Introduction to Leukemia Part 2

68問 • 2年前

問題一覧

- Acute megakaryoblastic leukemia - This is a rare disorder characterized by extensive proliferation of megakaryoblasts, atypical megakaryocytes and thrombocytopenia

What are the 2 goals in the treatment if Leukemias

Eradicate the leukemic cell mass, Give supportive care

What are the four general types of theraphy for leukemias?

Chemotherapy, Bone marrow transplant, Radiotheraphy, Immunotheraphy, Monoclonal antibodies

A combination of drugs is usually used in this theraphy

Chemotheraphy

It stimulate the patients own immune system to mount a response against the malignant cells

Immunotheraphy

An example of these are Rituxin

Monoclonal antibodies

Fill in the Blanks: Blast cut-off for a diagnosis of AML WHO- ____ FAB- ____

20%, 30%

AML with blasts 20 - 30 % by WHO can benefit from therapies for ________________ that were approved by USFDA

MYELODYSPASIA

Small, monomorphic

Large, heterogenous

Burkitt-cell type

Minimally differentiated

Without maturation

With maturation

Hypergranular promyelocytic

Myelomonocytic

(a) monoblastic, (b) monocytic

Erythroleukemia

Megakaryoblastic

Undifferentiated blasts, AML-not otherwise categorized

M0 myeloid

Blasts and promyelocytes predominate without further maturation of myeloid cells

M1 myeloid

Myeloid cells demonstrate maturation beyond the blast and promyelocyte stage

M2 myeloid

Promyelocytes predominate in the bone marrow

M3 myelomonocyte

Both myeloid and monocytic cells are present to the extent of at least 20% of the total leukocytes

M4 myelomonoctyic

Most cells are monocytic; two subtypes (a and b) are recognized, one characterized by large blasts in bone marrow and peripheral blood, the other (differentiated type) by monoblasts, promonocytes, and monocytes

M5 monocytic

Also known as Di Guglielmo syndrome; abnormal proliferation of both erythroid and granulocytic precursors; may include abnormal megakaryocytic and monocytic proliferations

M6 erythroleukemia

Large and small megakaryoblasts with a high nuclear- cytoplasmic ratio; pale, agranular cytoplasm

M7 megakaryocytic

One population of cells within the case; small cells predominant; nuclear shape is regular with an occasional cleft; chromatin pattern is homogeneous and nucleoli are rarely visible; cytoplasm is moderately basophilic

L1 homogenous

Large cells with an irregular nuclear shape; clefts in the nucleus are common; one or more large nucleoli are visible; cytoplasm varies in color

L2 heterogenous

Cells are large and homogeneous in size; nuclear shape is round or oval; one to three prominent nucleoli; cytoplasm is deeply basophilic with vacuoles often prominent

L3 Burkitt lymphoma type

Try to familliarize!

There is an increase in both erythroblasts and myeloblasts

Erythroleukemia

They may possibly cause myeloblastic leukemia

M1, M2 or M4

3 sequentially morphological defined phases

Preponderance of abnormal erythroblasts, Erythroleukemia, Myeloblastic leukemia

Erythroleukemia

-This is rare and is characterized by a bone marrow having a predominance of erythroblast -It has three sequentially morphologically defined phases -Anemia is common

-Acute monoblastic leukemia - >80% of the nonerythroid cells in the bone marrow are monocytic -There is extensive infiltration of the gums, CNS, lymph nodes and extramedullary sites

This type of M5 is well differentiated (<80% monoblasts)

M5B

This type of M5 is poorly differentiated (>80% monoblasts)

M5A

M5 is further divided into:

M5A, M5B

-Acute myelomonoblastic leukemia -Both myeloblasts and monoblasts are seen in the bone marrow and peripheral blood -Infiltration of extramedullary sites is more common than with the pure granulocytic variants

-Hypogranular promyelocytic -The bone marrow has > 30% blasts -The WBC count is increased. -Like the M3 type, treatment causes a release of the granules and may send the patient into disseminated intravascular coagulation and subsequent bleeding and -It is characterized by a 15,17 translocation

M3m

M3m is characterized by what?

15,17 chromosomal translocation

M3 is characterized by what?

15,17 chromosomal translocation

M2 is characterized by what?

8,21 chromosomal translocation

What does the treatment of M3 causes?

Treatment causes a release of the granules and may send the patient into disseminated intravascular coagulation and subsequent bleeding

-Hypergranular promyelocytic -This form of AML has a bone marrow with >30% blasts -Is more virulent than other forms -Occurs with a medium age of 39 -The WBC count is decreased -Treatment causes a release of the granules and may send the patient into disseminated intravascular coagulation and subsequent bleeding -It is characterized by a 15,17 chromosomal translocation

-Myeloblastic with maturation -The bone marrow shows 30-89% blasts and > 10% promyelocytes; -This is characterized by an 8,21 chromosomal translocation -This occurs in older adults

- Myeloblastic without maturation - The bone marrow shows >90% blasts and < 10% promyelocytes -The disease occurs in older adults

What are the different classifications of Acute myeloid leukemia ?

M1, M2, M3, M3m, M4, M5, M6, M7

The classification of Acute myeloid leukemia depends on this factors

Bone marrow blast morphology, Degree of cell maturation, Cytochemical stains, Immunophenotyping

What is the other term for Acute myeloid leukemia?

Acute granulocyte leukemia

It is a rare trilineage leukemia

B/T lymphoid/myeloid

Acute leukemias with mixed lineage(binotypic/phenotypes for two different lineages)

B lymphoid/myeloid, T lymphoid/myeloid, B/T lymphoid, Myeloid/Natural killer, B/T lymphoid/myeloid

•It is more common in males •It has a poorer prognosis than any of the B cell ALLs which have a cure rate of 70%

T cell ALL

True/False: If the WBC count is < 10 x 109/L at presentation, the prognosis is good; If the WBC count is > 20 x 109/L at presentation the prognosis is poor.

True

Patients younger then 1 and greater than 13 have a _______________.

poor prognosis

What are the most important prognostic indicators?

Age, WBC counts, Cell type

Clinical findings of ALL

Pancytopenia with resulting fatigue, pallor, fever, weight loss, irritability, anorexia, infection, bleeding, and bone pain.

Where does L2 occurs?

In adults

Absence of any leukemia related signs and symptoms and return of bone marrow and peripheral blood values to within normal value

Complete remission

Infiltration of extramedullary sites are common

Extensive infiltration of the gums, CNS....

Translation(Pre-finals)

MAHATHIR ALPHA · 55問 · 2年前

Translation(Pre-finals)