Lec 16 Flashcards
what are myeloid cells
granulocytes
monocytes
erythrocytes also
and megakaryocytic cell lineages
the 2 types of myeloid leukemia u need to know
- acute myeloid leuk
- chronic myeloid leuk
official WHO classification system
20% blast cell count in either blood, or bvone marrow
chromosome translocations
dysplasia
which group is aml most common in
65+ yrs old
what are the 2 most ccommon AML genetic mutations
- transloc between chrom 8 and 21 [t(8;21)]
- transloc between chrom 15 and 17
what might be an exception to the WHO diagnosis
if you see the particular genetic abnormality (e.g. PML-RARA) you dont need the 20% blast count to diagnose
whats a non cytogenetic testing way to possibly identify a malignant cell under the microscope
Auer rods
an accumulation of a certain protein
this was useful pre cytogenetic tests
how does FAB classification work
based on morphology, visualising what stage the cell is at
goes from M0 to M7 (and has subcategories)
what is FAB class M3
acute promyelocytic leukemia (APML)
which translocation is M3 APML
15 to 17
APML: which gene is on chrom 15
promyelocytic leukaemia gene (PML)
APML: what gene is on chrom 17
retinoic acid receptor alpha gene (the gene from 15 fuses with this one to form fusion product)
APML: what does the fusion product do
blocks differentiation of the cells
what can M3 APML be treated with
all-transretinoic acid (ATRA)
degrades the fusion product
which induces differentiation
what is M2 AML
granulated blasts with Auer rods
what translocation is the M2 AML
8 and 21
M2: what gene is on chrom 21 adn what does it do
AML1
- codes for alpha chain of a transcriptional apparatus called CORE BINDING FACTOR (CBF)
- critical for haemotpoietic development
M2: what gene is on chrom 8
ETO gene
M2: what happens when the translocation happens (effect of fusion gene)
Causes RUNX1 and RUNx1T1 to come together
which blocks transcription of genes needed for myeloid differeniation
what type of thingy is RUNx1T1
a co repressor
M2: what type of blasts usually seen in this disease
promeylocytes and myelocytes
clinical features ofAML
- anamia
- thrombocytopenia
- infections
- skin inflitration
- CNS disease
process of diagnosing AML
- full blood count
- blood film
- bone marrow smear
- immunophenotyping
- cytogenetics
what are some supportive treatments of AML
Treatment of bone marrow failure
Episodes of fever
