acute leukemia Flashcards
(31 cards)
generally speaking what is a leukemia ?
cancer of white blood cells, the cells appear in the peripheral blood
what is the main difference between acute and chronic leukemias ?
acute - associated with blast cells
chronic - associated with no blast cells
what age group is highly associated with ALL ?
children and adolescent
what is an important differential diagnosis of ALL in children ?
pertussis
how can we differentiate between pertussis and ALL ?
pertussis comes with symptoms of hypoglycemia and is associated with post tussive emesis , which is not present in ALL
what are the positive immune markers associated with ALL ?
TdT and CD10
“ happens in Ten year olds”
what genetic disease is associated with a higher risk of ALL?
down syndrome - where there is a higher risk of excess lymphoblasts
what are the gene translocations associated with ALL and what are their prognosis ?
associated with 9;22 - Philadelphia chromosome - worse prognosis
12;21 - better prognosis
what are TdT and CD10 markers of ?
TdT markers of pre t and pre b cells
CD10 are markers for pre B cell
what are the most common sites of metastasis associated with ALL ?
CNS and testes
what is seen on peripheral blood smear in ALL ?
lymphoblasts
what are the markers for mature B cells ?
Cd19, CD20, CD21
if you see positive TdT what does this indicate ?
lymphocyte lineage not seen in myeloblasts
what are the antigens associated with T cells ?
CD 1 all the way to CD 8
what is the usual lineage of ALL ?
usually a pre B cell malignancy
what is the presentation associated with T cell ALL ?
presents similarly to SVC syndrome
presents as a mediastinal mass , with a positive pemberton sign and congested neck veins
what are the markers seen in T cell ALL ?
usually CD7
what is the most common age group associated with AML ?
65 year olds is the median age
what is the mechanism associated with AML ?
symptoms are due to bone marrow suppression
what are the pripheral blood smear findings associated with AML ?
auer rods seen
or 30-50% blasts seen
myeloperoxidase positive
how can we differentiate between AML and ALL ?
ALL is MPO negative whist AML is MPO positive
also ALL happens in younger patients
if you see lymphoblasts thats definetly ALL and not AML
what is the gene translocation associated with AML ?
a common subtype of AML is APL associated with 15;17 (PML RARA)
the retinoic acid receptor is on chromosome 17
what complication is associated with the release of Auer rods in the circulation ?
associated with the onset of DIC
what is the treatmet for AML
the APL subtyppe is treated with all trans retinoic acid which allows the maturation of leukemic cells into granulocytes (mature)
