Section 21: A-(bunch of)-cutie Leukemias Flashcards
Male: RBC count, Hgb, & HCT Normal Ranges
RBC: 4.5 - 5.9 x 10^6 (△ 1.4)
Hgb: 13.5 - 17.5 x 10^3 (△ 4.0)
HCT: 41.0 - 53.0 (△12.0)
Female: RBC count, Hgb, & HCT Normal Ranges
RBC: 4.0 - 5.2 x 10^6 (△1.2)
Hgb: 12.0 - 16.0 x 10^3 (△4.0)
HCT: 36.0 - 46.0 (△10.0)
MCV, MCH, MCHC Normal Ranges
MCV: 80 - 96 (△20%)
MCH: 29 - 32 (△10%)
MCHC: 33.4 - 35.5 (△~5.0%)
WBC Normal Range
4.0 - 11.0 x 10^3
WBC Normal Range
4.0 - 11.0 x 10^3
Plt Normal Range
140,000 - 400,000
M0 Definition
Acute Myeloblastic Leukemia (AML) w/o cytological maturation or differentiation (cells committed but unable to tell which lineage)
M1 Definition
Acute Myeloblastic Leukemia (APL) w/o maturation (but can be differentiated)
M2 Definition
Acute Myeloblastic Leukemia (AML) w/ Maturation
M3 Definition
Acute Promyelocytic Leukemia (APL)
M3m Definition
Acute Promyelocytic Leukemia (APL) - Microgranular Variant
M4 Definition
Acute Myelomonocytic Leukemia (AMML)
M4e Definition
Acute Myelomonocytic Leukemia (AMML) w/ Eosinophilia
M5a Definition
Acute Monoblastic Leukemia (AMoL), poorly differentiated
M5b Definition
Acute Monocytic Leukemia (AMoL), differentiated
M6 Definition
Acute Erythroid Leukemia
M7 Definition
Acute Megakaryoblastic Leukemia
L1 Definition
Acute Lymphocytic Leukemia - Small Lymphoblasts
L2 Definition
Acute Lymphocytic Leukemia - Larger Blasts w Reactive Appearance
L3 Definition
Leukemic Conversion of Burkitt’s Lymphoma
Characteristics of M0
Requires Flow Cytometry or other Immunophenotyping
Non-responsive to cytochemical stains
Poor Prognosis
NO Auer Rods
Characteristics of M1
MPO (+), SPE (+), NSE (+/=)
4000 - 300,000 WBC
Auer Rods possible
Decreased Plts
Characteristics of M2
MPO (+), SPE (+), NSE (+/=)
Maturation of Promyelo- stage and beyond
Auer Rods possible
May be a late “acute phase” or “blast crisis” of CML
Characteristics of M3
Acute Promyelocytic Leukemia (AML w/ t(15;17))
MPO (+), SPE (+), NSE (+/=)
Frequent Auer rods, often multiple
Extremely Heavy Granulation
Decreased Plts
DIC complication - schistocytes common hallmark & can be made worse w treatment
Usually adults
BOTH M3 and M3m presentation simultaneously is possible, not exclusive.
Characteristics of M3m
Same as M3 except:
Granules so small they can’t be seen normally
Abnormal nuclear shapes (H, N, or Venn Diagram)
May be mistaken for an AML or AMoL
Characteristics of M4
Can demonstrate tissue infiltration of skin, gums, etc
May have Auer Rods
Blasts with both myelocytic and monocytic features
Decreased Plts
Characteristics of M4e
Same as M4 but with marrow eosinophilia (abnormal and immature forms, may also be in peripheral)
Characteristics of M5a
Monoblastic w/ poor differentiation
Decreased Plts
Infiltration of the skin, gums, meninges and other body tissues by malignant cells
Characteristics of M5b
Same as M5a except
Monoctic lineage (blasts and abundance of promonos/monos)
Characteristics of M6
Pure RBC precursors make up >80% marrow cellularity
No myeloid component, NO Auer Rods
Ringed Sideroblasts
Many nrbcs, bizarre rbc morphology. immature rbcs extremely abnormal
Marked erythroid hyperplasia
Possible abnormal megakaryo and plts
RBC indices afected by megaloblastic changes
Characteristics of M7
Rarest AML
NO Auer Rods
50% of blasts in BM must be megakaryoblasts
Dysplastic features seen in all cell lines
Associated with myelofibrosis due to megaryo stim effect on fibroblasts
May cause dry tap
General characteristics of ALLs
Disease of Children
Most common form is B-Cells
Can have 2nd peak mid life
WBC often greater than 100,000 but low or normal also possible
NO Auer Rods
Decreased Plts and granulocytes
CNS infiltration common
Characteristics of L1
Small lymphoblasts
Most common form
Occ. clefting
Inconspicuous nucleoli
Scanty cytoplasm
Uniform Population - homogenous
TdT (+)
Characteristics of L2
Large Lymphoblasts
Irregular nucleus
Often prominent nucleoli
Often moderately abundant cytoplasm
Cellular heterogeneity
TdT (+)
Characteristics of L3
Leukemic conversion of Burkitt’s Lymphoma
Large blasts w punched out vacuoles
Very basophilic cytoplasm
“Starry Night” BM
TdT (=)