Canine Acute Myeloid Leukemia + Myloproliferative Neoplasms + Myelodysplasia

Question 1

Is there sex predilection in dogs with AML

Answer 1

Yes - males (2:1)

Question 2

What stimulates multipotent stem cells to differentiate into
Erythroid lineage
Myeloid linage
Platelet lineage

Answer 2

Erythroid - EPO
Myeloid - colony-stimulating factors (CSFs)
Platelets - thrombopoietin

Question 3

What subtype of AML has not been described in dogs

Answer 3

M3

Question 4

What AML subtype is most common in dogs

Answer 4

M5a, M5b - 42%
Followed by M4 - 33%

Question 5

Missense mutations in what genes have been identified in AML

Answer 5

flt3
C-kit
Ras

Question 6

Phenotypic driver mutations in what genes have been identified in people with polycythemia vera, essential thrombocythemia, and primary myelofibrosis. Which one has been identified in 1 dog?

Answer 6

JAK2 - identified in one dog
CALR
MPL

Question 7

What is a typical PCV range with polycythemia vera

Answer 7

65-85%

Question 8

In humans, progenitor cells of polycythemia vera are hypersensitive to what?

Answer 8

IGF-1

Question 9

Philadelphia chromosome

Answer 9

Translocation between 9 and 22

Question 10

Raleigh chromosome

Answer 10

Translocation between 9 and 26

Question 11

Essential thrombocytosis is characterized by platelet counts

Answer 11

> 600k

Question 12

Negative prognostic factors for myelodysplastic syndrome

Answer 12

Increased percentage of blast cells
Cytopenias of more than one lineage
Cellular atypia

Question 13

Three subtypes of MDS for dogs and cats

Answer 13

MDS with excessive blasts - blasts are >5%
MDS with refractory cytopenias - blast percentages <5% and cytopenias in one or more lineages
MDS with erythroid predominance - M:E ratio <1

Question 14

What percent of MDS-EB progress to AML

Answer 14

<20%

Question 15

What percent of dogs with myeloid neoplasms have peripheral lymphadenopathy? hepatosplenomegaly?

Answer 15

Peripheral LNs 40-75%
Hepatosplenomegaly 40%

Question 16

AUL and AML (M1-M5, M7) bone marrow erythroid cell and blast cell percentages

Answer 16

BM erythroid <50%
Blast cells >30% of all nucleated cells

Question 17

MDS and CML bone marrow erythroid cell and blast cell percentages

Answer 17

BM erythroid <50%
Blast cells <30% of all nucleated cells

Question 18

M6 AML bone marrow erythroid cell and blast cell percentages

Answer 18

BM erythroid >50%
Blast cells >30% of all non erythroid cells

Question 19

MDS-Er bone marrow erythroid cell and blast cell percentages

Answer 19

BM erythroid >50%
Blast cells <30% of all non erythroid cells

OR Blast cells including rubriblasts <30% of all nucleated cells

Question 20

M6Er bone marrow erythroid cell and blast cell percentages

Answer 20

BM erythroid >50%
Blast cells >30% of all nucleated cells

Question 21

AML flow pattern

Answer 21

CD34+
CD45+
CD18+

Question 22

ACVP immunophenotyping panel and what each tests for

Answer 22

CD79a - B cells
CD3 - T cells
MPO - myeloid cells
CD11b - myeloid cells
CD41 - megakaryoblasts
CD1c - dendritic cells
CD34 - acute leukemias

Question 23

EPO concentrations in dogs with polycythemia vera versus secondary polycythemia

Answer 23

Polycythemia vera - low to low normal
Secondary polycythemia - high

Question 24

AML response rates and MSTs to chemo

Answer 24

Response rates 50-70%
MST 0.5-2.0m

Question 25

MST for AML with supportive care only

Answer 25

1-2 weeks

Question 26

PCV reduction in polycythemia vera - recommendations

Answer 26

Reduce to 50-60% or by 1/6th of starting value

Question 27

Chemo drug of choice for polycythemia Vera

Answer 27

Hydroxyurea

Question 28

What JAK2 inhibitor used in vet med could have therapeutic potential for PV in some dogs since the JAK2 mutation has been identified (1 of 5 dogs)

Answer 28

Oclacitinib (Apoquel)

Question 29

CML in humans is treated with what drug

Answer 29

Imatinib (Gleevec) - targets tyrosine kinase domain in abl (and c-kit and PDGF-R)

Question 30

CML chemo drug of choice in dogs

Answer 30

Hydroxyurea