OnlineMedEd: Hematology Oncology - "Leukemia" Flashcards

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1
Q

Chronic leukemia is what kind of cell?

A

Mature cells (not blasts)

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2
Q

A WBC greater than ________ is highly suggestive of cancer. So suggestive that you know it’s cancer.

A

60,000

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3
Q

When you see an extremely high WBC, first look at the _______________, then do ____________.

A

differential; a bone marrow biopsy

The differential can tell you if it is CML (indicated by PMN predominance) or CLL (indicated by lymphocyte predominance). Bone marrow biopsy will allow cytogenetic analysis.

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4
Q

Chronic leukemia causes what symptoms?

A

•Usually, it is asymptomatic.

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5
Q

How is CLL treated?

A
  • Stem-cell transplant (for younger than 65, otherwise healthy people)
  • Chemotherapy (for older people with symptoms)
  • Observation (for old, asymptomatic people)
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6
Q

What symptoms do those with acute leukemia have?

A

Acute leukemia crowds out the bone marrow and thus patients will present with
•Infections (due to low WBCs)
•Anemia (due to low RBCs)
•Bleeding (due to low platelets)

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7
Q

Greater than ___% blasts is diagnostic of acute leukemia.

A

20

This can be on bone marrow biopsy or peripheral smear. Though the test wants you to say bone marrow biopsy.

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8
Q

Review the treatment protocols for ALL and AML.

A

• AML:

  • M3 variant: vitamin A (think of MS3s with acne cause they’re so young); note: this is also the 15:17 translocation
  • Other variants: chemotherapy

•ALL:

  • Chemotherapy
  • CNS chemotherapy (“You need to put chemo on your bALL.”)
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9
Q

List three risk factors that predispose to development of AML.

A
  • Benzene
  • Radiation
  • CML
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10
Q

ALL has what two markers?

A
  • cALLa

* TDT

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11
Q

True or false: ALL needs CNS chemotherapy even if the LP didn’t show malignant cells.

A

True

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12
Q

What is the 9;22 translocation?

A

BCR-ABL

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13
Q

True or false: imatinib cures CML.

A

False

Eventually, the CML cells develop resistance to imatinib and undergo blast crisis.

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14
Q

Arrange CML, CLL, AML, and ALL by age, oldest-to-youngest.

A
  • CLL: 87
  • AML: 67
  • CML: 47
  • ALL: 7
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15
Q

Which cells have a higher N:C ratio, acute or chronic?

A

Chronic

Acute (immature) cells typically have large cytoplasms.

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