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Flashcards in Acute Leukemia Deck (33):
1

A disease involving a neoplastic proliferation of blasts and is defined by a >20% of blasts in the bone marrow…

Acute leukemia

2

What is the acute presentation that occurs with an increased number of blasts seen with acute leukemia?

Anemia (Fatigue)
Thrombocytopenia (bleeding)
Neutropenia (infection)

3

A large, immature cells with a punched out nucleoli seen with acute leukemias?

Blast

4

What are the 2 subdivisions of acute leukemia?

Acute lymphoblastic leukemia (ALL)
Acute myelogenous leukemia (AML)

5

Disease characterized by a neoplastic accumulation of lymphoblasts in the bone marrow…

Acute lymphoblastic leukemia

6

What nuclear stain is characteristic of acute lymphoblastic leukemia?

TdT

7

What is TdT?

A DNA polymerase seen within lymphoblasts

8

Acute lymphoblastic leukemia commonly arises in children and is associated with what disorder?

Down syndrome—usually arises AFTER age 5

9

What are the two subclassifications seen with acute lympoblastic leukemia?

B-ALL
T-ALL

10

What are the characteristics of B-acute lymphoblastic leukemia?

TdT + expressing CD 10, 19, and 20

11

B-acute lymphoblastic leukemia has an excellent response to chemotherapy, but what is required in order to effectively treat this disease?

Prophylactic chemotherapy to the scrotum and CSF due to tight barriers preventing the spread to drug to these areas

12

What are the two chromosomal translocations seen with acute lymphoblastic leukemia?

T(12;21)
T(9;22)

13

Of the two translocations seen in acute lymphoblastic leukemia, which one has a good prognosis and is commonly seen in children?

T(12;21)

14

Of the two translocations seen in acute lymphoblastic leukemia, which one has a poor prognosis and is commonly seen in adults?

T(9;22)

15

What are the characteristics of T-acute lymphoblastic lymphoma?

TdT + with expression of markers ranging from CD2-CD8

Blasts DO NOT express CD10

16

What is the typical presentation for T-acute lymphoblastic lymphoma?

Typically presents in teenagers as a mediastinal thymic mass

Called a lymphoma because a mass is formed

17

A disease involving the neoplastic accumulation of immature myeloid cells in the bone marrow?

Acute myeloid leukemia

18

What is the characteristic cytoplasmic stain that is seen with acute myeloid leukemia?

Myeloperoxidase (MPO)

19

What are the crystal aggregates of MPO seen with acute myeloid leukemia called?

Auer rods

20

What is the average age range associated with the development of acute myeloid leukemia?

50-60 years

21

What sub classifies the different acute myeloid leukemias?

Cytogenetic abnormalities
Lineage of immature myeloid cells
Surface markers

22

What are the most common subtypes of acute myeloid leukemia?

Acute promyelocytic leukemia
Acute monocytic leukemia
Acute megakaryoblastic leukemia

23

What is the characteristic chromosomal translocation seen with acute promyelocytic leukemia?

T(15;17)

24

What does the t(15;17) seen in acute promyelocytic leukemia involve?

Retinoic acid receptor (RAR) on chromesome 17

25

What does the translocation of RAR from chromosome 17 to 15 seen in acute promyelocytic leukemia cause?

Blocks maturation and causes promyelocytes (blasts) to accumulate

26

When promyelocytes accumulate in acute promyelocytic leukemia, what are patients at an increased risk of developing?

DIC

27

What is the treatment for acute promyelocytic leukemia?

All-trans-retinoic acid—ATRA, which is a vitamin A derivative

28

What is the mechanism of action of all-trans-retinoic acid when treating acute promyelocytic leukemia?

The ATRA binds to the altered RAR and causes the maturation of the blast

29

What are the characteristic findings with acute monocytic leukemia?

A proliferation of monoblasts
Usually lacks MPO
Infiltration of the gums by the blasts

30

What are the characteristic findings with acute megakaryoblastic leukemia?

A proliferation of megkaryoblasts
Lack MPO
Is associated with Down syndrome and arises BEFORE age 5

31

Myelodysplastic syndromes may develop into acute myeloid leukemia after exposure to what?

Alkylating agents
OR
Radiotherapy

32

What is the usually presentation seen with myelodysplastic syndrome?

Cytopenias
Hypercellular bone marrow
Abnormal maturation of cells
Increased blasts

33

What does most patients die from before myelodysplastic syndrome progresses into acute leukemia?

Infection or bleeding