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Emma Heme/Onc > Lab Dx of Cancer, Intro to Hematologic Malignancies, Acute Leukemias > Flashcards

Lab Dx of Cancer, Intro to Hematologic Malignancies, Acute Leukemias Flashcards

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1
Q

PSA

A

early detection/screening

men over 50, poor specificity for cancer

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2
Q

alpha-fetoprotein

A

diagnostic, assess for presence of testicular cancer

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3
Q

ER
HER2
KRAS

A

Predictive: Effective drug therapy

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4
Q

CEA

carcinoembryonic antigen

A

Post-Therapeutic Monitor: Detect tumor recurrence

colorectal cancer

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5
Q

BRAC1

A

Risk Stratification: Chance of getting cancer

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6
Q

k-ras mutation

A

Predicts lack of therapeutic response to a specifc drug

Testing should be done in all pts w/ metastatic colorectal cancer

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7
Q

Absence of MLH-1

A

raises possibility of inherited tumor susceptibility in the family

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8
Q

CA-125

A

ovarian cancer screening

can also be elevated in normal post-menopausal women

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9
Q

genetic diseases inc risk of hematologic malignancy

A

Down syndrome Klinefelter syndrome
Wiskott-Aldrich syndrome
Bloom syndrome Fanconi anemia neuroqbromatosis ataxia telangiectasia

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10
Q

viral infections inc risk of hematologic malignancy

A

EBV
HTLV
HHV-8
HIV

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11
Q

bacterial infections inc risk of hematologic malignancy

A

H. pylori

–> gastric MALT lymphoma

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12
Q

most significant tumor suppressor gene

A

p53

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13
Q

fluorescence in situ hybridization

A

each normal chromosome produces 2 dots

monosomy –> 1dot

trisomy –> 2dots

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14
Q

flow cytometry

A

uses Abs labeled to recognize cell surface antigens

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15
Q

most common childhood cancer

A

ALL

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16
Q

genetic disorders that are risk fx for acute leukemia

A 
Down
Klinefelter
Turner
Neurofibromatosis
Fanconi anemia
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17
Q

leukostasis

A

stasis of blood in cerebral/pulm circulation

blast >50,000

HA, visual change, confusion, stroke, coma (cerebral)

dyspnea, tachypnea, hypoxia

AML>ALL

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18
Q

ALL extra-medullary manifestations

A

lymphadenopathy
splenomegaly
mediastinal mass

leukemic meningitis rare at dx, CNS = common site of relapse

testes

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19
Q

AML extra-medullary manifestations

A

leukemic cutis
gingival hypertrophy
chloromas (green tumor of blasts)

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20
Q

ALL metabolic abnormalities

A

tumor lysis syndrome

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21
Q

AML metabolic abnormalities

A

hypOkalemia (via renal tubular damage by enzyme released from myeloblasts)

hypOglycemia (artificial finding due to metabolic activity of blasts in blood tube after draw)

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22
Q

WHO dx of AML

A

> 20% blasts in bone marrow

+ cytogenetic findings

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23
Q

Auer rods

Study These Flashcards
A

linear aggregates of primary granules seen only in myeloblasts

24
Q

myeloblast nucleoli

Study These Flashcards
A

single-multiple

25
lymphoblast nuclei
less conspicuous nucleoli
26
AML stains
lysozyme myeloperoxidase non-specific esterase
27
ALL stains
terminal deoxynucleotidyl transferase (TdT)
28
AML cell surface antigens
CD13 CD33 CD117
29
ALL cell surface antigens precursor B cell
CD10 CD19 CD20
30
ALL cell surface antigens precursor T cell
``` CD2 CD3 CD4 CD5 CD7 CD8 ```
31
acute leukemia transfusion support
required for effective support platelets (count of 10,000 is threshold) leukocyte depleted irradiated
32
leukostasis
IV fluids leukapheresis hydroxyurea to reduce leukemic burden steroids helpful if ALL avoid rbc transfusion (inc viscosity)
33
DIC tx during acute leukemia
replace clotting fx w/ FFP replace fibrinogen w/ cyroprecipitate platelet transfusion
34
tumor lysis syndrome tx during acute leukemia
IV hydration for rapid saline diuresis allopurinol to prevent accumulation of uric acid RASBURICASE hemodialysis if renal failure
35
rasburicase
catalyzes oxidation of uric acid to soluble allantoin
36
AML poor prognosis factors
older age 11q23 (MLL) deletions of 5/7 (alkylating agents) multiple cryogenic abnormalities hx of BM disorder
37
AML favorable risk cytogenetics
t(15;17) core binding factors
38
AML intermediate risk cytogenetics
normal karyotype
39
AML therapy-related AML from chemo
alkylating agents (4-6 yr post exposure) topoisomerase II inhibitors (1-3 yr post exposure) poor prognosis, unfavorable risk
40
AML curative therapy
induction (quickly restore normal hematopoiesis) post-remission (consolidation, eradicate residual leukemia cells)
41
most common AML induction regimen
cytarabine + anthracyline | daunorubicin, idarubicin
42
AML complete remission
<5% blasts in BM w/ recovery of normal hematopoiesis and resolution of all extra medullary infiltrates
43
acute promyelocytic leukemia
t(15;17) or detection of PML/RAR younger pts leukopenia often DIC at dx
44
APL tx
ATRA (all trans-retinoid acid), vitamin A analogue ligand for RAR receptor, binds PML-RAR fusion protein restores transcription of genes allowing differentiation NO lysis of blasts/marrow aplasia
45
APL differentiation syndrome
leukocytosis fever pulm infiltrates fatal if not recognized and tx w. steroids
46
arsenic trioxide (ATO)
induces apoptosis in APL cells and targets PML/RAR fusion protein --> differentiation
47
standard tx for APL
ATRA | anthracycline for induction
48
maintenance tx for ATRA and oral anti-metabolite
long-term remission in 70%
49
ATO w/ ARTA tx for what?
acute promyelocytic leukemia
50
ALL poor prognosis
infants/adults t(9;22) Philadelphia translocations (MLL, on 11) hypOploidy T cell boys
51
ALL good prognosis
1-9 y/o t(12;21) hypERploidy normal cytogenetics B cell immunophenotype girls minimal residual disease at end of induction tx
52
ALL induction therapy
multi-agent chemo ``` anthracycline vincristine glucocorticoid L-asparaginase cytarabine cyclophosphamide methotrexate ``` tyrosine kinase inhibitors in Ph+
53
_____ is a sanctuary site for leukemic blasts
CSF
54
to prevent relapse, CNS prophylaxis in ALL includes
intrathecal chemo with or without craniospiral irradiation
55
ALL maintenance therapy
prolonged chemo (shown to extend survival/improve cure rates)

Emma Heme/Onc (16 decks)

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