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34 Cards in this Set
- Front
- Back
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Demographics of AML
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M>F, age > 65
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Diagnostic finding on smear for AML
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auer rods
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Treatment for AML
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Danorubicin + Cytarabine + Etoposide
if not in remission repeat chemo, then try BMT |
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APL
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-subtype of AML
-chromosomal translocation involving retinoic acid receptor -accumulation of promyelocytes |
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Treatment of APL
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Tretinoin + danorubicin
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CML
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-M>F, increases with age
-translocation between chrom 9 and 22= philadelphia chromosome(chrom 22) (found in 90-95% of patients) -chronic phase may progress to acute phase and blast crisis in 4 yrs if not treated |
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CBC results for CML
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^ WBC
^ platelets decreased rbc |
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Blast crisis
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acute phase of CML leukemia with blood or marrow blasts > 20%
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Treatment of CML
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Imatinib (gleevec) +/- BMT
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How does Gleevec work
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for CML
-tyrosine kinase inhibitor that targets BCR/ABL gene cells for apoptosis |
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side effects of gleevec
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fluid retention
nausea muscle cramps diarrhea rash |
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Most common leukemia in childhood
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ALL
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Hematologic and bone marrow findings in ALL
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-high or low WBC
-anemia, thrombocytopenia -smear: lymphoblasts -bone marrow: blast cells |
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specific protein marker for ALL
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terminal deoxynucleotidyl transferase (TdT)
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Common B and T cell findings in ALL
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-most ALL types are B cells (CD 19 and CD 10)
-T cells usually CD 2,5, and 7 |
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treatment of ALL initially
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prednisone+vincristine+asparaginase (in kids)
methotrexate+cytarabine for CNS prophylaxis + Gleevec if philadelphia chrom |
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maintenance therapy for ALL
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mercaptourine+MTX+vincristine + prednisone
for 2-3 years |
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what differentiates myeloid leukemias from lymphoid leukemias
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proliferation of myeloid progenitor cells
-myeloid cells make granulocytes like neutrophils, basophils and eosinophils -no lymphocyte involvement |
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hematologic findings in AML
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-wbc usually high
-anemia, thrombocytopenia -smear: myeloblasts -bone marrow: blast cells -auer rods is pathognomonic -CD 13 or 33 |
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most common type of leukemia
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CLL
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hematologic findings of CLL
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-WBC high (almost always)
-lymphocytosis -anemia, thrombocytopenia not as frequent -smear: small mature lymphocytes -bone marrow: > 30% lymphocytes |
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lymphocyte findings in CLL
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B cell lineage
-CD 5 and 23 |
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Treatment for CLL
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NO CURE
-no treatment in low risk disease: follow lymphocyte doubling time and beta 2 microglobulin -higher risk: fludarabine+cyclophosphamide+bendamustine +/- monoclonal antibodies (rituximab) |
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hematologic findings in CML
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-elevated WBC (always)
-anemia, thrombocytopenia -smear: immature granulocytes, blast cells <5% -low leukocyte alk phos -bone marrow: hypercellular with left shifted myelopoisis, < 5% blasts |
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lymph node biopsy in Hodgkin lymphoma
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Reed sternberg cell, Large multinucleated cancerous cells
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Treatment of Hotchkins lymphoma
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Chemo: doxorubicin + bleomycin + vinblastine + dacarbazine + radiation
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Virus associated with Hodgkin lymphoma
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Epstein bar virus
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treatment of cdiff
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Vanc PO 125 mg q6h x 10d. Flagyl if allergy
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chemo that causes hemorrhagic cystitis
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Cyclophosphamide
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treatment of hemorrhagic cystitis
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Mesna given with cyclophosphamide. Irrigate bladder with formalin or NAC. Prostaglandins
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treatment of hemorrhagic cystitis
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Mesna given with cyclophosphamide. Irrigate bladder with formalin or NAC. Prostaglandins
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treatment of tumor lysis syndrome
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Aggressive hydration. Sodium bicarbonate for urinary alkalinization (keep urine pH at 7 or higher). IV allopurinol. Rasburicase if uric acid still >8 after 24 hours. Follow lytes and uric acid q6h. Monitor hyperkalemia
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treatment of tumor lysis syndrome
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Aggressive hydration. Sodium bicarbonate for urinary alkalinization (keep urine pH at 7 or higher). IV allopurinol. Rasburicase if uric acid still >8 after 24 hours. Follow lytes and uric acid q6h. Monitor hyperkalemia
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treatment of non Hodgkin lymphoma
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Cyclophosphamide , doxorubicin, vincristine , prednisone. Monoclonal antibodies
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