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Hematology > Ch16 Leukemia > Flashcards

Ch16 Leukemia Flashcards

0
Q

A rapidly progressive disease characterized by an abnormal expansion of immature cells or blasts can be defined as:

A

Acute leukemia

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1
Q

What is the name of a malignant disease of hematopoietic tissue characterized by replacement of normal BM elements with abnormal (neoplastic) blood cells.?

A

Leukemia

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2
Q

Slowly progressive disorder characterized by an abnormal expansion of mature cells

A

Chronic leukemia

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3
Q

Name the 2 major cell types of leukemia

A

Myelogenous and lymphocytic

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4
Q

More than 50% of leukemia cases occur in adults:

A

Over the age of 64

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5
Q

What are the most frequently seen adult cases of leukemia

A

Acute myeloid leukemia (AML)

Chronic lymphocytic leukemia (CLL)

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6
Q

What is the most frequently seen type of children leukemia?

A

Acute lymphoblastic leukemia (ALL)

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7
Q

What is a characteristic of acute leukemia?

A

Loss of BM function as well as anemia

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8
Q

Name a characteristic of chronic leukemia

A

Increased WBC count

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9
Q

Characteristics acute and chronic leukemia share

A

Enlarged spleen ( usually more pronounced in chronic)

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10
Q

What is the current survival rate of children leukemia?

A

> 30 years

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11
Q

What seems to be the cause/origin of leukemia?

A

Altered expression of oncogenes and tumor suppressor genes

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12
Q

What is the function of oncogenes?

A

To regulate cell proliferation and differentiation

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13
Q

If malignant cells are immature leukemia is said to be:

A

Acute

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14
Q

When the malignant cells are predominately mature cells leukemia is said to be:

A

Chronic

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15
Q

The term myeloid encompasses what type of leukemia?

A

Granulocytic
Monocytic
Megakaryocytic
Erythrocytic

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16
Q

What percentage of acute leukemia is seen in children

A

75%

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17
Q

What is the most common type of leukemia in adults?

A

AML - 80%

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18
Q

Name some initial symptoms of acute leukemia

A

Weakness
Bleeding abnormalities
Flu-like symptoms

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19
Q

A tumor or mass of myeloid cells outside of the marrow defines what?

A

A myeloid or granulocytes sarcoma

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20
Q

What is primarily seen in acute monoblastic leukemia?

A

Gingival-hypertrophy and oral lesions

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21
Q

What is a hallmark of precursor T-ALL?

A

Mediastinal mass from thy mic involvement

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22
Q

Leukemia lab test help by:

A

Determine prognosis
Guide therapy
Distinguish AML and ALL

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23
Q

Primary evaluations from acute leukemia include:

A

CBC, w/ WBC differential, and peripheral blood cell evaluation
Platelet count

24
Q

Acute leukemia lab results show:

A 
Anemia - mild to severe
Platelet count decreased 
WBC - very low to very high 
Blood smear - blasts or other immature cells 
Nucleated RBC - occasional
25
Q

What follow up exam is expected to further diagnosis of leukemia?

A

BM aspirates

26
Q

WHO classified acute leukemia to require a min blast of ____ in the peripheral blood

A

20%

27
Q

What flow marker is present in most cases of ALL but rarely expressed in AML?

A

Nuclear enzyme terminal deoxynucleotidyl transferase (TdT)

28
Q

Name lab studies that identify the specific genetic abnormalities seen in malignant blast cells

A

Karyotyping

Molecular genetic studies - FISH, PCR

29
Q

Patients with 38 instead of 46 chromosomes

A

Hyopdiploidy- acute leukemia, poor diagnosis

30
Q

Where are auer rods seen?

A

Granulocytes series, not in ALL

31
Q

Cytoplasmic inclusions that result from an abnormal fusion of primary granules and are pathognomic for myeloifproliferation process are called what?

A

Auer rods

32
Q

Sudan black B stain indicated what?

A

Myeloid differentiation

33
Q

What test is used to diagnose if peroxidase Is present in the primary granules of myeloid cells

A

Myeloperoxidase (MPO)

34
Q

What does Sudan black B stain?

A

Phospholipids
Neutral fats
Sterols

35
Q

What are the 2 techniques used to detect antigens

A

Flow cytometry

Immunhistochemestry

36
Q

Proteins on the cell membrane which can be used for flow cytometry and immunohistochemistry

A

Cell surface markers

37
Q

Why use cell surface markers?

A

Used to tell cell lineage and maturation stage

38
Q

What marker is very useful in assessing cell lineage in ALL?

A

Cytoplasmic markers

39
Q

A unique nuclear enzyme (DNA polymerase) present in stem cells and precursor B and T lymphoid cells

A

TdT

40
Q

Positive TdT is what leukemia?

A

ALL

41
Q

What is an essential component in the evaluation of newly diagnosed leukemia?

A

Cytogenetic analysis of leukemic cells

42
Q

Cytogenetic analysis of leukemic cells plays a major role in:

A 
Diagnosis
Subclassification
Prognosis
Therapy guide 
Monitoring effects of therapy
43
Q

What chromosomal abnormalities have been associated with acute promyelocytic leukemia?

A

(15:17)

44
Q

What is the difference in the classification of the acute leukemias between WHO and FAB?

A

Who says 20% blasts for diagnosis

FAB says 35% blasts to be AML

45
Q

WHO classification incorporates ____ major categories for acute myeloid leukemia

A

5

46
Q

What are the categories for acute myeloid leukemia?

A 
Recurrent genetic abnormalities
Multilineage dysplasia
Myeloidysplastic syndrome 
AML - not otherwise categorized 
Ambiguous lineage
47
Q

About _____ of newly diagnoses children with ALL can be cured

A

80%

48
Q

WHO classifies what type of leukemia on whether the lymphoblastic leukemia is a precursor B or a precursor T cell lineage?

A

ALL

49
Q

The stages of B-cell maturation can be identified by what?

A

TdT
Surface markers
Immunoglobulin

50
Q

How are t-cells identified and subclassed?

A

By using immunologic reagents

51
Q

Characteristics of Burkitts leukemia

A

Lack immunophenotypic characters of an early B-cell, mainly TdT is negative

52
Q

Which type of leukemia is due Tia translocation involving a rearrangement of an oncogene between a couple different chromosomes?

A

Burkitts leukemia

53
Q

What is the main goal in treating acute leukemia?

A

Poison and kill the dividing cells, usually by blocking DNA or RNA synthesis

54
Q

What cytochemical stain is best for differentiating AML from ALL

A

Myeloperoxidase

55
Q

How many blast cells in a bone marrow aspirates smear are necessary for a diagnosis of acute leukemia using FAB criteria?

A

30%

56
Q

How many blast cells in a bone marrow aspirates smear are necessary for a diagnosis of acute leukemia using WHO criteria?

A

20%

57
Q

Which cytochemical stain is useful in separating myelin last from monoblasts?

A

Nonspecific esterase

Hematology (10 decks)

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