Translocations with Disease Info Flashcards
t(9; 22)
Dx: Protein: Class of mutation: Prognosis: Epidemiology: Signs/Symptoms Tx:
CML and ALL BCR-ABL fusion protein Class 1 Poor Older Adults (CML) and Kids (ALL) CML: brusing, purpura, inc uric acid, fatigue, weight loss, abd tender/fullness ALL: none given
CML Tx: Imatinib, Busulfan, hydroxyurea, interferon
ALL Tx:
nduction: VCR, L-ASP, DEX, or PRED +/- Daunorubicin
Consolidation: Daunorubicin , HD ARA-C, VCR, Etoposide, TG or 6-MP, cyclophosphamide, L-ASP
CNS prophylaxis: with intrathecal MTX or ARA-C
Maintenance: 6-MO, MTX, prednisone
t(8, 21)
Dx: Protein: Class of mutation: Prognosis: Epidemiology: Notable cell morphology: Tx:
AML (M2 granulocytic maturation) RUNX1-RUNT1 or ETO-AML1 Class II Good Children Auer rods standard induction + ARA-C
t(15, 17)
Dx: Protein: Class of mutation: Prognosis: Notable cell morphology: Signs/Symptoms: Tx:
AML (M3 or promyelocytic) PML-RARA Class II Good Stacks of Auer rods, bat-wing nuclei DIC/Thrombocytopenia ATRA + arsenic + anthracycline
inv(16)
Dx: Protein: Class of mutation: Prognosis: Epidemiology: Notable cell morphology: Tx:
AML CBFB-MYH11 Class II good kids inc eosinophils in PBS and BM cytarabine (Goorha: Std induction + ARA-C)
del5q
Dx:
Tx:
MDS
Lenalidomide
t(v, 11q23)
Dx: Protein: Class of mutation: Prognosis: Epidemiology: Tx:
B-ALL MLL-AF4 Class II poor Kids <1 y/o
Induction: VCR, L-ASP, DEX, or PRED +/- Daunorubicin
Consolidation: Daunorubicin , HD ARA-C, VCR, Etoposide, TG or 6-MP, cyclophosphamide, L-ASP
CNS prophylaxis: with intrathecal MTX or ARA-C
Maintenance: 6-MO, MTX, prednisone
t(12, 21)
Dx: Protein: Class of mutation: Prognosis: Epidemiology: Tx:
B-ALL TEL-AML (sometimes also has pax5 del) Class II Good kids
Induction: VCR, L-ASP, DEX, or PRED +/- Daunorubicin
Consolidation: Daunorubicin , HD ARA-C, VCR, Etoposide, TG or 6-MP, cyclophosphamide, L-ASP
CNS prophylaxis: with intrathecal MTX or ARA-C
Maintenance: 6-MO, MTX, prednisone
t(14, 18)
follicular lymphoma
Bcl2-IgH promoter
t(14, 18) + Bcl-6
DLBL
t(8, 14)
Dx:
Protein:
Epidemiology:
Burkitts
c-myc rearragement
Kids (think africa), EBV transformation
t(2, 8)
Dx:
Protein:
Burkitts
C-MYC rearragement
Kids (think africa), EBV transformation
t(8, 22)
Dx:
Protein:
Burkitts
C-MYC rearragement
Kids (think africa), EBV transformation
FIP1 translocation or cKIT mutation
Dx:
Epidemiology:
Signs/Symptoms:
Cell morphology:
mastocytosis
kids?
benign cutaneous lesions (uticaria pigmentosa) –> spreads beyond the skin and causes flushing, hypotension, tachycardia, abdominal pain
“bland looking” cells that round, or spindle shape, sometimes with eosinophils
t(1, 19)
Dx: Protein: Epidemiology: Prognosis: Tx:
ALL
E2A-PBX
Kids
Good
Induction: VCR, L-ASP, DEX, or PRED +/- Daunorubicin
Consolidation: Daunorubicin , HD ARA-C, VCR, Etoposide, TG or 6-MP, cyclophosphamide, L-ASP
CNS prophylaxis: with intrathecal MTX or ARA-C
Maintenance: 6-MO, MTX, prednisone
Pax5 oncogene
memory B cell malignancy (mantle zone)
C-MAF and Cyclin D oncogenes
plasma cell malignancy (peri-follicular)
del11, 13, 17
Dx:
epidemiology:
Cell morphology
LN morphology
CLL
older males
smudge cells
pseudofollicular with loss of normal architecture
Trisomy 12
CLL
t(11; 14)
Dx:
Genetic abnormality:
Cell morphology:
LN morphology:
Mantle Cell lymphoma
Cyclin D1 overexpressed
smudge cells
homogenous starry sky
t(4; 14)
Dx:
protein:
epidemiology:
Signs/Symptoms:
plasma cell neoplasm
FGFR3
elderly
mild disease: asymptomatic, MUGS, inc total protein
severe disease–> MM: lytic bone lesions, fractures/pain, renal failure
t(14, 16)
Dx:
Protein:
epidemiology:
Signs/Symptoms:
plasma cell neoplasm
C-MAF
elderly
mild disease: asymptomatic, MUGS, inc total protein
severe disease–> MM: lytic bone lesions, fractures/pain, renal failure
t(14, 20)
Dx: Protein: epidemiology: Signs/symptoms: Tx:
plasma cell neoplasm
MAFB
elderly
mild disease: asymptomatic, MUGS, inc total protein
severe disease–> MM: lytic bone lesions, fractures/pain, renal failure
t(14, 18)
Dx: Fusion Protein: Epidemiology: LN morphology: prognosis:
follicular lymphoma and DLBL
Bcl2-IgH
Follicular: Adults DLBL: adults a/o kids
Follicular LN morph = many follicules that lack polarity, mitotic figures, and macrophages
more, bigger cells = bad
t(v, 3q27)
DLBL
t(2; 5)
Dx:
Protein:
prognosis:
anaplastic large cell lymphoma
ALK-NPM
Good (best lymphoma to get)
Jak2 with fibrosis of BM
Dx: Epidemiology: Pathogenesis Signs/Symptoms Cell Morphology Tx:
PMF
65 y/o 1:1 M to F
Megs–> cytokines–> Fibroblasts –> type III collagen in BM
dragging LUQ, speno and hepatomegaly, peripheral edema, neutrophillic dermatosis, portal hypertension,osteosclerosis, weight loss
Tear drops in PBS, strange Megs, basophillia
Androgens, procrit, hydroxyurea, thalidomide, lenalidomide
- *del5q may achieve remission
- *radiation for spleen, bone pain, extramedulalry tumors