W9- WBC DISORDERS Flashcards
What is it called when these abnormal cells are present both in the circulation and bone marrow
Leukemia
What is it called when these abnormal cells are present ONLY in the bone marrow
Aleukemic leukemia
What are the risk factor in developing leukemia
- Family history (genetic abnormalities, trisomy 21)
- occupational hazards (benzene exposure carcinogenicin nature)
- Ionizing radiation (rad dept)
- Immunologic deficiency (
- Autoimmune disease (e.g., SLE)
- Idiopathic (Leukemia)
Criteria for diagnosing leukemia
WHO: >20% blasts
FAB french american british: >30% blasts
In this disorder, the leukocyte count is variable
- DECREASE LAP/NAP score because of inactivity
- leukocytosis (50-300,00 cumm)
leukemia
- Excessive leukocytic response
- leukocytosis (50-100,000 cumm)
- INCREASE LAP/NAP score because of an inflammation
Leukemoid reaction
-Increase LAP/ NAp cause by premature release of the maturation stage in the bone marrow towards the circulation
that involves GEMM(granulocyte, erythrocyte, monocyte, and megakaryocyte) also known as myeloproliferative
Myeloid
involving the B or T cell and may be leukemia or lymphoma (solid tumor)
lymphoid
the blast is greater than 30%
-days to weeks (3 months)
Acute leukemia
the blast is less than 10%
-more than a year (1-2 years)
Chronic leukemia
what classification of leukemia is Rapid and progressive
- Affects all ages
- Elevated proliferative rates
- Blast are predominant
Acute leukemia
what classification of leukemia is Insidious
- Adults are affected
- Lower proliferative rates
- Mature cells are predominant
Chronic leukemia
What is the most common type of leukemia for adults ?
-there are presence of AUER RODS
Acute myeloblastic leukemia
What is it called when Auer rods are present in a lot of cell ?
Faggot cell
What stain is use in differentiating AML (acute myelocytic leukemia) from ALL ( acute lymphoblastic leukemia) , it is present in granulocyte and monocyte
Peroxidase
-bluish black
of all the granulocyte present, the eosinophil is resistant. there is still an activity even if there is a presence of sodium cyanide in the peroxidase stain. that’s why your eosinophil of leukemia will be diagnose through this stain
Cyanide-resistant peroxidase (CRP)
-brown and granular
it stains lipid component of cell
- it differentiate AML from ALL
Sudan black b (SBB)
- blask
the stain is chroloacetate
-it differentiates granulocytic from monocytic leukemia
Specific esterase (SE) -blue
Differentiates monocytic from granulocytic leukemia
Non-specific esterase (NSE)
-bright red
it stains glycogen and related substances anything carbohydrates -use in diagnosing your erythrocytic leukemia
periodic acid Schiff (PAS)
- reddish pink periphery
uses tartaric acid
-helpful in diagnosis of Hairy cell leukemia
Acid phosphatase (AP) - orange red
present in lymphoid lineage
differentiates ALL from AML
Terminal Deoxynucleotidyl transferase (TDT)
-fluoresecence
AML - M1
- WITH MATURATION
- <20% are monocytic lineage
- > 3% of the blast stain POSITIVE with MPO and SBB
- chromosome abnormality : t(8, 21)
- the most common subtype of leukemia
- may have Auer rods (altered primary granules )
AML- M2
- PROMYELOCYTIC leukemia
- > 30% of blast are type I, II and III
- abnormal promyelocyte Multiple auer rods (Faggot cell)
- chromosome abnormality: t(15;17)
- Associated with DIC (disseminated intravascular coagula) and hemorrhage
AML-M3
-MYELOMONOCYTIC LEUKEMIA or naegeli monocytic leukemia
- > 30% of the blast are type I and II with promonocytes
- Peripheral monocytes: >5x10^9/L
- High serum lysozyme
AML- M4
- most common subtype of AML leukemia of the myeloid lineage
- stains with (SE) specific esterase and (NSE) Nonspecific esterase,SBB, MBO
- MONOCYTIC LEUKEMIA or Schillings leukemia
- > 30% monoblast, promonocyte, and myeloblasts
- m5a: predominantly monoblast (>80%)
- m5b: predominantly promonocytes (<80%)
AML-M5
-stains with (NSE) non specific esterase
-ERYTHOLEUKEMIA or diguglielmo syndrome bone marrow is hypercellular ->50% are erythroblast ->30% are types I, II and III blast -immunophenotype: positive for glycophorin A
AML-M6
-positive for (PAS) periodic acid Schiff
- MEGAKARYOTIC LEUKEMIA
- > 30% are megakaryoblast with myeloblasts
- accompanied by atypical megarkaryocytes and the BONE marrow is often fibrotic
- immunophenotype: Glycoproteins 1b95 (responsible for the adhesion of the platelets) and 2b llb/ 3bllIa (responsible for the aggregation of platelet to platelet )
- EM ultracytochemical identifaction: Platelet peroxidase
AML-M7
- it requires immunocytochem staining for accurate diagnosing
- Factor A or 8? stain or antihemophilic factor
What is the most common type of leukemia in CHILDREN
-positive for terminal Deoxynucleotidyl transferase
Acute lymphoblastic leukemia
