Acute Leukemia Flashcards Preview

Block 6 > Acute Leukemia > Flashcards

Flashcards in Acute Leukemia Deck (13):
1

acute myelogeneous (non-lymphocytic) leukemia

etiology

Congenital
Viral
Oncogenes
Environmental Agents
Industrial Agents
Chemical Agents

radiation

therapeutic agents

2

hereditary factors of AML

Chromosomal Breakage
- Bloom’s Syndrome
- Fanconi’s Syndrome

Immunologic Disorders

Down’s Syndrome
- Nondisjunctive Conditions

3

clinical findings of AML

1) Symptomatology

Fatigue
Infection
Bleeding
Adenopathy
Left Upper Quadrant Discomfort
Leukostasis
Rectal Lesions

4

physcial findins of AML

Splenomegaly
Lymphadenopathy
Gingival Hypertrophy
Ecchymoses, Fundal Hemorrhages
Neurological Abnormalities
Granulocytic Sarcoma
Neutrophilic Dermatosis
Congestive Heart Failure

5

Other lab findings of AML

 HYPERURICEMIA
   RENAL INSUFFICIENCY
   HYPOKALEMIA
   HYPER- OR HYPOCALCEMIA
   CSF PLEOCYTOSIS
   COAGULOPATHY
   ANERGY

6

prognostic values of cytogenetics

favorable:

 T(8;21)
      INV (16)
      T(15;17)

unfavorable:

5a-
  7a-
       T(9;22)

7

Acute Promyelocytic leukemia

A unique leukemia subtype

Distinct clinical features
- Disseminated intravascular clotting

Distinct histological and cytogenetic features
- Azurophilic granules, Auer rods, t(15;17( or t(11;17)

Distinct molecular features
- PML-RARα

8

chemotherapy

induction

consollidation

maintenance

9

prognostic factors for remission and /or survival in APL

AGE
PRIOR RADIATION OR CHEMOTHERAPY
KARYOTPIC ABNORMALITIES, ESPECIALLY CHROMOSOMES 5 AND 7
HISTORY OF PRELEUKEMIA
GENDER
LEUKOCYTE COUNT AT PRESENTATION

10

Acute lymphoblastic leukemia

B cell ontogeny
- Earliest B cell
- Translocation to the Germinal Center
- Antigen presentation and B-cell activation
- Plasma Cell
- Memory B cell

 

Malignant transformation of a committed pre-B cell
- Characteristic pre-B cell markers
CD10
Terminal deoxynucleotidyl transferase
Other B-cell, T-cell, or NK-cell markers

11

Subtypes of ALL

Childhood A.L.L.  (L1 phenotype)
- CD10-positive, hyperdiploid

Adult A.L.L. (L2 phenotype)
- 30% are Philadelphia-chromosome positive

Burkitt’s lymphoma/leukemia (L3 phenotype)
c-myc juxtaposed to Ig H, κ or λ
t(8;14) OR t(2;8), t(8;22)

12

Distint clinical concerns in ALL

Sanctuary disease sites
- Central nervous system
- testis

The role of maintenance therapy

- Prolonged antimetabolite therapy

13

Treatment of ALL

Corticosteroids and Vinca alkaloids
Anthracycline antibiotics
L- Asparaginase
CNS prophylaxis
Cyclophosphamide