leukemia types

Question 1

What portion of leukemias does AML represent?

Answer 1

Represents 1/3 of all leukemias and 80% of acute leukemias in adults

Question 2

What happens in AML pathophysiology?

Answer 2

Uncontrolled proliferation of myeloblasts, hyperplasia of bone marrow; leukemic myeloblasts replace normal hematopoietic cells

Question 3

What is the onset of AML like?

Answer 3

Abrupt and dramatic

Question 4

What are common early complications in AML?

Answer 4

Serious infections and abnormal bleeding

Question 5

What symptoms bring AML patients in?

Answer 5

Easy bruising and getting sick frequently

Question 6

AML Risk Factors?

Answer 6

Age, Men > women, prior cancer treatment, high radiation exposure, chemical exposure, smoking, history of blood disorders, genetic disorders

Question 7

If leukemia type is unspecified in a question, which type should you assume?

Answer 7

ALL — assume a child

Question 8

ALL is the most common leukemia in which population?

Answer 8

Children

Question 9

What percent of adult acute leukemias are ALL?

Answer 9

0.2

Question 10

ALL pathophysiology?

Answer 10

Proliferation of immature small lymphocytes (mostly B-cell origin) in bone marrow

Question 11

What symptom is present in most ALL patients at diagnosis?

Answer 11

Fever

Question 12

What brings pediatric ALL patients in?

Answer 12

Fatigue, tired all the time, not playing normally; fever of unknown cause

Question 13

Symptom onset?

Answer 13

Quick and abrupt

Question 14

ALL clinical manifestations?

Answer 14

Bleeding, fever, progressive weakness, fatigue, bone/joint pain, petechiae, CNS infiltration(common)

Question 15

What causes CML?

Answer 15

Excessive development of neoplastic granulocytes in bone marrow

Question 16

Where do granulocytes go in CML?

Answer 16

Into blood in large numbers → infiltrate spleen and liver

Question 17

Describe disease progression in CML.

Answer 17

Long chronic stable phase (5–6 years), then blastic (acute) phase

Question 18

Symptoms in early CML?

Answer 18

None

Question 19

CML clinical manifestations?

Answer 19

Fatigue, weakness, fever, night sweats, sternal tenderness, weight loss, joint pain, bone pain, splenomegaly

Question 20

What chromosome abnormality is associated with CML?

Answer 20

Philadelphia Chromosome

Question 21

What creates the Philadelphia chromosome?

Answer 21

Translocation between BCR gene (chromosome 22) and ABL gene (chromosome 9) → BCR-ABL gene

Question 22

What does the BCR-ABL protein do?

Answer 22

Interferes with normal cell cycle regulation leading to uncontrolled proliferation

Question 23

How common is the Philadelphia chromosome in CML?

Answer 23

98% of patients (but can also be in ALL, sometimes AML)

Question 24

What occurs in CLL pathophysiology?

Answer 24

Production & accumulation of long-lived mature-appearing lymphocytes

Question 25

Where do lymphocytes infiltrate?

Answer 25

Liver, spleen, bone marrow

Question 26

CLL is the most common leukemia in which population?

Answer 26

Adults

Question 27

Age and gender trends in CLL?

Answer 27

Increased incidence after age 72, more common in males

Question 28

Are symptoms always present in CLL?

Answer 28

Frequently no symptoms

Question 29

Early manifestations of CLL?

Answer 29

Chronic fatigue, anorexia, splenomegaly, lymphadenopathy, hepatomegaly

Question 30

Progressive symptoms?

Answer 30

Fever, night sweats, weight loss, fatigue, frequent infections (common in all leukemias)