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16 Cards in this Set
- Front
- Back
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most common cancer of childhood
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acute lymphoblastic leukemia (ALL)
peak incidence = 3-6 yo |
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when should a pediatrician consider the dx of ALL?
what do you do when you see this? |
1) unexplained lymphadenopathy or marked HSM
2) bone pain (younger children can't walk), 3) bleeding (petechiae, purpura) 4) fever have to get a CBC (check for pancytopenia or WBC up and one other line down) |
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pro-dromal period for ALL is a ACUTE/CHRONIC process
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acute
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why must you not pre-treat (steroids) pt with suspected ALL?
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you put them at higher risk for not responding to standard tx
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what test do you have to do to dx ALL for sure?
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bone marrow aspirate/biopsy (CBC not it!) + karyotyping (gold standard to differentiate prognosis)
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what is the most common kind of precursor cell in ALL?
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b-cell precursor ALL
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name the 3 steps in identifying ALL subtype
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- morphology of blasts (can't define T or B lineage)
- immunophenotype (defines T,B, myeloid) - cytogenetics (best data for prognosis) |
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which test gives you best data for prognosis?
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cytogenetics
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name antigens:
pre-B pre-T myeloid "stem cell" |
pre-B: CD10, CD19, CD20, CD22
pre-T: CD 3, CD 5, CD 7 myeloid CD13, CD 14, CD15, CD33 “stem cell” CD 34 |
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what is a common translocation in infants (<1yo) with ALL with poor prognostic?
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t(4,11)
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name a chromosome translocation for ALL that has good prognosis
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t(12,21)
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all ALL pts have to have prophylatic radiation therapy of which body part?
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CNS
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what is the most important prognostic indicator in the therapy of ALL?
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early response to therapy and degree of response
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what is the worst prognostic sign of therpay in ALL pts?
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relapse
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name the chromosome findings with poor prognostic significance in ALL
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t (4;11)
t(1;19) t(9;22) |
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what is the common approach to therapy for ALL
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1. induction (try to reduce symptoms)
2. consolidate (try to get hard to reach places with cancer) 3. re-induce/re-consolidate 4. maintenance/continuation |
