124
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
AMoL; FAB M5
seen in adults(DIFFERENTIATED)
M5b
125
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
Characterized by 3=20% (WHO) or >30%
(FAB) marrow myeloblasts and >50%
dysplastic marrow normoblasts
AEL, Di Guglielmo syndrome; FAB M6
Acute erythroleukemia
126
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
are
PAS +
CD45 and CD71 (glycophorin A) +
malignant normoblasts
AEL, Di Guglielmo syndrome; FAB M6
Acute erythroleukemia
127
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
proliferation of
megakaryoblasts and atypical megakaryocytes
in the bone marrow;
<1% of AML
AMegL; FAB M7
Acute megakaryocytic leukemia
128
ACUTE MYELOID LEUKEMIA
(FAB CLASSIFICATION)
CD41, CD42, and CD61 (platelet markers)
positive
AMegL; FAB M7
Acute megakaryocytic leukemia
129
- leukemias contain two cell populations.
One population expresses myeloid antigens; the other population expresses lymphoid antigens.
BILINEAGE
130
- leukemias occur when myeloid and lymphoid antigens are expressed on the same cell; poor prognosis
BIPHENOTYPIC
