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Flashcards in Acute leukemias Deck (55):
1

What is the median age of onset for AML? Gender?

66 yo
Male:female (5:3)

2

What is the 5 year survival rate of acute leukemia?

24%

3

What is the median age of onset for ALL?

14 years

4

What is the 5 year survival rate for ALL?

65%

5

What are the genetic abnormalities that predispose pts to leukemia?

Downs
Turners (X)
Klinefelters(XXY)
NF-1

6

What are the three malignant conditions that are associated with acute leukemia?

MDS
Myeloproliferative syndrome
Marrow failure syndromes

7

What are the chemical exposure that can lead to MDS?

Benzenes
Tobacco
Alkylating agents

8

What chemo agents predispose to leukemia?

Alkyating agents

9

Who gets CML?

65 yo males

10

What is the incidence of CLL?

4/100000, but way underreported

11

What is the 5 year survival rate of CML? CLL?

CML = 60%
CLL = 80%

12

True or false: CLL does not usually need to be treated

True

13

What are the SSx of acute leukemia? (4)

General fatigue
Pallor
Ostalgia
Fever

14

What is sweet syndrome?

red/violaceous tender nodules and plaques (dermatosis) d/t PMN sequestration

15

What are the eye findings with acute leukemia?

Retinal hemorrhage

16

What are the CNS findings with acute leukemia?

CN palsies
HA

17

What are the oropharyngeal findings with acute leukemia?

wet purpure
Gum infiltration

18

Is organomegaly common in acute leukemia?

No

19

What is the classification system for AML?

FAB (M0-M7)
WHO classification

20

What is M3 leukemia?

acute progranulocytic leukemia

21

Auer rods = ?

AML

(fused lysosomes and PMN granules with enzymes and crystalline inclusions)

22

What is leukemia cutis?

skin manifestations of leukemia

23

What are the mouth findings of leukemia?

gingival hyperplasia

24

What are the drugs that can cause gingival hyperplasia?

Phenytoin

25

What is the recommended site of bone marrow extraction?

PSIS

26

What are the risk factors for bone marrow exams?

DIC
Bleeding
Infx

27

What is William Damesheck's insight?

Had to give a big dose of chemo to ablate the bone marrow

28

What is the 7+3 induction therapy for AML?

Anthracycline x 3 days + cytarabine x7 days

29

What are the drugs used to consolidation therapy?

High dose cytarabine, then bone marrow transplant

30

What is APL? What is the treatment?

Acute

31

Can there be a philadelphia chromosome with AML?

Yes

32

AML induction support is what?

Transfused pRBCs (irradiate)
Abx
Antiemetics

33

What is the risk of transfusion with AML during induction support?

TA-GvHD

34

What are the growth factors that can be used with AML induction support?

GM-CSF or G-CSF

35

What food should be avoided in induction support for AML?

no raw berries or veggies grown in dirt

36

What is the problem with tumor lysis in treating leukemia? How do you treat this?

Uric

Allopurinol and alkanization of urine

37

What happens with 1st trimester prego with new diagnosis of leukemia?

Child will not survive

38

What is APL genetic cause?

t(15;17) resulting in the fusion of PML/RAR-alpha

39

What is the treatment for APL?

All trans-retinoic acid with 7+3 induction

40

What is the prognosis for APL?

Highly curable

41

What is the major complication with APL?

DIC

42

What is the median age of ALL?

14 years

43

What is the prognosis for ALL if >35 yo

Bad

44

What are the chromosomal translocation for ALL?

t(9;22)

45

What is the treatment for ALL induction?

Ara-c with methotrexate

46

What is the treatment for ALL in adults?

Bone marrow transplant

47

What are the drugs used for ALL maintenance therapy in adults?

6MP
Vincristine
Methotrexate

48

Is there a maintenance therapy in AML?

NO

49

What are the ssx of CML?

Easy bleeding
Usual CA

50

What did Jane Rowley do?

Argued that specific gene translocations cause specific diseases

51

What is the translocation associated with CML?

9;22
BCR-ABL promotes Y kinase to promote cell growth

52

What are the three risk factors for CML?

Age
Radiation exposure
Male

53

What is the treatment for CML?

Imatinib (Gleevec)
Dasatinib
Nilotinib

54

What is the chemo treatment for CML?

Hydroxyurea

55

What is the major issue with imatinib?

Keep pts on the drug may cause relapse