AML Handout & Flow Cytometry - Harrington Flashcards
How should a cell sample be prepared for flow cytometry?
The sample must be diluted to a level that will not clog the cytometer, and it should be incubated with fluorescent antibodies.
What information is obtained from flow cytometry?
Forward scatter (size)
Side scatter (cytoplasmic complexity)
Fluorescence (immunophenotype)
Recall the cell lineages associated with the following CDs:
CD3
CD14
CD34
CD45
CD3 - T Lymphocytes
CD14 - Monocytes
CD34 - Blasts
CD45 - Leukocytes in general
Name 4 chromosomal aberrations associated with AML.
Which has the worst prognosis?
t(8;21), inv(16), t(15;17)
Bad: 11q23
Which mutations are associated with Auer rods?
Which is associated iwth dysplastic eosinophils?
t(8;21) and t(15;17)
Inv(16)
What is a t(15;17)-associated AML also called?
How is it treated, and why?
Acute Promyelocytic Leukemia (APL).
Treat with ATRA to rescue the cells from arrest of maturation.
What mutations are associated with myelodysplastic syndromes?
Monosomy 7 (7q), Monosomy 5 (5q)
Some chemotherapeutics can cause AML later in life. Name two such classes, and distinguish them.
Alkylating agents can cause AML ~5yrs later, with very poor prognosis. (5q/7q)
Topoisomerase II inhibitors can cause AML ~2.5yrs later, with poor prognosis. (11q23)
What is a myeloid sarcoma?
A solid, extramedullary solid tumor of white blood cells. It can be treated using the same means as equivalent AMLs.
What are the significance of markers FTL3 and NPM1?
These are new prognostic markers for AML. FTL3 is a receptor tyrosine kinase, whose gof mutation predicts poor prognosis. NPM1 mutation predicts a favorable prognosis (trumped by FTL3 though)
What is a langerhans cell histocytosis?
What factors is it associated with?
A solid tumor consisting of immature dendritic cells.
MHC-II, CD1a, Langerin (in Birbeck granules), BRAF.
Distinguish between multisystem and unisystem Langerhans cell histiocytoses.
What is the Hand-Schuller-Christian triad?
Multisystem is bad news. Unisystem is isolated, but both can affect any system.
Unisystem LCH of the head, resulting in Diabetes Insipidus, Exophthalmos, and Calvarial bone defect.
What are the primary and secondary causes of hemophagocytic lymphohistiocytosis?
Primary: Perforin/Granzyme mutations
Secondary: Infection, cancer, anything that can result in extreme inflammation.
Name some of the diagnostic criteria of HLH.
What is the most “classic” (secondary) cause?
Feer, cytopenias, splenomegaly, soluble CD25, hemophagocytosis, reduced NK cell activity, increased ferritin…
Lymphoma.
In a flow cytometry scatter plot:
Which cells are located in the bottom left?
The top left?
The bottom right?
Bottom left: RBCs (smallest, least complex)
Top left: Granulocytes (small but highly granular)
Bottom right: Blasts (large, variable cytoplasmic complexity)
