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OS Hematology/Oncology > Path/Leukemia > Flashcards

Path/Leukemia Flashcards

(54 cards)

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1
Q

Immunomarkers for AML

A

MPO
CD33 (myeloid transmem receptor)
CD13
HLA-DR

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2
Q

Immunomarkers for ALL

A

TdT
CD10 (Neprilysin/ CALLA)
CD19
CD20

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3
Q

AML inv(16) prognosis?

A

Good, use induction + ARA-C

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4
Q

AML t(8;21) ETO-AML prognosis?

A

good, use induction + ARA-C

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5
Q

AML t(9;11) prognosis?

A

intermediate

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6
Q

AML t(9;22) prognosis?

A

poor

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7
Q

AML t(15;17) PML-RARa treatment?

A

ATRA +/- ARA-C –> induction +/- arsenic

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8
Q

5- or 7- AML prognosis?

A

poor risk, start induction and allograft

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9
Q

FLT3-ITD+ mutation AML - prognosis and treatment?

A

poor, start allograft

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10
Q

FLT3-ITD- AML prognosis?

A

ARA-C (Cytarabine) and then allograft

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11
Q

t(9;22) BCR-ABL ALL prognosis?

A

poor

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12
Q

MLL-AF4 ALL prognosis?

A

poor

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13
Q

E2A-PBX ALL prognosis?

A

good

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14
Q

TEL-AML ALL prognosis?

A

good

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15
Q

Remission induction treatment for ALL?

A 
VCR
L-Asp
ARA-C
DEX or PRED
\+/- Daunorubicin
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16
Q

Consolidation treatment for ALL?

A 
Daunorubicin
ARA-C
Etoposide
Etoposide
Thioguanine or 6-MP
Cyclophosphamide,
L-ASP
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17
Q

Maintenance therapy for ALL

A

6-MP
MTX
Prednisone

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18
Q

TdT is a marker for these cells

A

Early B cells in marrow

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19
Q

These markers are expressed continuously throughout B cell development

A

CD19, CD20

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20
Q

What are the 5 criteria for defining a blast?

A

Big, high nucleus:cytoplasm, smudgy chromatin, large nucleolus, all look alike

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21
Q

What is basophilic stippling?

A

Dark dots of RNA left behind in RBCS; always pathological

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22
Q

What should a normal bone marrow aspirate show?

Study These Flashcards
A

Blasts below 4.5%; myeloid:erythroid precursor ratio at least 2:1

myeloid being granulocyte + monocyte

23
Q

What is the relationship between cellularity of BM and age?

Study These Flashcards
A

100% - Age = Normal % cells

24
Q

What CD marker is on both B and T cells?

25
WHat is a weakness of flow cytometry?
cannot assess erythroid line malignancies because RBCs are lysed
26
What does forward scatter measure?
cell size
27
How do you plot flow results initially?
CD45 (aka all lymphocytes) vs SSC
28
What marker is used for maturing granulocytes in flow?
CD33
29
What marker is best for HSCs in flow?
CD34
30
What are two advantages of IHC over flow?
Stain background lightly allows you to still see cell types Better for larger cells
31
What is a requirement for doing cytogenetics? (not FISH)
cell must be dividing
32
Advantage of FISH?
Cells can be in interphase
33
Normal myeloid blasts would have this immunophenotype
CD33+ CD34+
34
Normal lymphoid blasts would have this phenotype
CD10 CD19+
35
What is the best way to categorize/prognosticate AML types?
Genotype
36
What are Class I mutations?
Proliferation and survival advantages
37
What are Class II mutations?
Impaired differentiation/apoptosis
38
What is Gilliland's hypothesis?
Both a Class I and II mutation are needed to generate a neoplasm
39
Way to remember the AMLs that only need genetic analysis for diagnosis (4)
MYH INVerted Pml RUNs away RUNX1-RUNX1T1 inv(16) CBFB-MYH1 PML-RARA
40
Almost all of the AMLs we talked about are caused by these mutation types
Class II + I (Gilliland fulfilled)
41
t(8;21) AML - everything
Inhibited myeloid differentiation, aka backup ``` Gilliland fulfilled Kids/young adults Pancytopenia Blast diff blocked! CD13+ CD33+ CD34+ Auer rods, lots of blasts, Smudgy Good to chemo ``` t(8;21) is ETO-AML1 (RUNX1-RUNX1t1) - the blasts are "running and running" but can't go any further down the road, so they just keep multiplying like rabbits in the summer (8/21)
42
APL
t(15;17) PML-RARA fusion protein with TF+retinoic acid receptor causes INHIBITED GRANULOCYTE DIFFERENTIATION How fix? Help it grow! --> ATRA induction Arsenic if necessary Presents w/ thrombocytopenia, DIC!! CD34- (no blasts!) HLA-DR CD13+ CD33+ (myeloid blast markers) BAT WING nuclei Big blasts, few bc all are myeloid now Auer rods Cytoplasmic granules
43
Acute myelomonocytic leukemia
inv(16) or t(16;16) CBFB-MYH11 Inhibited myeloid maturation Younger/kids Mixed granulo/mono morphology Inc eosinophilia CD14+ CD11 = monocyte CD13+ CD33+ = granulocyte ARA-C otherwise poor prog
44
AML normal cytogenetics
Any age; pediatric is uncommon Gingival hypertrophy Molecular genetics > cytogenetics CD34+ Lots of blasts Undifferentiated May affect any non-lymphatic cell type
45
Tell me about stratifying cytogenetically normal AML to predict helpfulness of BMT
NPM1+ or [CEBPA+,FLT3-ITD-] --> BMT doesn't help FLT3-ITD+ or [NPMN1-,CEBPA-,FLT3-ITD-] --> BMT helps So remember [all negative ] means BMT and [FLT3+] also means BMT, otherwise BMT is not helpful
46
Markers of early B cell development
CD34 | TdT
47
Markers of middle B cell development
CD10 | CD19
48
Markers of late B cell development
CD20 | Cyto
49
TFs involved in early B cell development from stem cell
SPI1 | IKZF1
50
TF involved in middle B cell development
Pax5
51
ALL t(9;22) (B cell)
BCR-ABL1 fusion of two kinases (Class I) IKZF1 TF inhibition (Class II) Older adults + kids (early b cell immunophenotype) CD10+ CD19+ TdT+ Large agranular blasts Poor prognosis Anthracycline+Vinc+Prednisone induction MTX + 6MP maintenance
52
t(v 11q23) ALL
Rearranged MLL-->decrease diff Kids <1 yr CD10- (helps diff between t(9;22) CD19+ TdT+
53
ALL t(12;21)
TEL-AML1 Class II - inhib diff Doesn't support Gilliland Kids Big agranular blasts Tdt+ CD20- CD34+ Good prognosis 90% cure
54
T-ALL
Usually oncogene translocates to TCR promoter Kids - thymus/lymph nodes/spleen involved Big agranular blasts TdT+ CD5+/CD3+ (T cell markers) High risk

OS Hematology/Oncology (14 decks)

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