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27 Cards in this Set
- Front
- Back
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What is acute leukemia?
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Abrupt onset of pancytopenia (simultaneous presence of neutropenia, anemia, and thrombocytopenia)
- Neoplasm replaces hematopoeisis with IMMATURE marrow cells, neoplastic cells, immature cells that are dysfunctional |
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What is the difference between acute and chronic neoplasm (ie: leukemia)?
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Acute = immature neoplastic cells
Chronic = mature neoplastic cells |
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How are leukemias classified?
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1. Acute vs. Chronic
2. Myeloid vs. Lymphoid |
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What are the risk factors for acute leukemia?
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For most (95%), there are NONE
Others: Radiation, Chemo, Benzene, Faulty DNA repair mechanisms |
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What diseases/syndromes can transform into Acute Leukemia?
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1. Myelodysplastic Synrome (MDS)
2. Myeloproliferative Neoplasm (MPN) 3. Clonal Marrow Failure (ie aplastic anemia) - very rare |
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What is the most common pediatric cancer?
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Acute Lymphoid Leukemia (ALL)
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How many blood cells turn over Daily?
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1 x 10^11
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What is myelodysplastic syndrome?
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- Acquired. persistent reduction in myeloid blood cell counts
- Abnormal blood morphology |
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What is seen histologically in Myelodysplastic Syndrome (MDS)?
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1. Hypercellular Marrow
2. "Megaloblastoid" RBC precursors 3. Hypogranulocytic precursors 4. Clusters of hypoblated, "micro" megakaryocytes |
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How many mutations are needed to generate a leukemia?
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2-3 Hits
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What are the 2 categories of mutations seen in leukemia?
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1. Growth Promoting (FLT3)
2. Differentiation Block (PML-RARa) |
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What is the important mutation that causes a differentiation block in leukemia?
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t(15;17)
PML-RARa - causes Acute Pro-Myelocytic Leukemia |
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What cytogenetic abnormality is "commonly" seen in Leukemias?
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Balanced Translocations
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What translocation is seen in Acute Promyelocytic Leukemia?
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t(15;17) fuses PML transcription factor with retinoic acid receptor-a (PML-RARa)
- results in transciptional repression and maturational arrest at PROMYELOCYTE STAGE |
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What is the treatment for APL?
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All-trans retinoic acid (Vitamin A)
- restores transcription and induces differentiation |
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What is more commonly cured, adult or pediatric ALL?
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Pediatric
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What are the common symptoms of Leukemia?
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- Fatigue
- Pallor, Rashes/Petechiae/Ecchymoses - Infection, fever - Bleeding/easy bruising - SWOLLEN GUMS |
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What is leukostasis?
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Rare but serious complication in which there is abnormal blood circulation due to clogging of vessels from neoplasm
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What histological sign indicates that neoplasm is AML?
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The Auer Rod
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What is the preferred method to tell if Leukemia is ALL or AML?
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Flow Cytometry
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What does AML (myeloblasts) look like histologically?
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- Large Blasts, often with cytoplasmic granulation
- Irregular nuclear contour - AUER RODS |
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What does ALL (lymphoblasts) look like histologically?
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- Lack AUER Rods
- Extremley high N:C ratio - Smooth Nucleus - NO granulation |
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What cell markers are seen on Myeloid cells?
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CD 13, 33, and myeloperoxidase
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What cell markers are seen on B cells?
T Cells? |
B cells: CD 19, 79, Immunoglobin
T cells: CD 2, 3, 4, 7 |
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Is staging (where cancer has spread) useful in leukemia?
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NO
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What is most useful factor in determining prognosis/survival of AML?
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Genetics/Karyotype
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What are 3 favorable AML karyotypes?
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1. t(15;17) FAB M3 (APL)
2. t(8;21) FAB M2 3. inv16 FAB M4Eo |
