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27 Cards in this Set
- Front
- Back
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The diagnosis and classification (and ultimately management) of hematopoietic neoplasms is dependent on: (5)
Which is most important? |
Clinical manifestations
Morphology of biopsied tissue Special stains (immunohistochemistry/cytochemistry) Flow cytometry Molecular studies* Cytogenetics* Clinical manifestations |
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Pattern of gene _____ vary as cells mature and differentiate.
Can these help classify disease? How about disease progression? Point/type of origin? |
expression
yes Yes. Yes. |
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CD =
All normal leukocytes display CD___ to varying degrees. |
cluster of differentiation
CD45 |
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Flow cytometry is trying to line up cells.....
What is being measured? |
...single file.
emissions post-laser excitation. |
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What is immunophenotyping?
What does FACS stand for? |
identifying the pheynotype using fluorescently labeled antibodies (probe) in Flow cytometry.
FACS = fluorescence activated cell sorting |
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Low numbers correspond to ____-cell phenotypes?
Midteens? Nineteen & Early twenties? (Army help to remember) CD34? CD33? |
T-cells
Myelomonocytic B-cell stem cell, myeloid |
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CD4 = ?
CD13 = ? CD14 = ? CD15 = ? |
T-cells
13 = granulocyte 14 = monocytic 15 = granulocyte |
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Leukemias are Dx according to...
What are the two major categories? |
...the prominent cell type involved.
Acute Chronic |
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Characterize the two major categories of leukemias.
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Acute: rapid onset, aggressive, usually poorly differentiated (blasts)
Chronic: insidious onset, usually less aggressive and more mature appearing |
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Can chronic leukemias transform into something worse?
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Yes, they can.
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ALL is most common in adults or children?
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Children.
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Philadelphia chromosome shows up more frequently in children or adults?
Where does it have the worse prognosis? |
adults.
adults. |
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FACS stands for...
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...fluorescence activated cell sorting.
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What are the two types of ALL?
Which has a better prognosis? |
B-ALL, T-ALL
B-ALL, though it is better for children than adults. |
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What class of leukemia (acute or chronic) is seen here? What type of cells evidence this?
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Acute leukemia. These are blasts in the peripheral blood.
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In the context of ALL prognosis, list the following as favorable, intermediate, or unfavorable:
hyperdiploid hypodiploid t(1,19) t(9,22) t(12,21) abn(11q23) Why does this make sense, given which age range has the better overall prog? |
Favorable: hyper, t(12, 21)
Inter: t(1,19) Bad: t(9.22), hypo, abn(11q23) Kids have the better prog, and they also are more likely to have these favorable characteristics. |
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What is the name of the product of the t(12,21) translocation?
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TEL-AML1
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On the FAB subtypes, the only one we need to know is Promyelocytic = APL, a type of AML... what is the M#?
Which translocation is associated with APL? What percent evidence this? What do the others show? |
M3
t(15,17) 95% RARa rearrangement with other genes. |
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What could help us differentiate b/t a BM biopsy of AML and that of ALL?
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The AML one might have an abundance of pink cytoplasm (it's a disease of myeloid lineage, after all)
this isn't necessarily the case tho', so be careful. |
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How does ATRA work?
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Overcomes the avidity of RARa binding to the corepressor complex... since this is what's blocking differentiation, ATRA administration allows differentiation to occur again.
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50% of AMLs have _____ clonal cytogenetic abnormality.
Are they devoid of genetic mutations? What is the most frequent molecular abnormality in AML? Is it associated with good or bad prog? |
No.
No, their mutations are just at the genetic lvl, rather than the cytogenetic lvl. FLT3 Bad. |
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Differentiate between Benign Neutrophilia and CML based on the: a) peripheral smear and b) lab values
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Left shift isn't as marked in BN as it is in CML.
BN = normal or increased LAP CML = Decreased LAP |
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What is LAP?
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Leukocyte Alkaline Phosphatase
only important re: telling Benign neutropenia apart from CML. |
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What is the most common length of the BCR-ABL transcript produced in CML?
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p210
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+ Coombs
ITP AIHA white pulp in the spleen recurrant URI/LRI - all are associated with which leukemia? |
CLL, a mature B-cell lymphoma/leukemia.
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Cells expressing CD23, CD5, and exhibiting light-chain restriction suggest which type of diz?
Deletion of 13q14 is found in >50% of cases.... is it a a good or bad prognostic marker? |
CLL / SLL
Good. |
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Which diz can BCR-ABL drive independently? Which other diz is it associated with in which it is just a bad prognostic marker?
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CML
ALL |
