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Hematology Module 2 > Introduction to Leukocyte Neoplasms (Part 3 AML) > Flashcards

Introduction to Leukocyte Neoplasms (Part 3 AML) Flashcards

1
Q

Acute Myeloid Leukemia (AML) affects elements in what cell lineages?

A

granulocytic, monocytic, erythroid, or megakaryocytic lineages

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2
Q

Acute Myeloid Leukemia (AML) affects what age group?

A

All ages, predominated in adults around 65 years of age

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3
Q

How will someone present clinically with Acute Myeloid Leukemia (AML)?

A
  • Pallor, fatigue
  • Fever/ infection
  • Bruising/ bleeding
  • Malignant cell infiltration into other tissues
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4
Q

Acute Myeloid Leukemia (AML)

- peripheral blood

A
  • Variable leukocytosis
  • variable displasia
  • myeloblasts present in 95% of patients
  • Leukemic hiatus
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5
Q

Having many myeloblasts and some segs with no intermediate stages is known as what?

A

Leukemic Hiatus

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6
Q

Acute Myeloid Leukemia (AML)

- Bone marrow findings

A
  • Hypercellular increased blasts
  • > 20% blasts with limited maturation
  • variable dysplasia
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7
Q

Acute Myeloid Leukemia (AML)

- Immunophenotyping

A

CD34+, HLA-DR+, CD117+, CD13+, CD33+

the last two are very specific to AML

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8
Q

What six immature cells will you find in Acute Myeloid Leukemia (AML)?

A
  • Myeloblasts
  • Promyelocytes
  • Monoblasts
  • Promonocytes
  • Erythroblasts
  • Megakaryoblasts
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9
Q

Acute Myeloid Leukemia (AML) will have recurrent cytogenic abnormalities:
_______ - addition or deletion of part of - or entire- chromosome
_______ primarily translocations and inversions

A

Numerical

Structural

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10
Q

Acute Promyelocytic Leukemia (APL)

- cytogenetic abnormality

A

t(15;17)(q24;q21)

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11
Q

Acute Promyelocytic Leukemia (APL)

- two different types of APL

A
  • Typical (60-70%)

- Atypical (30-40%)

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12
Q

Of the two types of APL…which one has hyper granular promyelocytes and nuclei are often bi-lobed or kidney shaped

A

Typical

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13
Q

Of the two types of APL…which one has micro granular promyelocytes and nuclei that are predominately deeply notched/bilobed (Butterfly)

A

Atypical

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14
Q

Will Acute Promyelocytic Leukemia (APL) have Auer rods?

A

YES! They will have multiple Auer Rods (faggot cells)

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15
Q

In Acute Promyelocytic Leukemia (APL), t(15;17) creates a fusion gene. What is it?

A

PML-RARA

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16
Q

The PML-RARA fusion gene leads to what?

A

Uncontrolled proliferation and inhibition of cellular differentiation

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17
Q

Acute Promyelocytic Leukemia (APL)

- Lab Results

A
  • DIC/fibrinolysis coagulation
  • Thrombocytopenia
  • hyper or microgranular promyelocytes
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18
Q

When a slide from a patient with APL is stained with MPO, what will it look like?

A

Strongly Positive

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19
Q

Acute Promyelocytic Leukemia (APL)

- Treatment

A
  • Prescribe ATRA

- manage coagulopathy

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20
Q

AML - With Abnormal Marrow Eosinophils

- cytogenetic abnormality

A

inv(16)(p13.1;q22)

t(16;16) (p13.1;q22)

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21
Q

AML - With Abnormal Marrow Eosinophils

- age group affected

A

primarily young adults

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22
Q

AML - With Abnormal Marrow Eosinophils

- prognosis

A

favorable to average risk

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23
Q

AML - With Abnormal Marrow Eosinophils

- Peripheral Blood findings

A
  • myeloblasts (other immature myeloid cells)
  • monocytoid cells
  • thrombocytopenia
  • normal eos
24
Q

AML - With Abnormal Marrow Eosinophils

- Bone marrow findings

A
  • myeloblasts and promyelocytes (30-80%)
  • Monocytic component (>20%)
  • > 5% eosinophils (all stages of maturation)
25
AML with maturation | - cytogenetic abnormality
t(8;21)(q22;q22)
26
AML with maturation | - fusion gene
Runx1-Runx1T1
27
AML with maturation | - age affected
- 25-30 years old | - predominant in children and young adults
28
AML with maturation | - prognosis
- good in adults but poor in children | - response well with chemotherapy
29
AML with maturation | - PB findings
- Blasts with numerous azurophilic granules - Some may have very large granules (Pseudo-Chediak-Higashi) - Auer Rods likely
30
AML with maturation | - BM findings
dysplasia in neutrophil line | monos, eos, and eryth, components not affected
31
AML with Myelodysplasia-Related Changes | - wich AMLs are in this category
- AML evolving from previous myelodysplastic syndrome | - AML with cytogenetic abnormalites that marrow those of MDS syndromes
32
AML with Myelodysplasia-Related Changes | - age range affected
elderly population
33
AML with Myelodysplasia-Related Changes | - Lab findings
presents with severe pancytopenia
34
AML with Myelodysplasia-Related Changes | - prognosis
poor
35
AML- Therapy-Related Myeloid Neoplasms | - why does it occur?
occurs as a result of therapy-related cytotoxic chemotherapy and/or radiation therapy
36
AML- Therapy-Related Myeloid Neoplasms - Age affected - Prognosis
- median age 61 | - poor prognosis (<10% 5 yr survival rate)
37
AML not otherwise specified (NOS) | - divisions within this category are based primarily off of what?
morphological and cytochemical/immunophenotypic features
38
(M0) AML-NOS Minimal Differentiation | - What stains are negative?
MPO and most other stains are negative
39
(M0) AML-NOS Minimal Differentiation | - age affected
infants and older adults
40
(M0) AML-NOS Minimal Differentiation | - PB findings
Blasts: medium, round (1-2 nucleoli), fine chromatin, cytoplasm is AGRANULAR and BASOPHILIC
41
(M0) AML-NOS Minimal Differentiation - MPX/SBB stains - Auer rods?
neg/no auer rods
42
(M1) AML-NOS Without Maturation - Blast percentage - MPO/SBB stain? - Auer rods?
- >90% of non erythroid cells - MPO/SBB >3% (positive) - Auer rods (+/-)
43
(M2) AML-NOS With Maturation - MPO - Auer Rods? - age affected
- MPO Positive - Frequent Auer rods - all age groups
44
(M4) AML -NOS Myelomonocytic - Peripheral blood - Auer rods?
- Myeloblasts - Monocytoid cells - thromobcytopenia - Auer rods +/-
45
(M4) AML -NOS Myelomonocytic | - Bone marrow
- Myeloblasts >20% | - Monocyte components
46
(M4) AML -NOS Myelomonocytic | - stains
Blasts will be positive for both myeloid and monocytic markers (MPO+) (ANBE +)
47
(M5a) AML-NOS-Acute Monoblastic AND (M5b) Monocytic Leukemia - problems
- bleeding problems common at presentation - Cutaneous and gingival infiltration - CNS involvement common
48
(M5a) AML-NOS-Acute Monoblastic AND (M5b) Monocytic Leukemia - ANBE stain
ANBE- Positive
49
AML-NOS Acute Erythroid Leukemia | - Two subclasses
- Erythroleukemia (erythroid and myeloblasts in BM) | - Pure Erythroid leukemia (only erythroid precursors in BM)
50
AML-NOS Erythroleukemia (erythroid/myeloid) | - PAS stain
PAS- positive in RBC precursors, Chunky
51
(M7) AML-NOS- Megakaryoblastic | - PB
- Micromegakaryocytes | - pleomorphic blasts, blasts with agranular cytoplasm
52
(M7) AML-NOS- Megakaryoblastic | - BM and stains
- usually dry tap - MBO/SBB- negative - Factor VIII stain-pos
53
AML-NOS-Basopilic Leukemia | - increased what?
blasts and immature basos
54
AML-NOS Acute Panmyelosis with Myelobibrosis (APMF) - clinical - increase in what?
- bone pain and extensive myelofibrosis | - Increased blasts of all myeloid lines
55
After chemotherapy patients often develop severe leukcytopenia so what do we do to concentrate the cells for a differential?
We make a buffy coat smear by adding EDTA-anticoag blood into a WINTROBE tube

Hematology Module 2 (14 decks)

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