Flashcards in Ch. 6 - Acute and Chronic Leukemias Deck (65):
What type of leukemia do pts of 0-14 years get?
What type of leukemia do pts of 15-59 years get?
What type of leukemia do pts of 40-60 years get?
What type of leukemia do pts of >60 years get?
In acute myelogenous leukemia, maturation of the (blank) is arrested
Evidence of marrow failure shows as what type of changes in lab work?
leukocytosis with increased blasts
Evidence of marrow failure shows as what type of clinical symptoms?
monocytic gum infiltration
What is done with a bone marrow BIOPSY>
sent to histology
what is done with a bone marrow ASPIRATE?
1. flow cytometry
2. peripheral smear
3. cytogenetics including FISH and karyotype
csome issues including t(15;17)(q22;q12) corresponding to FAB M3, presenting in decades 3-5 is what leukemia?
Acute promyelocytic leukemia
How quickly does APL replicate?
Quickly. That's how quickly. rapid doubling time, baby.
T/F: APL has low numbers of Auer rods
false; large numbers
What is the two item treatment for APL?
All-trans retinoic acid (ATRA) and an alkylating agent
T/F: APL has a remission rate above 80%
T/F: Acute monocytic leukemia presents with large numbers of auer rods
false; they are rare
Gum infiltration is common in which leukemia
acute monocytic leukemia
How do you Dx Acute monocytic leukemia?
Which leukemia is caused by the t(9;22) BCR-ABL fusion product, aka the PHILADELPHIA CSOME
Chronic Myelogenous leukemia
T/F: the chronic phase of AML can last years before converting to a blast crisis
What are the risk factors that lead to CML?
radiation or benzene exposure
T/F: The Philly csome is specific for CML
The BCR-ABL fusion protein on the Philly csome produces a constitutively active (blank), leading to dysregulation of proliferation and apoptosis
The ABL portion of the fusion protein comes from csome (9/22)
the BCR portion of the fusion protein comes from csome (9/22)
The BCR-ABL fusion protein activates what intracellular cascade pathway?
What is the WBC count in CML?
A differential of a pt with CML would show (full/inhibited) granulocyte differentiation
What are the clinical findings of someone with CML?
fever, night sweats, wt. loss, splenomegaly, bleeding.ecchymoses
CML leads to an increase in (one/all) myeloid products
A blast crisis has greater than (blank) percent blasts
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
CML is treated with (blank) type drugs--think about what the Philly csome produces
tyrosine kinase inhibitor
Gleevec is a drug used to treat (blank)
With allogenic (stem cell/bone marrow) transplant, 5 year progression free survival of CML is 80-95%
What is the most common leukemia in children?
B cell ALL
What percent of ALLs are B cell?
75% of B cell ALL cases involve children under the age of (blank)
What two markers do B cell ALLs express?
CD10 and tdt
B cell ALLs are caused by (differentiated/undifferentiated) lymphoblasts
What is the most common secondary site of ALL involvement?
also seen in the lymph nodes, spleen, liver and testis
What age group gives a favorable prognosis for B cell ALL?
What genetic markers give a favorable impression for ALL?
and hyperdiploidy of the cancer cells
What type of leukemia often presents with a mediastinal mass?
T cell ALL
How do T cell ALL markers differ from B cell ALL markers?
B cell: CD10 and tdt POS
T cell: CD10 - and tdt +
CD3 is a pan-(blank) cell marker
(blank) is a clonal B cell neoplasms caused by a light chain restriction
chronic lymphocytic leukemia
Overall, what is the most common human leukemia?
What is the most common leukemia of the elderly?
what two markers does CLL express?
CD5 and CD23
What two markers do the virgin mature B cells express in CLL?
CD19 and CD20
What is the blast percent in CLL
Name the disease:
small mature lymphs
clumped chromatin/TORTOISE SHELL appearance
T/F: There is a T cell variant of CLL
T/F: CLL warrants aggresive chemotherapy
What drug is given if Tx is warranted for CLL?
A mutated (blank) gene is extremely favorable in CLL with a median survival of 293 months
Ig Variable heavy chain-- IGVH
ZAP-70 and CD38 expression in CLL are (favorable/unfavorable)
What is the Richter transformation?
transition from CLL to DLBCL; median survival less than one year--formation of lymphocytic lymphoma solid tumors
What is this disease?
CD11c, CD25, CD103
Neoplasm of memory B cells
Older Caucasian males
Hairy cell leukemia
What is unique about where hairy cell leukemia sets up shop in the spleen?
sequesters in the RED pulp
In hairy cell leukemia the bone marrow has a distinct (blank) appearance
The dense (blank) network in hairy cell leukemia leads to a dry tap during bone marrow aspiration
Adult T cell leukemia is caused by what virus?
Where is HTLV endemic?
Japan, West Afrika, Carribean