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34 Cards in this Set
- Front
- Back
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What do the following Translocations express? Which cancer?
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t(15,17)
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PML-RAR
APML (AML) |
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t(14,18)
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BCl2
follicular |
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t(8,14)
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C-myc
Burkitt’s |
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t(11,14)
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Cyclin D
Mantle cell lymphoma |
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t(9,22)
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Philadelphia -- BCR-ABL (tyr K)
CML (chronic myelogenous leukemia) |
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Jak 2 mt
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All myeloproliferative Disorders (CML; PV, ET, Myelofibrosis)
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Where do you see the following smears?
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Auer rods
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AML
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Smudge Cells
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CLL/SLL
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Hairy Cytoplasm
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Hairy Cell leukemia
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RS cells
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HL
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Sezary Bodies
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Mycosis Fungoides
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Starry sky
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Burkitt’s lymphoma
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Tear Drop cell
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Myelofibrosis
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For the following give me Clinical Features, Prognosis, Tx
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AML
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MPO+ (Auer rods)
CD33, 13+ Superficial infiltration (gums, skin) Good: inv (16) t(8,21)= ETO t(15,17) = PML-RAR 7 (ara C) +3 (anthracycline) ATRA for APML |
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ALL
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tDt+
Tissue infiltration (LAD, splenomegaly, CNS, testes) Good: t(12,21) = TEL/AML Hyperploidy Bad: t(9,22) = Philadelphia (BCR-ABL) CNS px |
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CLL
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CD5, 23, 19, 20 +
Smudge cells Complications: Hemolytic anemia Ricther transformation to Large B-cell Bad: Zap 70 17q deletion CD38+ Reye Staging: ↑ lymphocytes → accumulate LN → accumulate Spleen → accumulate BM (BM failure) 0 = lymphocytosis 1= LAD 2= splenomegaly 3= Anemia 4= thrombocytopenia Tx: Wait and Watch |
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Hairy Cell
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+TRAP
Hairy cytoplasmic process Tx: 2-CDA (cladribine) |
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HL=
RS cells → B-symptoms CD15, 30+, 20- (except: Lymphocyte predominant) Localized LAD Stage: 1 |
1 LN
2 = >1LN same side diaphragm 3 = >1LN diff side diaphragm 4 = extranodal ABVD: Adriamycin Bleomycin Vinblastine Dacarbazine |
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Follicular Lymphoma=
t(14, 18) |
Bcl2
CD19, 20, 10+ BM: Paratrabecular lymphoid aggregates Rituximab + Bendamustine |
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Marginal Lymphoma
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MALToma (H. pylori)
Lymphoepithelial lesions (destroy glands) Antibiotic |
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Mycosis Fungoides
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Sezary cells
Microabscesses (epidermis) |
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Diffuse Large B cell
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CD19, 20
Bad: APLES = age >60, performance status, LDH, extranodal, Stage 3, 4 R-CHOP: Rituximab Cyclophosphamide HydroxyDaunrubocin Oncovine Prednisone |
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Brukitt’s=
t(8,14) |
C myc
Starry Sky CD10, 20, BCl6 African -- EBV CNS prophylaxis |
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Mantle cell lymphoma
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t(11,14) = Cyclin D
CD5, 20+, 23- (ddx CLL) |
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Lymphoblastic Lymphoma
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similar to ALL:
+tDt Mediastinal (thymus) enlargement CNS prophylaxis |
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Clinical features & tx for all MPD?
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panhyperplasia (↑ of all myeloid cells) -- Hydroxyurea
Jak 2 mt -- Ruxolitinib Splenomegaly |
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For the following give me Clinical features, Ddx, Tx
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Polycythemia Vera
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↑ RBCs, ↓ EPO (-ve feedback)
Venous thrombosis (RBC viscosity) Ddx: Reactive Polycythemia = ↑ RBCs, ↑ EPO - Lung dz = ↓ O2 sat - Renal dz, Ectopic = nl O2 sat Phlebotomy |
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Essential Thrombocythemia
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↑ platelets (>600k) → Thrombosis
Ddx: Reactive Thrombocytosis -Fe deficiency anemia → ↑ serum ferritin Antiplatelet therapy |
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Myelofibrosis
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↑ stromal cells → ↑ PDGF → marrow fibrosis
Tear Drop cells BM transplant |
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Chronic myelogenous leukemia (CML)
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↑ granulocytes
Ph+ =t(9,22) Basophillia Progress to Acute Leukemia w/ out tx: 1. Chronic phase (Premalignant) = asymptomatic 2. accelerating phase 3. Blast phase (malignant) -- >20% blasts -- acute leukemia Ddx: Leukemoid rxn - High LAP Imatinib Mesylate (gleevac) = Tyr K (-) |
