Ch. 6 - Acute and Chronic Leukemias Flashcards Preview

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Flashcards in Ch. 6 - Acute and Chronic Leukemias Deck (65):
1

What type of leukemia do pts of 0-14 years get?

ALL

2

What type of leukemia do pts of 15-59 years get?

AML

3

What type of leukemia do pts of 40-60 years get?

AML/CML

4

What type of leukemia do pts of >60 years get?

CLL

5

In acute myelogenous leukemia, maturation of the (blank) is arrested

granulocyte

6

Evidence of marrow failure shows as what type of changes in lab work?

Anemia
thrombocytopenia
neutropenia
leukocytosis with increased blasts

7

Evidence of marrow failure shows as what type of clinical symptoms?

Fatigue
bleeding/ecchymosis
DIC
monocytic gum infiltration

8

What is done with a bone marrow BIOPSY>

sent to histology

9

what is done with a bone marrow ASPIRATE?

1. flow cytometry
2. peripheral smear
3. cytogenetics including FISH and karyotype

10

csome issues including t(15;17)(q22;q12) corresponding to FAB M3, presenting in decades 3-5 is what leukemia?

Acute promyelocytic leukemia

11

How quickly does APL replicate?

Quickly. That's how quickly. rapid doubling time, baby.

12

T/F: APL has low numbers of Auer rods

false; large numbers

13

What is the two item treatment for APL?

All-trans retinoic acid (ATRA) and an alkylating agent

14

T/F: APL has a remission rate above 80%

true

15

T/F: Acute monocytic leukemia presents with large numbers of auer rods

false; they are rare

16

Gum infiltration is common in which leukemia

acute monocytic leukemia

17

How do you Dx Acute monocytic leukemia?

immunophenotype

18

Which leukemia is caused by the t(9;22) BCR-ABL fusion product, aka the PHILADELPHIA CSOME

Chronic Myelogenous leukemia

19

T/F: the chronic phase of AML can last years before converting to a blast crisis

true

20

What are the risk factors that lead to CML?

radiation or benzene exposure

21

T/F: The Philly csome is specific for CML

false!!!!

22

The BCR-ABL fusion protein on the Philly csome produces a constitutively active (blank), leading to dysregulation of proliferation and apoptosis

tyrosine kinase

23

The ABL portion of the fusion protein comes from csome (9/22)

9

24

the BCR portion of the fusion protein comes from csome (9/22)

22

25

The BCR-ABL fusion protein activates what intracellular cascade pathway?

STAT pathway

26

What is the WBC count in CML?

>5

27

A differential of a pt with CML would show (full/inhibited) granulocyte differentiation

full

28

What are the clinical findings of someone with CML?

fever, night sweats, wt. loss, splenomegaly, bleeding.ecchymoses

29

CML leads to an increase in (one/all) myeloid products

all

30

A blast crisis has greater than (blank) percent blasts

20%

31

What is the the cause of death in a blast crisis?

hyperviscous blood leading to heart failure, lung infiltrates, kideny injury from rapidly dying cells.

Short story: multi organ failure

32

CML is treated with (blank) type drugs--think about what the Philly csome produces

tyrosine kinase inhibitor

33

Gleevec is a drug used to treat (blank)

CML

34

With allogenic (stem cell/bone marrow) transplant, 5 year progression free survival of CML is 80-95%

stem cell

35

What is the most common leukemia in children?

B cell ALL

36

What percent of ALLs are B cell?

80-85%

37

75% of B cell ALL cases involve children under the age of (blank)

6

38

What two markers do B cell ALLs express?

CD10 and tdt

39

B cell ALLs are caused by (differentiated/undifferentiated) lymphoblasts

primitive undifferentiated

40

What is the most common secondary site of ALL involvement?

THE CNS
also seen in the lymph nodes, spleen, liver and testis

41

What age group gives a favorable prognosis for B cell ALL?

1-10

42

What genetic markers give a favorable impression for ALL?

t(12;22)/ETV/RUNX1
and hyperdiploidy of the cancer cells

43

What type of leukemia often presents with a mediastinal mass?

T cell ALL

44

How do T cell ALL markers differ from B cell ALL markers?

B cell: CD10 and tdt POS
T cell: CD10 - and tdt +

45

CD3 is a pan-(blank) cell marker

T cell

46

(blank) is a clonal B cell neoplasms caused by a light chain restriction

chronic lymphocytic leukemia

47

Overall, what is the most common human leukemia?

CLL

48

What is the most common leukemia of the elderly?

CLL

49

what two markers does CLL express?

CD5 and CD23

50

What two markers do the virgin mature B cells express in CLL?

CD19 and CD20

51

What is the blast percent in CLL

52

Name the disease:
WBC 10-100
small mature lymphs
clumped chromatin/TORTOISE SHELL appearance
Smudge cells

CLL

53

T/F: There is a T cell variant of CLL

false

54

T/F: CLL warrants aggresive chemotherapy

false

55

What drug is given if Tx is warranted for CLL?

Chlorambucil

56

A mutated (blank) gene is extremely favorable in CLL with a median survival of 293 months

Ig Variable heavy chain-- IGVH

57

ZAP-70 and CD38 expression in CLL are (favorable/unfavorable)

unfavorable

58

What is the Richter transformation?

transition from CLL to DLBCL; median survival less than one year--formation of lymphocytic lymphoma solid tumors

59

What is this disease?
CD11c, CD25, CD103
Neoplasm of memory B cells
Older Caucasian males
Indolent disease
Pancytopenia, monocytopenia
Splenomegaly

Hairy cell leukemia

60

What is unique about where hairy cell leukemia sets up shop in the spleen?

sequesters in the RED pulp

61

In hairy cell leukemia the bone marrow has a distinct (blank) appearance

fried egg

62

The dense (blank) network in hairy cell leukemia leads to a dry tap during bone marrow aspiration

reticulun

63

Adult T cell leukemia is caused by what virus?

HTLV-1

64

Where is HTLV endemic?

Japan, West Afrika, Carribean

65

What cancer has floret or clover leaf cells?

Adult T cell leukemia