Leukemia

Front 1

Malignant neoplasms of the hematopoietic stem cells with diffuse replacement of bone marrow.

Back 1

Leukemia

Front 2

4 main types of leukemia

Back 2

✔Acute lymphoblastic(lymphocytic)leukemia (ALL)

✔Acute myeloid(myelogenous) leukemia (AML)

✔Chronic lymphocytic leukemia (CLL)

✔Chronic myeloid (myelogenous) leukemia(CML)

Front 3

This involves immature lymphocytes and their progenitors that originate in the bone marrow but infiltrate the spleen, lymphnodes, CNS and other tissues.

Back 3

Lymphocytic leukemia

Front 4

This involves the pluripotent myeloid stem cells in bone marrow and interfere with the maturation of all blood cells, including the granulocytes, erythrocyters and thrombocytes.

Back 4

Myelogenous leukemia

Front 5

This tyoe has greater that 20%blast cell in the bone marrow, and blast cell “crowds out” that leads to inhibition of production of other blood cell.

Back 5

Acute leukemia

Front 6

This type of acute leukemia is the build up of lymphoid blast cells.

Back 6

Acute lymphoblastic (lymphocytic) leukemia (ALL)

Front 7

This type of acute leukemia is the build up of myeloid blast cells.

Back 7

Acute myeloid (myelogenous) leukemia (AML)

Front 8

A condition ij which there is an abnormal build up of blast which is below 20 %. Also, means "bad formation of bone marrow"

Back 8

Myelodysplastic syndrome

Front 9

It is a DNA polymerase that is present only in the nucleus of lymphoblast, not in the lymphoblast or more mature cells or more mature cells and not in myeloblast

Back 9

TDT- Terminal deoxynucleotidyl transferase

Front 10

TRUE OR FALSE. Lymphoblast has positive nuclear staining or TdT’s in the cell nucleus

Back 10

True

Front 11

Enzyme in myeloblasts

Back 11

Myeloperoxidase

Front 12

A crystalized version of myeloperoxidase that can be seen in cytoplasmic staining.

Back 12

Auer rods

Front 13

It is a malignant disease of the bone marrow in which early lymphoid precursors proliferate and replace the normal hematopoetic cell of the marrow.

Back 13

Acute lymphoblastic leukemia

Front 14

Most common type of cancer of leukemia in children.

Back 14

Acute lymphoblastic leukemia

Front 15

It is resistant to therapy, heamatopoietic stem cell

Back 15

Preleukemic clone

Front 16

Etiology of acute lymphoblastic leukemia

Back 16

It is concluded that the B-cell precursor ALL has a multifactorial etiology, with 2 step process of genetic mutation and exposure to infection playing a prominent role

1.) first step occurs in utero, when fusion gene formation or hyperdiploidy generates a covert, preleukemic clone

2.) second step is the post natal acquisition of secondary genetic changes that drive the conversion to overt leukemia.

Front 17

Subtypes of acute lymphoblastic leukemia

Back 17

B Acute lymphoblastic leukemia

T Acute lymphoblastic leukemia

Front 18

It is commonly seen and has specific markers C10, C19 and C20

Back 18

B Acute lymphoblastic leukemia

Front 19

Tx for B Acute lymphoblastic leukemia

Back 19

Chemotherapy

Front 20

Etiology of subtype B ALL

Back 20

Translocation of chromosome 12 and 21 t(12;21) happens on children

Front 21

A t( 9;22) or sometimes called __________ seen more in adults.

Back 21

Philadelphia chromosome

Front 22

A subtype of ALL in which its surface markers range from CD2 to CD8. It has present thymic mass in the mediastinum that happens on teenagers

Back 22

T Acute lymphoblastic leukemia

Front 23

It is called acute lymphoblastic lymphoma

Back 23

T Acute lymphoblastic leukemia

Front 24

Leukemia vs. Lymphoma

Back 24

In leukemia, malignant cell float around in the blood, in lymphoma malignant cell forms into mass.

Front 25

Pathophysiolgy of ALL

Back 25

Front 26

Risk factors of ALL

Back 26

✔Male✔Being white✔Previous chemotherapy treatment✔Exposure to radiation

Front 27

Symptoms of acute lymphoblastic leukemia

Back 27

✔Weakness or feeling tired✔Fever✔Easy bruising or bleeding✔Bleeding under the skin✔Shortness of breath✔Weight loss or loss of appetite✔Pain the bones or stomach✔Pain or Feeling of fullness below the ribs✔Painless lumps in the neck, underarm, stomach or groin

Front 28

Tx for acute lymphoblastic leukemia

Back 28

✅Chemotherapy✅Radiation therapy✅Stem cell transplants✅Targeted therapy – does not harm normal effect

Front 29

It is a malignant disease of the bone marrow in which hematopoietic precursors are arrested in an early stage of development.

Back 29

Acute myeloid (myelogenous) leukemia (AML)

Front 30

Other terms for Acute myeloid leukemia

Back 30

acute myelocytic leukemia, acute granulocytic leukemia, acute non-lymphocytic leukemia.

Front 31

Most common acute leukemia in adults. (50-60yrs. old)

Back 31

Acute myeloid (myelogenous) leukemia (AML)

Hint 31

This type of cancer usually gets worse quickly if not treated.

Front 32

Etiology of AML

Back 32

Antecedent hematologic disorders

Familial syndromes

Environmental exposures

Drug exposure

Hint 32

Germline mutation gene AML1 (RUNX1, CBFA2) moderate cytopenia, autosomal dominant disorder

Front 33

Subclassification of AML

Back 33

Cytogenetic abnormalities

Lineage of myeloblast

Surface markers

Front 34

Important subtype of cytogenic abnormality

Back 34

Acute promyelocytic leukemia

Front 35

It is characterized by translocation of chromosomes 15 and 17 or t(15;17)

Back 35

Acute promyelocytic leukemia

Front 36

TRUE OR FALSE. The translocation of chromosomes 15 and 17 ends up disrupting the retinoic acid receptor which alters the ability of the cell to mature leading to build up of promyelocytes.

Back 36

True

Front 37

Lineage of myeloblast

Back 37

⚪Erythroblast AML

⚪Megakaryoblast AML

-build up of megakaryoblast-No myeloperoxidase

-There’s an association with down syndrome before the age of five

⚪Monoblast AML – or the Acute Monocytic Leukemia

-Monoblast build up and these lack myeloperoxidase

-it is now observed infiltration of patients gums.

-Classic sign.

Front 38

It is a derivative of vitamin A that binds to the disrupted retinoic acid receptor and causes the blast to mature into neutrophils which eventually go on to die but it does lessen the leukemic burden since there isn’t as many blasts floating around.

Back 38

All-trans-retinoic acid (ATRA)

Front 39

A cancer of the leukocytes, wherein there is a lot of partially developed white blood cell in the blood for a very long period of time.

Back 39

Chronic leukemia

Front 40

Characteristic of chronic leukemia

Back 40

Normal cells are being “crowded out”

Front 41

Most common cause of chronic leukemia

Back 41

chromosomal abnormalities in hematopoietic stem cell that are destined to become leukocytes.

Eg.

Chromosomal deletion, trisomy, translocation.

Front 42

A type of chronic leukemia in which the cells divide too quickly, and usually happens on middle aged or older.

Back 42

Chronic myeloid (myelogenous) leukemia (CML)

Hint 42

The only known risk is exposure to high levels or radiation.

Front 43

Phases of chronic myeloid leukemia

Back 43

✔Chronic phase

– earliest stage, easiest to treat, has no symptoms

✔Accelerated phase

– Increase in abnormal blood cells.

- Symptoms: feeling tired, fever, bruises, night sweats, short of breath, lose of some weight, loss of appetite, pain or swelling on the left side of abdomen (enlargement of spleen), pain of bones.

✔Blastic phase

– leukemia cell multiply .

- Symptoms: infection, bleeding, skin changes including bumps and tumors, swollen glands, bone pain.

Front 44

Treatment for chronic myeloid leukemia

Back 44

Tyrosine kinase inhibitors – slows down the rate by which the body makes leukemia

Front 45

Pathophysiology of chronic myeloid leukemia

Back 45

Front 46

It is a cancer that affects the lymphocyte in which the cells don’t die as they should

Back 46

Chronic lymphocytic leukemia (CLL)

Hint 46

- Common in adults.

- The cause is most likely mutation also however specidic chromosome is unknown

Front 47

Pathophysiology of chronic lymphocytic leukemia

Back 47

Front 48

Tx for chronic lymphocytic anemia

Back 48

✔For detection: Aspiration and Biopsy is performed:

⚫Aspiration – thin, hollow needle is inserted into the bone ( hip) to take small amount of liquid marrow.

⚫Biopsy – uses slightly larger needle to remove a small amount of bone, marrow, and blood.

✔Chemotherapy

✔Immunotherapy

✔Target therapy

✔Radiation therapy

✔Surgery

✔Leukapheresis

✔Stem cell transplants

Front 49

Symptoms of chronic leukemia

Back 49

✔In CML, hepatosplenomegaly

- Feeling of fullness

✔In CLL, lymphadenopathy

- Pain in the lymph node

Front 50

Diagnosis for chronic leukemia

Back 50

✔Starts with blood smear

⚫In CML – increase granulocytes and monocytes

⚫In CLL – smudge cells- immature b cell that are brocken in the smear.

✔Genetic testing could be done to look for Philadelphia gene