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acute and chronic luekemias
acute and chronic leukemias
49
Medical
Graduate
09/04/2011

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Term
aml vs. all
Definition
AML: granules stickign together, auer rods and more cytoplasm. ALL: no auer rods with minaml cytoplasm.
Term
class I mutation
Definition
prolfieration uncontrolled,
Term
class II
Definition
blcok in differentiation.
Term
aml :poor prognosis
Definition
5q-, monosomy 7, trisomy 8, 11q23
Term
AML M3 marker/translocation
Definition
PML-RARa (15:17 translocation), transciptional repressor- arrest of cellualr differentiation. ATRA causes diff and cell death of promyelcoytes
Term
MRD tests
Definition
cytogenetics, ISH, rt-cr.
Term
aml markers
Definition
cd13,cd33, glycophorin (m6), platelet antigens (m7)
Term
all b cell marker
Definition
b lienage: cd19, cd 22, cd10 plus/minus, srafce IG surfae Ig, and tdt-
Term
all t lienage:
Definition
cd1-8
Term
chloroma/granulocytic acoma
Definition
trumor formaiton.
Term
ALL
Definition
most common in children: regualr sypmtoms ofbm failure (nuetropenia, anemia, thrombocytopenia, organ infiltration.) plsu cns and testicular involvement. Nutropenic fevers Treatment: combination chemotherapy. Look at image.
Term
ALL prognosis : sex, phoneotype, age, cytogetnetics,
Definition
girls better prognosis, b-all>t ALL, child>adult/infant. Cyotgenetics: PH, 11q23 are poor markers. Hyperploidy is good marker. Good prognosis
Term
AML se
Definition
markers: cd13,cd33, myeloperoxidae, sudan , black,esterase, Auer Rods (image) . Secondary AML can delevop. Treatmetn: bad prognosis: chemo, itnermediate: transplatn optional, poor: definte transplant . For Aml 3 also give ATRA
Term
Sceondary Aml
Definition
result of myelodysplasia previous chemotherapy, poor prognosis.
Term
aml favorable markers (godo ones)
Definition
t (8:21)- m2 , m3-15:17, eosonophillia-ivn16 , younger age, wbc <30,000 - these are favorable .
Term
aml unfavorable ones:
Definition
older age, way higher wbc, if secondary in nature, deletion of five:7,, t (6;9) , t(9:22), chromosome 11 abnormality. acute monocytic luekemia- (m5) T (9:11). Flt3 trisomy 8
Term
CML
Definition
adult luekemia. clonality of the true HSC. Most asyptoamtic and diagnosed via cbc. Philadelphai chrososome, t9:22, bc-abl (defective apoptosis advantage). Able to transform to blastphase due to addition of molelcular changes. A lot of healthy white blodo cells produced. (slide)
Term
Imatinib (gleevec)
Definition
prevents atp dependant tyrosien phosphorylation of substrate. For treatmetn of oPh translcoation in CML.
Term
CLL
Definition
common in older patietns , more males. B cell disease, cells accumulate in traidtionalareas (blodo , bone marrow, liver spleen, lymph nodes). Diagnosis: asymptomatic, thouh also commonly presents with symmetrical lymphaedenoapthy. Hypoglobluiemic so have ifnections, also hemolytic anemia. lab findings: lymphocytosis ,smudge cells. Anemic (bm infiltartion). smudge cells , marekrs: cd5 ( t cell) , cd,19,20 (b cell) and cd 23 positive.
Term
CLL classification
Definition
rai: absolute lymphocytosis (0), lymphocytosis and absolute lymphocytsosis (0)nodes (1) lymphocytosis with spleen/liver (2), lymphocytotsis and anemia (3), lymphocytosis and thrombocytopenia (4). Binet staging based on hemoglobin, plasma cell numbeers, whetehr 3 lymph nodes are involved.
Term
CLL prognosis: sex, binet, bm involvement, cytogenetics, vh Ig genes, LDH, cd38, zap70
Definition
binet A -G , binet,b,c-B, female-G , BM involvement-nodular-G, diffuse-B cytogenetics-13 chromosome deletin-good, b-trisomy 12, p53 mutation-b. vh Ig mutation-G, LDH elevated levels-B, cd38 presence-B, zap70 presence-B
Term
CLL treatment
Definition
Just watch them if asymptomatic. No curative treatment. Only treat for lymph nodes if become painful, or if compress on important organs. Combinational chemotherapy based on patient. Monoclonal antibodies: can target cd20,cd52.
Term
Multiple myeloma
Definition
cells feed on their microenvironment, microenvivonremtn growth factors actively promote prolfieration.. Pathobiology: presents as disease of bone marrow only : IgG in blood and urine , serum M protein spike. Osteolytic bone lesions due to osteoclast actiating factors released from malignant cells ... Disease pattern: remission followed by relapse , until eventually relapse for ood. Staging: serum macrolobulin and albumin levels (3 stages dpenednign on levels ) look at slide
Term
multiple myeloma negative prognostic factors .
Definition
generally bad prognosis to begin with. high ldh, chrosome 13 deletion, hypoploidy, t(4:14, 1416,7q-), kidney failure . , ciruclating palsma in bodo cells.
Term
Multiple myeloma diagnosis
Definition
clonal plasma cells in marrow/ plasmacytoma. 2. monclolonal protein in serum or urine. 3. organ related dysfunciton.
Term
Multiple myeloma supportive therapies
Definition
treat bone disease (bisphosphonphates), anemia, renal failure, and hypercalcemia. Autologous transplants increase life. When to start therapy:don’t strt until symptomatic.
Term
acute leukemia
Definition
rapidly fatal diesease 20 percent blasts in BM
Term
msot ommon luekemia in kids
Definition
ALL
Term
msot common leukemia in adults
Definition
AML: granules stickign together, auer rods and more cytoplasm. ALL: no auer rods with minaml cytoplasm.
Term
most common cause of leukemia
Definition
age, rather than genetics.
Term
0.39
Definition
bcr-abl, in pre-b all and cml
Term
rara-pml
Definition
aml m3 (15:17)
Term
tel-aml1
Definition
12:21 in preb all. FAVORABLE
Term
actiavated ras oncogene poitn mutatino
Definition
seen in aml and all
Term
acute luekemia clinical manisfestatiosn
Definition
included yperkalemia and hyperuricemia. Decreased nomral or elevated wbc. Organ inflitraion, includignginvial hypetrophy
Term
pre-b all markers
Definition
cd19, cd22 , tdt postivie always. Sometimes: cd10.
Term
b-all
Definition
Term
DIC
Definition
occurs commonly in AML.
Term
tumor lysis syndrome
Definition
rapid release of itnracellualr contents. Leadgin to lifet hretenign concentrations.
Term
HYPERLEUKOCYTOSIS
Definition
LUKEMIC OBSTRUCTION ANDI NFILTRATION: LUNGS AND CNS MSOT COMMON ORGANS. Aml-m3 and m5 . Treat rapidly and avoid transfusions
Term
aml
Definition
occurs in all age groups but most commo nleukemia ina dults. Primary and secondary aml , simliar c lincial feaatures to ALL.
Term
aml prognosis
Definition
bad
Term
aml treatment
Definition
favorble- conventional chemotherpy interdmatie- tranpslant optional. Adverse- needwtranasplant. Idnuction chemo and consoloditiaon chemo, and maintenance . Give atra for aml m3.
Term
blast crisis
Definition
cml; additioanl molecular changes.
Term
multiple myelomadisease progression
Definition
several remission but eventually resistant disease and death
Term
MGUS and smoldering MM
Definition
some inceased in M protein , but no syptoms of MM, don’t treat unless diseasep rogression because good chance wont develop to malignancy. EVEn indolent MM is not terated, only start treatmetn with symptomatic mM.
Term
AML CLASSIFICATION
Definition
BASED ON morphology of AML (level of differentiation)
Term
t- cell aLL markers
Definition
cd 10 negative and tdt positive
Term
cll markers
Definition
cd 5 positive (t cell marker) , cd 19, cd 20 , cd23 positive
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