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Flashcards in Leukemia Deck (43):
1

what cells are derived from the Myeloblast 

  • erythrocyte
  • Thrombocyte
  • Monocyte
  • Neutrophil
  • Basophil
  • Eosinophil 

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2

What can cause elevated neutrophils 

bacterial infections 

3

What can cause elevated immature neutrophils (bands) 

  • acute bacterial infections
  • sepsis 

4

What can cause elevated lymphcytes 

viral infections 

5

What can cause the presence of atypical lymphcytes 

epstein-barr virus 

6

What is the most common acute leukemia in adults

acute Myelogenous leukemia

7

what lab values would lead you to suspect acute Myelogenous leukemia

  • peripheral blood is always abnormal
  • accumulation of leukemic blasts 
  • reduced production of normal cells
    • neutrophils
    • erythrocytes
    • platelets 

8

what are two important causes of acute Myelogenous leukemia

  • chemical exposure
  • Myelodysplastic syndrome (MDS): malignant hematologic disease 

9

AML signs and symptoms arrives from which three cells being affected 

  • RBC-> anemia
  • Neutropenia
  • thrombocytopenia

10

AML prognosis 

  • favorable if younger than 60 yo
  • unfavorable if older than 60 yo or evolved from MDS 

11

 what is expected on peripheral smear in acute Myelogenous leukemia

Auer rods 

12

what needs to be found in bone marrow biopsy for diagnosis of AML 

Blasts > or = 20% of sample 

13

What is Myelodysplastic syndrome 

  • ineffective hematopoiesis
  • see cytopenias 
  • more common in those > 60 y.o.

14

What is tumor lysis syndrome 

  • emergeny!-> associated with high mortality 
  • initiation of cytotoxic therapy or can occur spontaneously 
  • massive tumor cell lysis: release of cellular contents

15

tumor lysis syndrome is manifested by what 4 symptoms

  • Hyperkalemia
  • Hyperphosphatemia
  • Hypocalcemia
  • Hypouricemia 

16

treatment of tumor lysis syndrome

  • prevention
  • fluids
  • frequent monitoring of 
    • K
    • phosphorus
    • uric acid
    • calcium 

17

risk factor for chronic myeloid leukemia

ionizing radiation 

18

90% of chronic myeloid leukemia is due to what genetic abnormality 

  • philadelphia chromosome 
  • translocation of chromosomes 9 and 22 

19

what are B symptoms 

  • fever
  • drenching night swights
  • weight loss 

20

presentation

  • fatigue
  • malaise
  • abdominal fullness
  • splenomegaly
  • B symptoms 

chronic myeloid leukemia

21

chronic myeloid leukemia presents in what 3 phases 

  1. chronic
  2. accelerated
  3. blast

22

chronic phase of chronic myeloid leukemia

  • 80% patient diagnosed in this phase
  • asymptomatic
  • WBC > 100,000
  • <10% blood or bone marrow cells are blasts
  • typically lasts 5-6 yrs

23

accelerated phase of chronic myeloid leukemia

  • 10-19% blood or BM cells are blasts 
  • symptomatic
    • anemia
    • fatigue
    • malaise
    • flu-like symptoms 

24

blast crisis stage of chronic myeloid leukemia

  • 20% or more of blood or bone marrow cells are blasts
  • symptomatic
    • splenomegally
    • fatigue
    • fever 

25

how is chronic myeloid leukemia diagnosed 

  • bone marrow biopsy
  • identification of Philadelphia chromosome 

26

treatment of chronic myeloid leukemia

  • tyrosine kinase inhibitors
    • gleevac=imatinib 

27

complications of chronic myeloid leukemia

  • hyperleukocytosis
    • wbc > 100,000/mcl
    • emergency!
    • decreased tissue perfusion
    • may require leukapheresis 
  • hyperviscosity syndrome 

28

what is the most common cancer in children and teens 

acute lymphocytic leukemia

29

In acute lymphocytic leukemia, is cure rate more favorable in children or adults 

children

30

acute lymphocytic leukemia laboratory findings 

  • blasts in peripheral blood
  • cytopenia
    • neutropenia
    • anemia
    • thrombocytopenia
  • elevated LDH

31

what is expected to be found in peripheral smear of acute lymphocytic leukemia patients

lymphoblasts 

32

how is acute lymphocytic leukemia diagnosed 

  • peripheral smear
  • bone marrow biopsy 

33

precursor B-cell acute lymphocytic leukemia has what prognosis 

  • 70-80% cases of childhoos ALL
  • favorable!
    • 90% enter remission 

34

T cell acute lymphocytic leukemia

  • older age, male predominance
  • hyperleukocytosis at dx
  • tend to have more problems than B-cell ALL

35

what is Mature B-cell acute lymphocytic leukemia? Prognosis?

  • Burkitt cell leukemia/lyphoma
  • favorable prognosis 

36

acute lymphocytic leukemia treatment 

  • induction chemotherapy
  • monoclonal antibodies 

37

what is the most prevalent leukemia in adults in western countries 

chronic lymphocytic leukemia 

38

what malignancy has the highest inheritability 

chronic lymphocytic leukemia 

39

what is chronic lymphocytic leukemia 

  • accumulation of incompetent lymphocytes in blood, bone marrow, and lymph nodes

40

chronic lymphocytic leukemia clinical features 

  • bone marrow failure
    • anemia
    • thrombocytopenia
    • neutropenia
  • organomegaly in advanced disease
    • lymphadenopathy
    • splenomegaly
    • hepatomegaly 

41

presentation

  • anemia
  • B symptoms
  • atypical infections
  • death due to 
    • infection
    • bleeding
    • cachexia

chronic lymphocytic leukemia 

42

how is chronic lymphocytic leukemia diagnosed 

  • bone marrow biopsy
  • lymph node biopsy 

43

treatment of chronic lymphocytic leukemia 

  • Rituximab and other monoclonal antibodies