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22 Cards in this Set
- Front
- Back
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What are some etiologies of leukemia? (5)
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1) chemical exposure (benzene)
2) radiation therapy 3) chemo therapy* 4) inherited genetic instability (Down's) 5) transforming virus * major cause nowadays |
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AML cytogenetics ~
M2 = t(___:___) M3 = t(___:___) M4 = inversion ___ Biphenotypic AML = t(___:___) |
8:21
15:17 16 4:11 |
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How does AML present clinically?
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1) DIC
2) leukostasis (>75000 blasts) 3) hyperuricemia 4) hepatosplenomegaly 5) pancytopenia 6) "tumor lysis syndrome" |
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What are some good cytogenetic prognostic factors for AML?
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inversion 16, t(15;17), t(8;21)
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What are some bad prognostic factors for AML?
(age, WBC count, etc.) |
> 60 yrs
high WBC count prior Myelodysplastic Syndrome prior chemo therapy |
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What is consolidation therapy for AML?
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HIGH dose cytarabine
(tox: leukopenia, thrombocytopenia, megaloblastic anemia) |
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What is used in targeted therapy for AML?
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anti-CD33, because young cells have CD33
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Acute Promyelocytic Leukemia (M3 AML) responds to _____ & _____ therapy.
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all trans retinoic acid
arsenic |
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What stain can differentiate between lymphoid blasts and myeloblasts?
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PAS - lymphoid blasts have glycogen
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Pre-B lymphoblsts are positive for _____ & _____.
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TDT & CD10 (CALLA)
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ALL affects mostly _____.
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children (30% of childhood leukemias)
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ALL has higher incidence of tumor spread to _____ & _____.
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CNS, testes
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Treatment of ALL includes:
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induction
consolidation maintenance CNS prophylaxis (intrathecal) allogeneic transplant |
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Cytogenetic abnormality in CML:
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t(9:22) --> bcr-abl chimeric protein --> super pluripotent stem cell --> become either lymphoid or myeloid cells
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CML clinical features:
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1) no sxs in early stage, just high WBC
2) rising WBC in all stages 3) low neutrophilic ALP 4) accelerated phase - anemia, thrombocytopenia, but basophilia and fibrosis |
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CLL expresses which surface protein marker?
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CD5
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CLL typically occurs in which gender and age population?
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Men > 50 yrs
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Clinicaly features of CLL:
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1) hypogammaglobulinemia
2) inc. infections 3) T-cell dysregulation 4) second malignancy 5) autoimmunity (hemolytic anemia) |
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Indications for initiating therapy in CLL:
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massive LNs and spleen
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CLL Tx:
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1) alkylater therapy (chlorambucil, cytoxan)
2) purine analog (fludarabine) 3) rituximab, campath |
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MDS definition:
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Absence of pluripotent progenitors.
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MDS presentation:
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inc. incidence with age, progressive pancytopenia, macrocytosis, poikilocytosis, anisocytosis
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