chronic leukemia Flashcards
(25 cards)
what is CML ?
malignant disorder of myeloid pprogenitor cells
clonal proliferation of mature granulocytes
this happens due to BCR ABL gene translocation
9;22
what is seen on peripheral blood smear of CML?
lots of mature granulocytes - basophils
eosinophils all type of cells are found (soup)
what are the phases associated with CML ?
chronic phase - usually asymptomatic
accelerated phase - treatment failure
blast crisis - associated with AML
what is a leukomoid reaction ?
normal response to infection , where there is an increase in WBC especially neutrophils
how can we distinguish a leukomoid reaction from CML ?
leukemoid reaction is associated with infection and an increase in the total WBC count , more bands and neutrophils
also associated with a higher LAP score , a low one indicates CML
what is the treatment for CML ?
a tyrosine kinase inhibitor - imatinib
which stage of CML is associated with response to treatment ?
the chronic phase
what is CLL and what is the most common presentation ?
disorder of naive lymphocytes
usually asymptomatic
what marker is highly associated with CLL ?
CD 5 and CD20 and 23 are co expressed
what is seen on PBS in CLL ?
smudge cells
what is richter transformation ?
associated with the turnover from CLL to a more aggressive from turning into a diffuse large b cell lymphoma , which is a poorer prognosis
what does richter transformation in CLL present as ?
a patient that has been previously diagnosed with CLL who suddemly starts worsening , lymphadenopathy , splenomegaly
what are the changes in CD from CLL to DLBCL ?
from CD 5 , CD 20 and 23
to
CD 10 CD 20
what is the association between CLL and SLL ?
2 manifestations of the same disease
where CML is in the BM and the blood
whilst SLL is more in the lymph nodes
how do we differentiate between SLL and CLL ?
by the degree of lymphocytosis
where there is more lymphocytosis in CLL
why is there an increased susceptibility to bacterial infections in CLL ?
associated with hypogammaglobulinemia
decreased IgG, IgA, IgM
what type of anemia is associated with CLL ?
autoimmune warm hemolytic anemia
what are the CD associated with CLL ?
CD5 and CD 23
what is hairy cell leukemia and what are the associated CDs
?
chronic b cell malignancy , CD19, CD20, CD22
what is the sensitive marker for hairy cell leukemia ?
CD103
what is seen on peripheral smear of hairy cell leukemia ?
lymphocytes with hair like cytoplasmic reactions
TRAP positive
what is seen on BM biopsy in hairy cell leukemia ?
dry tap due to extensive fibrosis
what is specific about the splenomegaly seen in hairy cell leukaemia ?
massive splenomegaly
obliteration of the white pulp
red pulp is engorged
what is the treatment for hairy cell leukemia ?
purine analogues - cladribine
