Myelocytic Leukemias

Question 1

Most common type of adult leukemia (incidence increases with age)

Answer 1

AML

Question 2

Involves a defect of HSC (CD34+)

Answer 2

AML

Question 3

condensed primary granules

Answer 3

Auer Rods

Question 4

due to increased cell turnover

Answer 4

Hyperuricemia

Question 5

due to cell lysis

Answer 5

Hyperphosphatemia

Question 6

due to progressive bone destruction

Answer 6

Hypokalemia

Question 7

Hyperuricemia due to increased cell turnover
Hyperphosphatemia due to cell lysis
Hypokalemia due to progressive bone destruction

Answer 7

These are all signs of tumor lysis syndrome- a group of metabolic complications that can occur in patients with a malignancy

Question 8

abnormal hyperproliferation of bizarre granulocyte and/or monocyte precursors

Answer 8

Dysmyelopoiesis

Question 9

found in children and adults younger than 60 years old

Answer 9

AML w/ t(8;21) (q22:q22)

Question 10

Blasts are large with abundant, dysplastic cytoplasm and numerous primary granules and auer rods. Sometimes exhibit pseudo-pelger huet
MBO & SBB 1+
PAS neg
SE +
+/- auer rods

Answer 10

AML w/ t(8;21) (q22:q22)

Question 11

Eosinophilia with dysplastic changed

Answer 11

AML w/ inv(16)(p13.1p22)

Question 12

good prognosis

Answer 12

AML w/ t(8;21) (q22:q22)

Question 13

AMLs and occurs at any age (usually young)

Answer 13

AML w/ inv(16)(p13.1p22)

Question 14

Abnormal hypergranular promyelocytes with Auer rods

Answer 14

AML w/ t(15;17) (q22;q12)- Acute promyelocytic leukemia (APL)

Question 15

AML w/ t(15;17) (q22;q12)-

Answer 15

Acute promyelocytic leukemia (APL)

Question 16

Leukemic cells also have defective retinoic acid receptor (RARa gene), so can be treated with ATRA

Answer 16

APL t(15;17)

Question 17

Strongly associated with DIC

Answer 17

APL

Question 18

A promyelocytes primary granules are rich in thromboplastin-like substances… which trigger a

Answer 18

bleeding diathesis

Question 19

cells look agranular if only light microscopy used in what variant?

Answer 19

Microgranular APL

Question 20

Prolonged clotting time tests
⬇ plt. Count (because plts. Used up making clots)
MPO and SBB= 2+ pos. (increased primary granules)
PAS neg
SE pos
Frequently auer rods, can be in bundles (so-called “faggot cells”)
Both NSEs neg

Answer 20

Both variants of APL

Question 21

hypergranulation and “coin-on-coin” nucleus

Answer 21

APL

Question 22

Bundles of Auer Rods

Answer 22

Faggot cell

Question 23

MBO and SBB still +
Both NSEs now start to be + (monos)
SE still +
PAS still (-)
+/- Auer rods (depending on the myelocytic cells involved)
CD 11b, CD 4, CD 36, and CD 64

Answer 23

AMML

Question 24

20% monos 20% granulocytes

Answer 24

AMML

Question 25

Usually CD4 and CD64 pos (“gold std.”)

Answer 25

AMoL

Question 26

When >80% leukemic cells are monocytic

Answer 26

AMoL

Question 27

<20% granulocytes

Answer 27

AMoL

Question 28

MPO and SBB +/- (most frequently NEG) Both NSEs pos (NBE 3+!) Fluoride inhibition step (Neg) PAS pos (finally) Very rare Auer rods (most frequently NEG)

Answer 28

AMoL

Question 29

marked erythroid precursor hyperplasia!!

Answer 29

AEL

Question 30

Makes up only 3% of AMLs

Answer 30

AEL

Question 31

Can evolve further into AML

Answer 31

AEL

Question 32

abnormal proliferation of bizarre RBC precursors, with reverse M:E ratio due to huge # of abnormal erythroblasts, and even a few ringed sideroblasts

Answer 32

dyserythropoiesis

Question 33

Lots of myeloblasts

Answer 33

AEL

Question 34

- >50% bizarre, multinucleated, megaloblastoid nRBCs!! - Some abnormal megakaryocytes

Answer 34

AEL

Question 35

“dry tap” upon bone marrow aspiration due to myelofibrosis

Answer 35

AMegL

Question 36

⬆ #s of megakaryocyte precursors, include megakaryoblasts, atypical megakaryocytes (with “blebbing”), and giant platelets

Answer 36

dysmegakaryopoiesis

Question 37

May plt.- specific receptors, such as GPIIb/IIIa receptor + (for fibrinogen)

Answer 37

AMegL

Question 38

ACP positive

Answer 38

AMegL also in T-cell ALL