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SALMAN HARRISON'S > 100 - Acute Myeloid Lymphoma > Flashcards

100 - Acute Myeloid Lymphoma Flashcards

1
Q

AML (____) is a neoplastic disease characterized by an _____ of the blood, BM and other tissues by ___, ___, ___ cells from the hematopoietic system

A 
Acute myeloid leukemia
Infiltration 
Proliferative
Clonal
Unsorted
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2
Q

AML is the most common leukemia in ___ with median age at diagnosis of ___ survival of __ years in 27%

A

Adults
67
5

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3
Q

Most cases of AML are ___. Myeloid leukemia with genetic predisposition are linked to several syndromes of BM failure such as: ____,____. and biological disorders such as dyskeratosis congenital

A

Idiopathic
Fanconi anemia
Schwachman diamond

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4
Q

AML is also found in higher rates in patient with ___

A

Trisomy 21

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5
Q

In order to diagnose AML there need to be > ___ blasts in the BM/blood, unless there following genetic alteration exist: (3)

A 
20%
t(15:17)
t(8:21)
inv(16)
t:(16:16)
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6
Q

The mutation ____ is linked with very good prognosis with ___ cure rate

A

t(15:17)

85%

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7
Q

The mutations ____ and ____are linked with good prognosis with ___ cure rate

A

t(8:21)
inv(16)
55%

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8
Q

In AML without cytogenic abnormalities there is an ___ with ___ cure rate

A

Intermediate outcome risk

40%

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9
Q

The worse prognosis is for ___ and ___ genetic changes.

A

t(6:9)

inv(3)

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10
Q

Old age is a ___ prognosis in AML, and predicts a more ___ disease and difficulty to withstand therapy

A

Bad

Resistant

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11
Q

There is a lower response criteria when symptoms such as ___, ___, ___ are present ___ months before the diagnosis

A

Anemia
Leukopenia
Thrombocytopenia
3

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12
Q

Complete remission after blood and BM examination is achieved according to the following: (5)

A 
Neutrophils >=1000
Platelets>=100,000 without blasts in circulation
BM blasts <5%
No auer rods  
No extramedullary leukemia
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13
Q

The common clinical symptoms in AML include: (5)

A
  1. Fatigue
  2. Lethargy
  3. Anorexia and weight loss
  4. Fever
  5. Abnormal hemostasis
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14
Q

Less common clinical symptoms in AML include: (5)

A 
Bone pain
Lymphadenopathy
Non specific cough
Headache
Sweating
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15
Q

What is myeloid sarcoma (rare)?

A

A tumor mass consisting of myeloid blasts occuring at anatomic sites other than bone marrow (skin, LN, GI, sot tissue, testis)

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16
Q

Most AML patients will present with non severe ___. usually normocytic normochromic with a decrease in ___.

A

Anemia

Reticulocytes

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17
Q

It is recommended to treat most AML patients with anemia and thrombocytopenia with ____ even if the decrease is not severe

A

Blood products

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18
Q

The median of white count in AML patients is ___. Older patients will present with ____ counts

A

15K

Lower

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19
Q

In AML patients 25-40% of patients will present with leukocytes count of ____

A

5K

20
Q

In AML patients 20% of patients will present with leukocytes count of ____

A

> 100,000K

21
Q

____ are not always present, but when they do the diagnosis is certain

A

Auer rods

22
Q

In AML patients 75% of patients will present with platelets count of ____

A

<100,000

23
Q

In AML patients 25% of patients will present with platelets count of ____

A

<25,000

24
Q

50% of AML patients present a slight elevation in ___ when diagnosed. In 10% of patients it will sink in the kidneys, rarely leading to ____

A

Uric acid

Renal Failure

25
Q

In AML chemotherapy may lead to substantial ____, therefore all patients will be treated with ___ or ___ when chemo starts.

A

Hyperuricemia
Alopurinol
Rasburicase

26
Q

What are the two stages when treating AML?

A
  1. Induction

2. Post remission (consolidation)

27
Q

One of the most important factors when choosing the suitable treatment in AML is ___. When

A

Age

60

28
Q

What is the induction therapy drugs for AML patients <60?

A

Cytarabine
+
Anthracycline (daunorubicin, idarubicin, mitoxantrone)

29
Q

Young AML patients who did not get to the point of remission after induction will go through:

A

A second round of induction

30
Q

Consolidation therapy in young AML patients include:

A

Intense chemotherapy for 2+4 cycles + BM transplantation (allogenic autologous)

31
Q

Consolidation therapy in old AML patients include:

A

Reduced chemotherapy

Allogenic BM transplantation if possible

32
Q

Supportive therapy in AML patients include central line and the following: (2)

A
  1. Platelets infusion keeping the levels > 10K

2. RBC infusion keeping Hgb levels > 7-9

33
Q

APL has long term prognosis of ___

A

85%

34
Q

10% of patients who receive the normal protocol die because of ___ due to particles released from the ___ in the blasts

A

DIC

Auer rods

35
Q

APL leukemic cells are: ___

A

t(15:17)

36
Q

The drug of choice in APL is:___ which does not cause ___

A

Tretinoin

DIC

37
Q

Post remission treatment = __

A

consolidation

38
Q

Without consolidation therapy, all AML patients will experience __

A

relapse

39
Q

The goal of consolidation therapy is to __ all of the residual __ cells

A

eradicate

lukemia

40
Q

Young patients are recommended to go through intensive chemotherapy consolidation therapy:

A 
high dose cytarabine for 2+4 cycles 
\+ 
BM transplantation (HSCT) allogenic / autologous
41
Q

Old patients are recommended to go through reduced chemotherapy consolidation therapy. ___ transplantation should be considered in patients < __ without ___ illness and __ match

A

Allogenic
75
background
HLA

42
Q

The leading mortality cause in AML patients is __. All patients will develop __ during the treatment, but only half will have __

A

infection
fever
infection

43
Q

Neutropenic patients should be treated with __ and __ when going through __ and __ therapy. Patients with positive __/__ should be treated with prophylaxes __

A 
Abx
antifungal
induction
consolidation
VZV
herpes
antiviral
44
Q

The recommended monotherapy Abx are: 3

A

Imipenem-cilastatin
meropenem
piperacillin
cephalosporine

45
Q

If a neutropenic AML patient suffers from fever under treatment for 4-7 days, we should consider __ treatment: 3

A

antifungal
caspofungin
voriconazole
liposomal amphotericin B

46
Q

A neutropenic AML patient with fever should continue Abx and/or antifungal until the source of __ is found or the patients is no longer __

A

infection

neutropenic

SALMAN HARRISON'S (163 decks)

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