acute leukemia Module 10

Question 1

Compare AML to CML

Answer 1

• AML common in adults, ALL common in children. Both have anemia, thrombocytopenia, neutropenia, AML has myeloblasts, ALL has lymphoblassts. ALL small nuclei, indistinct nucleoli, AML medium to large nuclie distinct nucleoli, ALL PAS positive TdT positive, AML sudan black and peroxidase positive.

Question 2

Determine ALL from CLL flow cytometry

Answer 2

CD13 and 33 are AML markers, CD 10 is Calla, T and B cell specific. CD2,3,5,7 T cell positive.

Question 3

Common ALL A marke

Answer 3

CD10 zinc metalloprotease, B and T cell positive.

Question 4

CD13 and CD 33 markers in AML

Answer 4

• M0 - M3 (promyelocytic leukemia)

Question 5

CD 11 and CD14 AML differentiation -

Answer 5

M3 and M4 (promylocytic and promonmyleocytic)

Gycophorin AML differentiation - only ertyhroid,

Question 6

AML - promylocytic - cell shape -

Answer 6

auer rods, hypergranulated promyleocytes with odd shaped nuclei. rar fusion. treat with retinoic acid.

Question 7

Retinoic acid therapy

Answer 7

• promyleocytic leukemia

Question 8

AML with multilineage dysplasia -

Answer 8

de novo or following MPD / MDS treatment. Dysplasia 2 or more cell lines. Dysplasia includes: hypogranular PMNs, hyposegmentation, erythroblasts that are megaloblastoid or have fragmented nuclei, ringed sideroblasts, and micromegakaryocytes

Question 9

AML and MDS therapy related

Answer 9

• from alkylating agent or topoisomerase II agent. Ie ringed sideroblasts, micromegakryocytes, hyposegmentation or hypgranular PMNs

Question 10

AML without differentiationcell looks

Answer 10

• myloblasts, auer rods, vacuoles.

Question 11

AML with differentiation cell looks -

Answer 11

myeloblasts and PMN.

Question 12

Acute myelomoncytic leukemia

Answer 12

neutrophils and monocytes have impaired differentiation therefore myleoblasts and monocytes muramidase / lysozyme high.

Question 13

Acute erythroid leukemia cell looks

Answer 13

Myeoloid ertyhroid more serious than pure AEL. Megaloblastoid with ringed sideroblasts, BFU e or CFU-e is cancer cell.

Question 14

Cell morphology in pediatric all

Answer 14

indented nuclei inconspicuous nucleol homgenous lymphoblasts in bone marrowi fewer mutations

Question 15

Cell morphology in Adult ALL

Answer 15

• irregular nuclei conspicuous nuceloli heterogeneous lymphoblasts in bone marrow

Question 16

Morphologic features of Non burkitt ALL -

Answer 16

heterogeneous cell size, fine or clumped chromatin, everything else variable

Question 17

Morphologic features Burkitt ALL

Answer 17

• Large cells, fine chromatin, regular oval nuclei, prominent nucleoli and deep basophilia.

Question 18

Pan B cell Marker -

Answer 18

cd19

Question 19

CD2 tcell expression

Answer 19

• pre tcell

Question 20

Pan t cell markers

Answer 20

• cd3 and cd7

Question 21

AML treatment -

Answer 21

ATRA, BMT/ SCT, Epigenetic therapies

Question 22

ALL treatment -

Answer 22

Induction therapy, CNS radiation or intrathecal irradiation, Maintenace chemotherapy, cord blood transfusion

Question 23

Promyelocytic leukemia L

Answer 23

retinoic acid causes differentiation of myeloid precursors into granulocytes

• The PML-RAR fusion protein does not respond to physological levels of retinoic acid
• Blocks differentiation
• Extra retinoic acid given to treat

Question 24

First 3 types AML

Answer 24

minimally differentiated and without maturation (both CD34 / HSC +)
with maturation usually cd34 -

Question 25

Lineage speific AMLs

Answer 25

myelomonocutic leukemia, monoblastic leukemia, erythroid leukemia, megakaryoblastic leukemia (usually cd34 HSC +)

Question 26

CD 11b abd CD14

Answer 26

more specific for AMML, monoblastic leukemia because they are monocyte markers.

Question 27

Gycophorin positive for

Answer 27

erythroid leukemia

Question 28

Non Burkitt ALL types

Answer 28

Btype, T type, lymphoblastic lymphoma

Question 29

Compare burkitt vs non burkitt ALL

Answer 29

Burkitt type: Large cells, fine homogenous chromatin, regular oval or round nucleus, prominent nucleoli, abundant cytoplasm