Pediatric Leukemia Flashcards
Most common malignant neoplasms in childhood?
Leukemia
What causes increased incidence in ALL in kids?
Medical radiation
Most common genetic cause of leukemias?
Translocations
Most common and easily curable form of childhood leukemia?
ALL Acute Lymphoblastic Leukemia
ALL affects lymphocytes, but which lymphocyte line is the most commonly affected?
B-cell lineage
What occurs in ALL?
BM produces immature cells that develop into leukemic lymphoblasts that build up and crowd out the healthy cells
Who is most likely to get ALL?
White males between 2-5 years of age
What adds an increased risk of getting ALL?
Kids with chromosomal abnormalities
What happens with ALL in twins?
Risk is greater than 70% of second twin getting ALL if first twin was diagnosed during first year of life and they shared a placenta
If first develops ALL by 5-7 then risk of second twin is 2x risk of getting than general population
Most important distinguishing morphologic feature of a ALL subtype?
FAB L3 subtype-evidence of a mature B-cell leukemia AKA Burkitt Leukemia
What feature of ALL is adequate to establish an ALL diagnosis?
Morphology
Two chromosomal abnormalities most seen in ALL:
12 -> 21 favorable prognosis (more common)
9 -> 22 poor prognosis
Clinical manifestation of ALL infiltrating leukemic cells into normal tissues resulting in BM failure?
Anemia
Neutropenia
Thrombocytopenia
What site does B-ALL usually manifest and create significant problems?
Testes
CNS
Where does T-ALL usually manifest and create significant problems?
Anterior mediastinal mass (thymic mass)
How is ALL diagnosis confirmed?
Immature blast cells on peripheral blood smear or BM biopsy
What important test is done at the time of ALL diagnosis?
Lumbar puncture
ALL prognosis four groups and criteria?
Low risk
Standard risk
High risk
Very high risk
Low risk criteria:
1-9 years old; initial WBC less than 50k; 12->21
High risk criteria:
Younger than 1 year old or 10 years old and older; initial WBC greater than 50k; CNS or Testicular disease; 4->11
Very high risk criteria:
Missing 1 or more chromosomes; 9->22; or fail to achieve remission after 4 weeks of therapy
What are the markers on T-ALL cells?
TdT+
What are the markers on B-ALL cells?
CD10+
What percent of childhood leukemias are AML?
11%
Most common classification system for AML subtypes?
FAB system
What percent of childhood leukemias are CML?
2-3%
What gene causes CML?
9->22 translocation
