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31 Cards in this Set
- Front
- Back
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AML cells express what CD antigens?
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CD13 and CD33
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ALL cells express what CD antigens?
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CD10 and CD20
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Burkitt's Leukemia is characterized by what chromosomal abnormality?
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t(8;14)-- c-MYC to IgH
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Philadelphia chromosome (t9; 22) leads to expression of what protein?
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BCR-ABL, a dysregulated tyrosine kinase. (leading to CML)
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Genetic cause of acute promyelocytic leukemia
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Retinoic acid receptor alpha (RARa) on chromosome 17 translocates, resultant protein binds to RARa target genes but BLOCKS transcription rather than activates
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What drug can be used to treat acute promyelocytic leukemia?
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all-trans retinoic acid (ATRA).
RARa binds ATRA and is thus displaced from DNA allowing differentiation to proceed |
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The Wnt signaling pathway is involved in regulating what cellular property?
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self-renewal capacity
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The most common hematological cancer is?
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Non-Hodgkins Lymphoma, which accounts for 50% of all diagnoses and a third of all deaths
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Staining for ___ and ___ distinguishes mantle cell lymphoma
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CD5 and Cyclin-D1
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Staining for ___ and ___ distinguishes SLL
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CD5 and CD23
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Staining for ___ and ___ distinguishes marginal zone lymphoma
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the ABSENCE of CD5 and CD10
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What kind of biopsy is preferred for a suspected lymphoma?
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An open excision if possible
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What NHL stages are amenable to radiation therapy?
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Stages I or II.
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Criteria for the International Prognostic Index (IPI)
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Age
Performance Status LDH Extranodal Sites Stage |
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Differences between FL-IPI and IPI
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FL-IPI accounts for: Nodal sites > 5 and Hemoglobin < 12
in the place of: Extranodal sites and Performance Status |
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Components of CHOP
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Cyclophosphamide
Doxorubicin Vincristine Prednisone The best because it is the least toxic |
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This translocation leads to constitutive expression of Cyclin D1 and this disease
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t(11;14) --> Mantle Cell Lymphoma
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MGUS
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• Incidence:
– 2% age >50, 3% age > 70 • Diagnosis: – serum Ig ≤ 3g/dl – < 10% plasma cells in marrow • Prognosis: – progression 1% / year |
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Symptoms of Multiple Myeloma
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• Bone disease (80%)
• Anemia • Hypercalcemia • Infection • Renal Failure • Hyperviscosity • Amyloidosis • Neurologic |
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Multiple Myeloma Staging
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Durie-Salmon--
I, II, III based on anemia, hyperCa+, bone lesions A or B (absence or presence of renal failure) ISS is better. |
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Standard of care for patients with Multiple Myeloma
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high dose melphalan and autologous bone marrow transplant
Thalidomide for newly diagnosed patients |
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Side Effects of Thalidomide
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–Sedation
–peripheral neuropathy –Venous blood clots |
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Bortezemib
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boron-based agent that stops proteosome disposal
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Plasma Cell Leukemia
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sub-type of MM
Primary--5% (bias toward IgA) Secondary--end-state of heavily treated MM, Tx is palliative |
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Walderstrom's Macroglobulinemia (lymphoplasmacytic lymphoma)
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confused with MM. Does not cause bone lesions.
IgM spike, lymphadenopathy, subtype of NHL |
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Heavy Chain Disease mu-HCD
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secrete abnomal Ig lacking light chains and truncated heavy chains (Fc only)
present with: fatigue, weight loss, recurrent Infx, splenomegaly. 75% have , hepatomegaly, 40% have adenopathy and lytic bone lesions |
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Arthralgia, myalgias and renal disease can be caused by what plasma cell disorder
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Type II/III cryoblogulinemia
(immune complexes activate complement leading to inflammation) |
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Hyperviscosity is associated with what plasma cell d/o
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Type I cryoglobulinemia
(which usually has an underlying lymphoproliferative disorder) |
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HCV is associated with what plasma cell disorder
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Type II Cyroglobulinemia
(along with EBV, CMV, and syphilis) |
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Treatment of cryoglobulinemia
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Type I -- treat underlying d/o
Type II-- IFN-a and ribavirin NSAIDs, steroids |
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What is the cause of most myeloproliferative disorders?
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dysregulated tyrosine kinases
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