Leukemias Flashcards Preview

SBL Exam 1 WBCs, Spleen, and Thymus > Leukemias > Flashcards

Flashcards in Leukemias Deck (27)
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1

What is the most common cancer in children?

ALL, acute lymphocytic leukemia

2

What are B-ALL and T-ALL?

(cell type, markers)

B-ALL (B cell acute lymphocytic leukemia):

-leukemia of immature B cells (lymphoblasts)

-TdT+, CD10, CD19, CD20

 

T-ALL (T cell acute lymphocytic leukemia/lymphoma):

-leukemia/lymphoma of immature T cells (lymphoblasts) with a common thymic mass

-TdT+, variable CD1-8

3

What genotypic factors are associated with B-ALL?

-misc. translocations; most common t(12;21) RUNX1/ETV6

4

What genotypic factors are associated with T-ALL?

-increased NOTCH1 function

-misc. translocations

5

What are the common demographic factors of B-ALL?

Age: peak at 3y/o, uncommon after age of 15

Race/ethnicity: whites/hispanics 3x more than blacks

Gender: ~equal

6

What are the common demographic factors T-ALL?

Age: peak in adolescence, uncommon in adults

Race/ethnicity: whites/hispanics 3x more than blacks

Gender: males > females

7

What is the common presentation of B-ALL?

-aggressive in progression (days to weeks)

-decreased bone marrow function; ie., fatigue (anemia), fever/infections (neutropenia), and bleeding (thrombocytopenia)

-mass effects (pain around lesion)

-HA and vomiting from meningeal spread

 

8

What is the common presentation of T-ALL?

-aggressive in progression (days to weeks)

-decreased bone marrow function; ie., fatigue from anemia, infections, and bleeding

-mass effects (pain around lesion) **thymic mass**, possible compression of medistinal structures

-HA and vomiting from meningeal spread

9

What is the course/prognosis of ALL?

Aggressive course

 

Good prognosis:

-remission: 95%

-cure: 75-85%

10

What factors provide a favorable outcome in ALL?

-age between 2-10 y/o

-low WBC

-hyperploidy

-chromosomal trisomy (4, 7, or 10)

-t(12;21)

11

What factors provide an unfavorable outcome in ALL?

-less than 2 y/o

-greater than 10 y/o

-peripheral blast count of >100,000

-pressence of t(9;22) BCR-ABL "Philadelphia chromosome"

12

What is the most common leukemia in adults?

CLL

13

What are CLL and SLL? (cell type and key features)

CLL (chronic lymphocytic leukemia):

-leukemia of naive, mature B cells

-**CD5** and CD20 positive

-"smudge cells"

 

SLL (small lymphocytic lymphoma)

-CLL involing lymph node mass

14

What genotypic factors are associated with CLL/SLL?

-deletions (11q, 13q, and 17p)

-trisomy 12q

-no translocations

15

What is the common presentation of CLL/SLL?

-older adults, median 60 y/o

-typcially asymptomatic/nonspecific

-decreased immune function

-lymphadenopathy and hepatosplenomegaly common in those that are symptomatic

 

16

What are potential complications of CLL/SLL?

-decreased immune fucntion/hypogammaglobulinemia -> increased infections

-autoimmune hemolytic anemia/thrombocytopenia (10-15%)

-progression to diffuse large B-cell lymphoma (Richter transformation)

17

What factors provide an unfavorable outcome in CLL/SLL?

-deletions of 11q and 17p

-lack of somatic hypermutation

-expression of ZAP-70

-NOTCH1 mutations

18

What is the course/prognosis of CLL/SLL?

-indolent course

-variable prognosis, death from complications or years to decades of survival

19

What is hairy cell leukemia?

-rare B cell leukemia

-BRAF mutation

-"hairy" cells on microscopy

-cells accumulate in red pulp of spleen (normally leukemias are in white pulp)

-"dry tap" on marrow aspiration due to fibrosis

20

What is the common presentation of hairy cell leukemia?

-older males

-pancytopenia

-splenomegaly (accumulation in red pulp)

21

What is ATLL? (cell type and key features)

adult T cell lymphoma

-CD4 T cells

-occurs in adults with HTLV-1 

 

 

22

What is the common presentation of ATLL?

-only adults

-typically Japanese, West African, or Carribean (HTLV-1 is endemic to these regions)

-skin lesions

-hypercalcemia with lytic bone lesions

23

What is the course/prognosis of ATLL?

aggressive course

 

poor progonsis even with treatment (months to a year)

24

Compare ATLL and MM.

both have lytic "punched-outbone lesions and hypercalcemia

 

ATLL will present with rash, MM will not

25

What is mycosis fungoides/Sé​zary syndrome?

-cancer of mature CD4 T cells

-infiltrate skin

-aggregates of cancer cells in skin produces characteristics Pautrier microabscesses

-cerebriform nuclei Sé​zary cells in blood

26

What is the common presentation of mycosis fungoides/Sézary syndrome?

-adults

-rash or erythema with skin plaques and nodules

27

What is the course/prognosis of mycosis fungoides/Sé​zary syndrome?

indolent course

 

great prognosis, responds well to treatment

 

frequently will relapse but still responds well