Pediatric Leukemia

Question 1

Most common malignant neoplasms in childhood?

Answer 1

Leukemia

Question 2

What causes increased incidence in ALL in kids?

Answer 2

Medical radiation

Question 3

Most common genetic cause of leukemias?

Answer 3

Translocations

Question 4

Most common and easily curable form of childhood leukemia?

Answer 4

ALL Acute Lymphoblastic Leukemia

Question 5

ALL affects lymphocytes, but which lymphocyte line is the most commonly affected?

Answer 5

B-cell lineage

Question 6

What occurs in ALL?

Answer 6

BM produces immature cells that develop into leukemic lymphoblasts that build up and crowd out the healthy cells

Question 7

Who is most likely to get ALL?

Answer 7

White males between 2-5 years of age

Question 8

What adds an increased risk of getting ALL?

Answer 8

Kids with chromosomal abnormalities

Question 9

What happens with ALL in twins?

Answer 9

Risk is greater than 70% of second twin getting ALL if first twin was diagnosed during first year of life and they shared a placenta
If first develops ALL by 5-7 then risk of second twin is 2x risk of getting than general population

Question 10

Most important distinguishing morphologic feature of a ALL subtype?

Answer 10

FAB L3 subtype-evidence of a mature B-cell leukemia AKA Burkitt Leukemia

Question 11

What feature of ALL is adequate to establish an ALL diagnosis?

Answer 11

Morphology

Question 12

Two chromosomal abnormalities most seen in ALL:

Answer 12

12 -> 21 favorable prognosis (more common)

9 -> 22 poor prognosis

Question 13

Clinical manifestation of ALL infiltrating leukemic cells into normal tissues resulting in BM failure?

Answer 13

Anemia
Neutropenia
Thrombocytopenia

Question 14

What site does B-ALL usually manifest and create significant problems?

Answer 14

Testes

CNS

Question 15

Where does T-ALL usually manifest and create significant problems?

Answer 15

Anterior mediastinal mass (thymic mass)

Question 16

How is ALL diagnosis confirmed?

Answer 16

Immature blast cells on peripheral blood smear or BM biopsy

Question 17

What important test is done at the time of ALL diagnosis?

Answer 17

Lumbar puncture

Question 18

ALL prognosis four groups and criteria?

Answer 18

Low risk
Standard risk
High risk
Very high risk

Question 19

Low risk criteria:

Answer 19

1-9 years old; initial WBC less than 50k; 12->21

Question 20

High risk criteria:

Answer 20

Younger than 1 year old or 10 years old and older; initial WBC greater than 50k; CNS or Testicular disease; 4->11

Question 21

Very high risk criteria:

Answer 21

Missing 1 or more chromosomes; 9->22; or fail to achieve remission after 4 weeks of therapy

Question 22

What are the markers on T-ALL cells?

Answer 22

TdT+

Question 23

What are the markers on B-ALL cells?

Answer 23

CD10+

Question 24

What percent of childhood leukemias are AML?

Answer 24

11%

Question 25

Most common classification system for AML subtypes?

Answer 25

FAB system

Question 26

What percent of childhood leukemias are CML?

Answer 26

2-3%

Question 27

What gene causes CML?

Answer 27

9->22 translocation