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IHO Week 1 > Nikevich IHO Week 4 > Flashcards

Nikevich IHO Week 4 Flashcards

1
Q

uncontrolled proliferation and accumulation of neoplastic hematopoietic precursor cells or meyloid lineage

A

Acute Myelogenous Leukemia

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2
Q

20% myeoblasts in BM or 30% myeloblasts in BM

A

AML

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3
Q

Things that increase the risk of AML

A

Down syndrome, ataxia telagiectasia, fanconi anemia, Li Fraumeni syndrome, Wiskott-Aldrich, familial leukemia, myelodysplasia, PNH

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4
Q

When is secondary AML described

A

with prior chemotherapy, radiation or benzene

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5
Q

Pancytopenia, B sx, extramedullary ds, hyperleukocytosis, coagulation abnormalities

A

AML

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6
Q

FAB M0

A

undifferentiated myeloid leukemia

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7
Q

FAB M1

A

Acute myeloid leukemia without maturation

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8
Q

FAB M2

A

acute myeloid leukemia with maturation

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9
Q

FAB M3

A

acute promyelocytic leukemia

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10
Q

FAB M4

A

acute myelomonocytic leukemia

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11
Q

FAB M5

A

acute monocytic leukemia

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12
Q

FAB M6

A

acute erythroleukemia

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13
Q

FAB M7

A

acute megakaryocytic leukemia

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14
Q

FAB vs WHO

A

> 30% BM myeloblasts versus >20% myeloblasts

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15
Q

age

A

Favorable Features for AML

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16
Q

Good risk genetics for AML; single most important prognostic factor

A

t(8;21), t(16;16), t(15;17) and NFM1+/Flt3

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17
Q

poor risk cytogenetics, age >60, presence of infx or sepsis, poor performance status, prior MDS, secondary AML, extreme leukocytosis, extramedullary ds

A

Unfavorable Features for AML

18
Q

Unfavorable risk genotype

A

del 5, del 7, trisomy 8, 11q23, other complex karyotypes

19
Q

Treatment of AML

A

age

20
Q

most with t(15;17) creates fusion gene, PML/RAR-alpha (poor risk disease with t(11;17)

A

acute promeylocytic leukemia (M3)

21
Q

Therapy for Acute Promyelocytic leukemia (M3)-Induction

A

Induction therapy with ATRA plus anthracycline-based chemotherapy

22
Q

Therapy for Acute Promyelocytic leukemia (M3)-Consolidation

A

Consolidation with 2 courses anthracycline-based chemotherapy

23
Q

Therapy for Acute Promyelocytic leukemia (M3)-Maintenance

A

ATRA, 6-MP, methotrexate

24
Q

Therapy for Acute Promyelocytic leukemia (M3)-Relapse

A

aresenic trioxide

25
Q

What is common presentation of acute promyelocytic leukemia?

A

DIC (disseminated intravascular coagulopathy): coagulopathy, depressed fibrinogen, thrombocytopenia, fatal hemorrhage

26
Q

hyperleukocytosis (hyperviscosity, sludging in vasculature with ischemia and/or infarct), leukopheresis (reduce WBC to

A

AML-M4

27
Q

Flt-3 receptor tyrosine kinase inhibitors; side effects include QTc prolongation, used in AML relapse, ‘bridge to transplant’

A

Quizartinib

28
Q

core binding factor, C-kit overexpression in CBF and AML

A

Dasatinib

29
Q

uncontrolled clonal accumulation of mature lymphocytes, unclear mechanism of initiation, molecular characterization, mutated or not mutated Ig Vh genes

A

Chronic Lymphocytic Leukemia

30
Q

Dx of Chronic Lymphocytic Leukemia

A

Need absolute lymphocytosis greater than 5000/mL, CD5/19/20/23

31
Q

Differential Dx for CLL

A

follicular lymphoma or mantle cell lymphoma with leukemic phase, prolymphocytic leukemia, SLVL, HCL

32
Q

Dx of Mantle Cell Lymphoma (a nasty form of NHL)

A

CD5+, CD23-, cyclin D1+

33
Q

What is the difference between CLL and SLL

A

the tissue phase of CLL

34
Q

Autoimmune complications of CLL

A

autoimmune hemolytic anemia, pure red cell aplasia, immune-mediated thrombocytopenia, neutropenia

35
Q

advanced stage at dx, rapid lymphocyte 2x, diffuse marrow infiltration, advanced age/male gender, CLL-PLL, abnormal karyotype, elevated B2 microglobulin, soluble CD23, CD38+ or ZAP-70+

A

Poor Prognostic Factors of CLL

36
Q

CLL-cytogenetic abnormalities (ALWAYS get FISH with CLL)

A

13q-, normal karyotype, trisomy 12, 11q-, 17p-

37
Q

What if your lab is unable to perform Ig gene mutation studies?

A

CD38 may be a surrogate marker for Ig gene mutations

38
Q

Poorer prognosis of CLL

A

CD38+, unmutated Ig genes, 9 year survival, ZAP-70+

39
Q

Better prognosis of CLL

A

CD38-, mutated Ig genes, >20 yr survival

40
Q

Two meds to tx CLL in both younger pts. with good prognosis and older much more frail pts.

A

Ibrutinib and Ventoclax

41
Q

Ibrutinib Rx Dosing for Mantle Cell versus CLL

A

Mantle Cell: 560 mg daily
CLL: 420 mg daily
hold for grade 3 toxicity and resume, if toxicity recurs reduce dose

IHO Week 1 (16 decks)

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