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Flashcards in Leukemia Deck (19):
1

Leukemia

malignant transformation of WBCs. Myeloid or lymphoid

2

acute leukemia versus chronic leukemia

acute- immature
chronic- mature

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acute lymphoblastic/ lymphocytic leukemia

rapid proliferation of immature lymphocytes

occurs primarily in children
young children, ages 2-5
whites

MC cancer in children
Down syndrome (we ALL fall Down)

H and P
bone pain
frequent infections
anemia (fatigue, dyspnea on exertion, pallor, thrombocytopenia)
lymphadenopathy
hepatosplenomegaly

PBS: abundant blasts

PAS and TdT positive

Philadelphia chromosome t[9;22], found in 15% of adult ALL cases

Treatment: Imatinib, targets Philadelphia chromosome tumors

4

chronic myelogenous leukemia

proliferation of mature granuloctytes

midlife, can be associated with radiation exposure

feared complication: blast crisis
mature myeloid cells transform into immature blasts, thus blast crisis can be fatal

H and P:
possibly asymptomatic
fatigue
weightloss, nightsweats, hepatosplenomegaly

Labs:
no smudge cells
very high WBC
increasd myeloid precursors (promyelocytes, myelocytes, and metamyelocytes)

Philadelphia chromosome
almost always CML
(t[9;22] BCR-ABL, which is an oncogene tyrosine kinase always switched on)

Treatment:
imatinib

5

Acute myelogenous leukemia

Proliferation of immature myeloid cells

20% are blast

fatigue, easy bruising, frequent infections, unlike ALL you DO NOT see a lot of bone pain

Bone marrow biopsy shows blasts (myeloid cell line)
Myeloperoxidase positive

PBS:
Auer rods in the cytoplasm of blasts
notched nuclei

6

Chronic lymphocytic leukemia

mature B cells
elderly patients

H and P: similar to Hodgkin lymphoma
fatigue
frequent infections
night sweats
fevers
lymphadenopathy
hepatosplenomegaly
may be asymptomatic

Labs:
increased WBC (>100,000)

Bone marrow biopsy:
mature lymphs filling up the marrow space

slides:
Smudge cells (lymphocytes tear apart when you put them on a glass slide)

7

Hairy cell leukemia

looks hairy
better prognosis than CML

fatigue
frequent infections
abdominal fullness
massive splenomegaly
no lymphadenopathy

8

Myelodysplastic syndrome

ineffective production of WBCs
pre-leukemic state (could progress to cancer)

keep a close eye on these

typically, hypogranulated PMNs and
hyperlobular granulocytes with nuclei

Anemia (macrocytosis)
Polycythemia vera is a type

The pseudo-Pelger-Huet anomaly:
PMNs have nuclei with 2 lobes connected by a thin strand

Treatment:
monitor for progression
Transfusions
Growth factors
Stem cell transplant

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Oncology therapy

Surgery
Radiation
Chemotherapy

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Most common neoplasm in children

ALL

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most common leukemia in adults

CLL

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Philadelphia chromosome is almost always seen

CML

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Smudge cells on peripheral smear

CLL

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Peripheral blasts are PAS+ and TdT+

ALL

15

Peripheral blasts are PAS-, myeloperoxidase +, and have Auer rods

AML

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Pancytopenia in a Down syndrome patient

ALL

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Associated with translocation 9;22

ALL, CML, AML
primarily CML

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WBCs with hair-like projections

hairy cell leukemia

19

medication as/w 95% remission in CML

Imatinib