Cancer stuffs - Acute leukemias Flashcards Preview

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Flashcards in Cancer stuffs - Acute leukemias Deck (38)
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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