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17 Cards in this Set
- Front
- Back
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Leukemia can be divided into? (4) |
- acute lymphoblastic leukemia (ALL) - acute myeloid leukemia (AML) - chronic lymphocytic leukemia (CLL) - chronic myeloid leukemia (CML) |
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What is acute leukemia? |
Malignant disorder - hematopoetic blast cells > 20% of bone marrow cells |
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What happens to blast cells in acute leukemia? |
Accumulated in blood, bone marrow and later in other tissues |
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2 types of acute leukemia? Other type? |
- ALL - AML - rare = undifferentiated / mixed |
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How to differentiate types of acute leukemia? |
Subclassification depends on: - morphological - immunological - cytochemical - cytogenetics |
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What causes acute leukemia? |
Malignant cells may have: - chromosomal translocation - other DNA mutation |
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What common symptoms can be seen in patients with acute leukemia? |
Bone marrow failure: - anemia - abnormal bruising / bleeding - infection ↑ cellular catabolism |
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More specific symptoms for each acute leukemia? |
AML - M3 - DIC sy. AML - M4 / M5 - tissue infiltration on skin ALL - lymphadenopathy - splenomegaly - tissue infiltration (testes, CNS) |
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What does it mean with ↑ cellular catabolism? |
- sweating - fever - general malaise |
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What can be done to diagnose acute leukemia? |
- FBC, U&E - bone marrow aspiration - test for coagulation profile (APTT) - analysis of blasts |
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What can be seen in FBC, U&E, coagulation profile of acute leukemia? |
FBC - anemia - neutropenia (risk of infection) - thrombocytopenia (bleeding) - leukocytosis - caused by blast cells U&E - ↑serum uric acid - ↑ LDH Coagulation profile - abnormal (M3) |
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What can be seen on BM aspiration? |
Infiltration of BM with blast cells > 20% |
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How can we analyst blasts? |
1. Morphologically 2. Cytochemically 3. Immunophenotype 4. Cytogenetic analysis |
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Describe analysis of blasts morphologically? |
Check myeloid lineage - Auer rods may present in AML * condensation of granules |
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How to differentiate ALL & AML cytochemically? |
Myeloid lineage: +ve myeloperoxidase & Sudan black Lymphoid lineage: +ve periodic acid Schiff (PAS) |
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How immunophenotyping may help to differentiate AML & ALL? |
EGIL classification (identify cell antigens) AML: - CD33+, CD13+, CD14+ (monocytic) ALL: - B lineage = CD19, CD10, CD20, Ig - T lineage = CD7, CD3 |
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What is importance of cytogenetic analysis? |
Can give diagnostic & prognosis info: GOOD RISK: - t(8,21) - t(15,17) - inversion 16 POOR PROGNOSIS: - complex karyotypes abnormalities - monosomy 5 / 7 - deletion of 5q, - bcr / abl |
