WBCII, Putthoff, lec Flashcards
What are the neoplasms of immature B and T cells
ALL from B cell or T cell
what is the most common childhood cancer
ALL, 85% B cell
where is precursor for B and T cell ALL
B from bone marrow
T from tymus
peak incidence of B and T cell ALL
B is age 3
T is adolescence when thymus is full size
what genotypes are assoc with B cell ALL
t(12;21) involves RUNX1 and ETV6
trisomy 4 7 and 10
philedelphia chromosome 9;22
hyperdiploidy
what genotypes are assoc with T cell ALL
NOTCH1 mutations
What are clinical features of ALL
abrupt onset Sx
fatigue, fever, infections, bleeding
bone pain, lymphadenopathy, HSM, testicular enlargement
HA, vomiting, nerve palsies from meningeal involvemnt
what are the Sx specific to T cell ALL
complications from compression Large vessels and airways in the mediastinum
What Sx of ALL are from problems assoc with marrow
fatigue, fever, infecitons, bleeding
what Sx of ALL are assoc with neoplastic infiltration
bone pain
adenopathy
HSM
testicular involvement and the CNS Sx
What is distribution in poplation of ALL
more common in hispanics
3W:B
more male than female
what are good prognostic factors for ALL
between ages 2-10, low WBC, hyperdiploidy, trisomies 4,7,10 and t12;21
what are bad prognostic factors of ALL
age less than 2 or greater than 10
peripheral blast count >100,000
the philadelphia translocation 9;22 BCR/-ABL fusion
what do the nuclei look like on smear of ALL
spiculated nuclei
What CD marker is assoc with B cell neoplasms
CD 10
increased intracell terminal dinucleotide transferase TdT is assoc with what neoplasms
B and T cell ALL
most common leukemia in adults in westerm world?
CLL or SLL
What genotypes are assoc with CLL
trisomy 12
deletions:11q,13q,17p
What is immunophenotype CLL
CD19, CD20, CD23, CD5
low level Ig on surface
population affected by CLL
2M:1F
avg age 60
Sx CLL
easy fatiguability, weight loss, anorexia
generalized lymphadenopathy, HSM
increased infections
hypogammaglobulinemia
sometimes hemolytic anemia or thrombocytopenia from auto Ab
buzzwords for CLL
smudge cells, growth confined to proliferation centers, richter syndrome
what is richter syndrome
the transformation of CLL to diffuse large B cell lymphoma or a prolymphocyte evolution
aggressive with less than 1 yr survivial
What is absolute lymphocyte count in CLL
> 5000
how do you Dx CLL
peripheral blood smear
Prognosis CLL
4-6 yrs. can be >10 if mild
Tx CLL
gentle chemo and immunotherapy with Ab to CD20 or inhibitors of BTK