Cancer stuffs - Acute leukemias Flashcards Preview

TT DD ex 3 and BL ex 2 > Cancer stuffs - Acute leukemias > Flashcards

Flashcards in Cancer stuffs - Acute leukemias Deck (38):
1

Two types of acute leukemias

1. Acute myeloid leukemia (AML)
2. Acute lymphoblastic leukemia (ALL)

2

3 different types of Acute Myeloid Leukimias (AML)

1. Congenital
2. Therapeutic-AML
3. NOS

3

General signs/symptoms of Acute leukemias

1. anemia: fatigue, malaise, pallor
2. thrombocytopenia: bruising, petichiae, hemorrhage
3. neutropenia: fever, recurrent infxn

4

What is the general blast marker used to diagnose Acute Leukemias?

CD34

5

General characteristics of AML
- severity
- target population
- common markers

- progressive
- 90% of AML occurs in adults
- Common blast marker: CD34
- common myeloid markers: CD117, myeloperoxidase

6

General characteristics of ALL
- severity
- target population
- common markers

- disease "explodes": rapidly fatal w/o treatment
- 75% of ALL occurs in children <6
- Common blast marker: CD34
- common lymphoblast marker: tdt

7

5 Different types of Congenital AML

1. RUNX1-RUNX1
2. CBFB-MYH11
3. PML-RARA
4. RBM1-MLK1
5. MLL

8

General risk factors of acute leukemias

1. translocations
2. previous chemo: alk agents, topo II inhib.
3. previous exposure of active marrow to ioniz rad.
4. tobacco smoke
5. benzene exposure
6. genetics

9

Different types of T-AML

(therapeutic)

1. Alkylating agent or ionizing radiation
2. Topo II inhib.

10

Different types of NOS AML

Ones with these mutations:
1. FLT3
2. NPM1
3. CEBPA

11

Different types of ALL

1. B-ALL
2. T-ALL

12

RUNX1-RUNX1 genetic translocation/mutation

t(8;21)

13

CBFB genetic translocation/mutation

t(16;16) or inv(16)

14

PML-RARA genetic translocation/mutation

t(15;17)

15

RBM15-MLK1 genetic translocation/mutation

t(1;22)

16

AML Congenital MLL genetic translocation/mutation

11q23

17

T-AML genetic translocation/mutations

For alylating agent or radiation:
- whole/partial loss of ch 5 and/or 7

For topo II inhib
- often MLL (11q23) gene

18

AML NOS genetic translocation/mutation

These mutations:
FLT3 (ITD)
NPM1
CEBPA

19

BCR-ABL genetic translocation/mutation

t(9;22) p190

20

ALL - B-ALL - MLLgenetic translocation/mutation

11q23

21

ETV6-RUNX1 genetic translocation/mutation

t(12;21)

22

T-ALL:
- % of ALL
- common markers

20-25% of ALL

general blast marker: CD34
common lymphoblast marker: tdt
t cell markers: CD3, CD7

23

B-ALL:
- % of ALL
- common markers

80-85% of ALL

general blast marker: CD34
common lymphoblast marker: tdt
B cell markers: CD19, CD22
- lack CD20 (of mature B cells like in Non-Hodgkin)

24

Prognosis of Congenital AML:
1. RUNX1-RUNX1
2. CBFB-MYH11
4. RBM1-MLK1
5. MLL

1. RUNX1-RUNX1 - Good
2. CBFB-MYH11 - Good
4. RBM1-MLK1 - Good
5. MLL - Poor

25

Prognosis of:
- T-AML
-FLT3
- NPM1
- CEBPA


- T-AML:
Very poor
(luckily its only 10-20% of AML)

-FLT3: very poor
- NPM1 : good (if FLT3 not present)
- CEBPA: good (if FLT3 not present)

26

Alkylating agents/radiation are types of T-AML that progress to AML via which cancer?

MDS

27

Prognosis of B-ALL:
BCR-ABL
MLL
ETV6-RUNX1

BCR-ABL: worst of all ALL
MLL: poor
ETV6-RUNX1: very favorable

28

Prognosis of T-ALL

Good
Kids: 95% cure, 100% remission
Adults: 50% cure, 60-80% remission

29

What does RUNX1 code for?

alpha subunit of CBF txn factor

30

What does CBFB code for?

beta subunit of CBF txn factor

31

What type of cells are you likely to see in CBFB-MYH11?

baso-eos
- immature eosinophils w/ baso granules

32

What type of cells are you likely to see in PML-RARA?

hypergranular cells
multiple auer rods

33

What type of cells are you likely to see in RBM15-MLK1

megakaryoblastic differentiation

34

What type of cells are you likely to see in Congenital AML MLL?

monocytic differentiation

35

Which AML is more likely to be seen in pts with Down Syndrome?

RBM15-MLK1

36

Which AML is more likely to be at risk for DIC? How do you treat it?

PML-RARA (APL)

treat w/ ATRA

37

BCR-ABL B-ALL vs MLL B-ALL ivs T-ALL in patient populations

BCR-ABL: more common in adults
MLL: more common in neonates/infants
T-ALL: more common in males, adolescents/young adults

38

Which cancer is more likely to present with a mediastinal mass?

T-ALL