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23 Cards in this Set
- Front
- Back
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ALL
acute lymphoblastic leukemia more likely T or B? |
B-ALL is 80%
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LBL
lymphoblastic leukemia more likely T or B? |
LBL is more likely T (90%)
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most common age for ALL
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75% are kids <6 yo
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ALL requires involvement of PB, BM or both?
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ALL requires BM involvement. PB is also usually involved.
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ALL extramedullary sites
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CNS (give prophylactic intrathecal chemo)
LN, spleen, liver, testis |
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most common site of B-LBL
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head and neck
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Markers of [early/pro] B-ALL?
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CD19, Tdt
cytoCD79a CD22 +/- CD13 and CD33 (myeloid) |
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from early/pro B-ALL to common B-ALL, what marker is added?
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CD10 is positive on common B-ALL.
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from common B-ALL to pre-B ALL, what marker is added?
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cytoplasmic mu is positive on pre-B-ALL.
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gene rearrangements in B-ALL
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all have clonal DJ rearrangement of IGH.
70% have TCR rearrangement! |
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poor prognosis in B-ALL
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-t(17;19) (rare)
-amplification of AML1 on chr 21 (iAMP21) (5%) -CNS involvement @dx -infancy or age>10 -MRD post tx |
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B-ALL
prognosis in kids? prognosis in adults? |
kids CR >95%
adults CR 60-85% |
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Ph+ B-ALL
kids or adults more? |
t(9;22) is more often in adults B-ALL (25%) than kids (3%)
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Ph+ B-ALL
immunophenotype? |
positive
CD19, Tdt, CD10, 13, 33, 25 (CD117 neg) |
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can t(9;22) occur in T-ALL?
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yes, rarely. More often B-ALL.
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Ph+ B-ALL
which fusion protein? |
adults:
half with p210 (like CML) half with p190 kids: most with p190 |
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Ph+ B-ALL
better or worse prognosis than B-ALL, NOS? |
worse prognosis
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B-ALL with t(v;11q23) MLL rearranged
age? |
this is the most common leukemia in infants <1 yo
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B-ALL with t(v;11q23) MLL rearranged
presentation? |
very high WBC >100k/ul
CNS involvement at dx cmn |
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B-ALL with t(v;11q23) MLL rearranged
immunophenotype? |
19+ Tdt+, 15+ (early/pro-B)
CD10 neg, CD24 neg NG2+ (neural glial antigen 2) |
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B-ALL with t(v;11q23) MLL rearranged
m.c. v? |
4q21 (AF4) is mc translocation partner
other cmn: 19p13 (ENL; also in T-ALL) 9p22 (AF9; also in AML(9;11)) |
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B-ALL with t(v;11q23) MLL rearranged
Flt3 yes or no? |
Flt 3 frequently overexpressed
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B-ALL with t(v;11q23) MLL rearranged
prognosis? |
poor, espec <6 months old
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