AML

Question 1

Granulocytic maturation
Extramedullary involvement
Favorable prognosis

Answer 1

AML with t(8;21)

Question 2

Immunophenotypic features of myelomonocytic leukemia (dual differentiation towards granulocytes and monocytes)
Eosinophils with dysplastic features
Extramedullary involvement
Favorable prognosis

Answer 2

AML with inv(16)

Question 3

Atypical promyelocytes -- Hypergranular 
Have reniform nuclei 
Multiple prominent Auer rods 
Hypergranular cases show leukopenia
Microgranular cases show leukocytosis 
Commonly manifests as DIC at diagnosis 
Responds to ATRA

Answer 3

AML with t(15;17)

Question 4

Infantile AML
Monocytic features and presents with hyperleukocytosis
Exramedullary tissue infiltration is common
Can have several translocation partners

Answer 4

AML with 11q23 (MLL) rearrangements
t(9;11) has intermediate prognosis
Others involving MLL gene have intermediate to poor prognosis

Question 5

Characterized by dysplasia in >50% of two or more lineages
And/or myelodysplasia-associated cytogenetic abnormalities – Monosomy 7/del(7q), Monosomy 5/del(5q) or complex karyotypes
Predominantly in older individuals
Unfavorable prognosis

Answer 5

AML with myelodysplasia-related changes

Question 6

Occurs in patients previously treated with chemo/radiotherapy
Can be caused by either alkylating agents or topoisomerase II inhibitors

Answer 6

Therapy-related AML and MDS

Question 7

Occur a median of 5 years after treatment
Risk due to total dose and patient age
Multi-lineage dysplasia
Abberrancies of Chr 5 and 7

Answer 7

Alkylating agent related AML/MDS

Question 8

Tend to occur sooner than 5 years after treatment (median 2.5-3 years)
Usually monocytic or myelomonocytic
11q23 (MLL) balanced translocations are common
Poor prognosis
Resembles de novo AML with 11q23 (MLL) gene arrangements

Answer 8

Topoisomerase II inhibitor-related AML

Question 9

Extramedullary tumor of immature myeloid cells
Can occur after, concurrent or preceding AML diagnosis
Usually treated in same fashion as AML

Answer 9

Myeloid sarcoma

Question 10

Receptor tyrosine kinase with important role in hematopoietic progenitor survival and proliferation
Activating mutation caused by internal tandem duplications of the juxtamembrane domain confers poor prognosis

Answer 10

FLT3– new prognositic marker in AML

Question 11

Nucleocytoplasmic shuffling protein 
Mutation in 50-60% of AML with NORMAL karyotype 
Favorable prognosis (in cases w/o mutated FLT3)

Answer 11

NPM1