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Hematology Exam 3 > Acute Leukemia > Flashcards

Flashcards in Acute Leukemia Deck (12)
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1
Q

What illnesses go on to develop Acute Leukemia?

A

Genetic abnormalities: Trisomy 21, Fanconi’s Anemia, Klinefelters, Turners
Benign conditions: Paroxysmal Nocturnal Hemoglobinuria, Aplastic anemia
Malignant conditions: Myelodysplastic syndrome, Myeloproliferative syndrome

2
Q

What exposures lead to acute leukemia?

A

Chemicals: benzene
Radiation therapy, radiation
Tobacco
Chemotherapy: alkylating agents

3
Q

What is the presentation of Leukemia?

A

Fatigue, pallor, weakness, bone pain, fever/infection, Petechiae, ecchymoses, infiltration of skin, Sweet’s syndrome
Retinal hemorrhage, CNS symptoms, Wet purpura, gum infiltration, Joint issues, NO ORGANOMEGALY in AML

4
Q

which of the acute leukemias do you treat differently?

A

Acute Progranulocytic Leukemia

M3

5
Q

Where do you see Auer Rods?

A

AML, Myeloperoxidase inclusions
aka leukemia cutis - sores on the skin
Gingival infiltration -

6
Q

What is unique about APL?

A

result of translocation t15:17
Tx: All trans Retinoic acid (ATRA) - it is a maturation agent
all get 7+3 induction also
Arsenic trioxide

APL differention syndrome: edema, Pleural effusion, lung probs
DIC

7
Q

what are complications of bone marrow exam?

A

bleeding - controlled by pressure,
Infection
sternal aspiration - bad

8
Q

What is the tx for AML?

A

need to anialate the marrow
Cytarabine for 7 days, then 3 days of anthracyclines
follow with consolidation chemo
allogenic stem cell transplant for high risk
add imatinib if tyrosine kinase +
IF not able to do the 7 + 3 (age >60 yrs)
supprortive,
high dose cytarabine
FLAG
Gentuzumab/azacitadine
make sure EF is >40% b4 adding drugs

AML Induction support
Irradiate all blood products
platelet infusion
abx prophylactic, anti emetics

9
Q

What is the tx for AML?

A

need to anialate the marrow
Cytarabine for 7 days, then 3 days of anthracyclines
follow with consolidation chemo
allogenic stem cell transplant for high risk
add imatinib if tyrosine kinase +

IF not able to do the 7 + 3 (age >60 yrs)
supprortive, 
high dose cytarabine
FLAG
Gentuzumab/azacitadine
make sure EF is >40% b4 adding drugs
AML Induction support
Irradiate all blood products
platelet infusion
abx prophylactic, anti emetics, PICC line, WBC growth factors (G-CSF), HEPA rooms (pressure higher in room - flow out), no raw fruits and veggies, no sick visitors
allopurinol, alkalinize, 
menorhaggia: progesterone
10
Q

What is the prognosis for acute leukemia?

A

w/ tx 50% cured

>5% die in 50 days under 50 as complication of tx

11
Q

What is ALL?

A

Median age 14
Lymphoid
Chromosome structual abnormalities in kids more than adults
Molecular markers: MDR gene, Notch-1 mut, Glutathione s transferase, thymidylate synthase genotype

B or T?

If over 35 not good. B cell >30K not good, T cell >100k not good, time to remission >4 wks not good, drug resistance not good

Tx;
induction: CHemo adults
allogenic peripheral blood stem cell tranx for adults

Maintenance: forever
POMP

12
Q

CML

A

Presentation: easy bleed, fatigue, fever, infections
Lot of mature WBC in marrow,
Philadelphia chromosome 9:22, BCR-ABL
Tx: Imatinib