AML & Myelodysplasia- Krafts Flashcards Preview

IHO WEEK 3 > AML & Myelodysplasia- Krafts > Flashcards

Flashcards in AML & Myelodysplasia- Krafts Deck (31):
1

What is the difference between a leukemia and a lymphoma?

Leukemia- starts in the bone marrow (myeloid or lymphoid)

Lymphoma- starts in the lymph nodes (lymphoid only)

2

How are acute and chronic leukemias different morphologically?

-Acute leukemias have tons of blasts
-chronic leukemias have more mature cells

3

What are acute leukemias?

malignant, monoclonal proliferations of immature myeloid or lymphoid cells in the bone marrow (basically when marrow fills up with malignant blasts)

4

What is "bone marrow failure"? Would you expect RBC, WBC, and platelets to go up or down in the blood?

When malignant cells "fill up" the bone marrow, and don't leave room for normal RBC, WBC and platelets to grow

So their counts will go DOWN in the blood

5

What are some general clinical features of acute leukemias?

Sudden onset (days or weeks)
Fatigues
Tachycardia
Recurrent infections
Excessive bleeding or bruising
Bone pain
Symptoms of extramedullary involvement

6

What percent of blasts are needed in the blood/bone marrow to make the diagnosis of AML?

20%

7

What are two morphologic clues indicating myeloid leukemia?

Dysgranulopoiesis = disordered neutrophil production (hypogranularity or hyposegmentation= one nuclear lobe)

Auer rods= needle-like, eosinophilic inclusions in the cytoplasm

8

What does the MPO stain highlight?

Myeloperoxidase is stain that highlights neutrophils and their precursors

Can indicate myeloblasts

9

What does the NSE stain highlight?

Non-specific esterase

Stain highlights monocytes and their precurosrs

10

What is a common myeloid marker used for immunophenotying?

CD33- virtually all myeloid cells

11

What are cytogenetic studies?

Looking for specific chromosomal abnormality

12

What does abnormality 11q23 indicate for prognosis?

worse prognosis

13

What does abnormality t(8;21) indicate for prognosis?

better prognosis

14

What does abnormality t(15:17) indicate for prognosis?

better prognosis

15

What does abnormality inv(16) indicate for prognosis?

better prognosis

16

What does abnormality AML with FLT3 indicate for prognosis?

worse prognosis

17

AML M0

TON OF MYELOBLASTS
minimal differentiation

-malignant myeloblasts are stuck in such an early stage in development you can't tell if myeloid or lymphoid
-No auer rods, no MPO stain

**need to do immunophenotying to determine

18

AML M1

increased myeloblasts with some differentiation

See some auer rods, and +MPO stain

19

AML M2

Myeloblasts + maturing neutrophils

See Auer rods, +MPO stain, and maturation

20

***AML M3

Increased promyelocytes
usually with t(15;17) translocation
Faggot cells- many auer rods!!

21

t(15;17) translocation

Seen in M3
Abnormal retinoic acid receptors that interferes with maturation of the cells.

Treatement = ATRA (targets messed up receptor) = good prognosis

22

AML M4

Myeloblasts + moncytic cells
Dual lineage
Some have inv(16) = better prognosis

23

AML M5A and M5B

M5A= monoblasts
M5B= promonocytes

24

What does monocytic involvement have an increased incidence of? (M4 and M5)

extramedullary involvement
Common sites are: skin, CNS, gums and testes

25

AML M6

Erythroblasts + myeloblasts

Erythorid precursors may be giant, with blobbed nuclei or multinucleation

26

AML M7

Megakaryocytes

No specific cytochemical stains, have to do flow cytometery

27

What is the most common genetic abnormality in AML?

FLT3 mutation (seen in 1/3 of cases)

most cases have monocytic component

Mutation indicates increases relapse rate and shortened survival

Poor prognosis

28

AML with multi-lineage dysplasia?

At least 20% blasts
Dysplasia in at least two myeloid cell lines
Overall prognosis is poor

29

Common patient presentation with multi-lineage dysplasia?

ELDERLY!
Severe pancytopenia

30

What two classes of chemotherapy usually cause AML or myleodysplastic syndrome?

Alkylating agents
Topo II inhibitors

31

What is myelodysplastic syndrome?

abnormal stem cells, dysmelopoiesis

may evolve into acute leukemia