Leukemia and Lymphoma Flashcards
(47 cards)
Leukopenia is a WBC count less than…
< 4.5k
leukocytosis is a WBC count…
> 11K
This leukemia:
is the most common acute leukemia in adults
Average age is 65 yo
rare and rarely fatal,
acute myeloid leukemia (AML)
A 65 yo patient w/ a hx of benzene exposure complains of anemic sxs, neutropenic sxs (fever), bleeding, and ophthalmic changes.
What do you suspect based off this hx?
AML
For a pt. you suspect of AML, what should you expect to see on CBC with Diff and in the peripheral smear
+ pancytopenia
+ 20% blasts
+ Auer Rods on peripheral smear
For a pt. you suspect of AML, what would a CMP show? What two other labs might help with a dx?
elevated creatinine, liver fxn, increased potassium, calcium
elevated Uric Acid and elevated LDH
Can auer rods be seen in disorders other than AML?
Yes, they are pathognomonic only of myeloblasts
You suspect a patient has AML.
Labs indicate the following:
+ pancytopenia
+ elevated LDH, Uric Acid
+ elevated calcium and potassium
+ Auer Rods
What test do you want ot order to confirm you dx?
bone marrow aspiration and biopsy showing 20% blasts
Induction tx for AML includes what?
chemotherapy for 6 mo
consolidation therapy for AML includes what?
stem cell transplant
What is a common progression to AML?
Myelodysplastic syndromes
This disease is characterized by abnormal cell maturation, and ineffective blood cell production leading to pancytopenia.
it is commonly asymptomatic and found incidentally on CBC
Cure is via bone marrow transplant
It can progress to AML?
myelodysplastic syndrome
This disease occurs 12-24 hours after cytotoxic therapy
is associated with high mortality
and occurs when massive tumor cells lyse to release contents (K, PO3, nucleic acid)
tumor lysis syndrome
What should you expect to see on labs in tumor lysis syndrome?
hyperkalemia, hyperphosphatemia, hypocalcemia, hyperuricemia
how do you treat TLS?
prevention, monitor cardiac fx
This leukemia is associated with the BCR-ABL1 fusion gene, the philadelphia chromosome and tyrosine kinase activation…
chronic myeloid leukemia (CML)
A 50 yo male pt. presents c the following after routine blood work. Pt. appears asymptomatic:
- hx of ionizing radiation
- profound leukocytosis (WBC > 100k)
- B sxs
- Splenomegaly
- fatigue
What do you suspect?
CML
When a patient c CML is in blast crisis, what would be present?
20% blast cells
fatigue, fever, extramedullary blasts, splenomegally
How do you diagnose a pt. you suspect of CML?
identification of philadelphia chromosome or BCR-ABL gene
CML can be treated with…
Tyrosine Kinase Inhibitors
Monoclonal Abs
Chemo
Allogenic Stem Cell Transplant
Complications of CML include…
tumor lysis syndrome
hyperleukocytosis
hyperviscosity syndrome
Tx with leukapheresis/plasma exchange
A 2 year old male patient of caucasian descent c NF1 presents c. the following…
Hx:
+ Fever, Fatigue, Pallor, Bone pain
+ hx genetic disorders
PE:
+hepatosplenomegaly, nontender LAD
Labs:
+ Neutropenia, anemia, thrombocytopenia
+ elevated LDH
Peripheral smear:
+ 20% lymphoblasts
What do you suspect, and what test do you want to Dx?
suspect ALL
Get bone marrow biopsy
70-80% of childhood ALL is what subtype?
precursor B-Cell ALL
Precursor B-Cell ALL has a favorable or unfavorable prognosis?
favorale
