BCB Lecture 7 Adult 11/02/26

Adult ALL cases and deaths

6250 cases/1450 deaths

What percent of ALL cases occur in adults

40%

What type of cells are involved in ALL in adults

mostly B-cell (70%)

Treatment of adult ALL

Chemo them stem cell transplant

Survival rate of adult ALL

80-90%

What number of ALL deaths are adults

4 out of 5

Risks of adult ALL

exposure, radiation, chemical, viral (HTLV, EBV)

What commonly is found in genome of ALL cases

DNA translocations

Symptoms of adult ALL

• Tired

• weak

• dizzy

• fever

• infections

• bruising

• bleeding

• enlarged spleen/thymus

Types of adult ALL

Pre-B cell

Common ALL

Mature B-cell

Pre-t cell

Maure t-cell

Rates of each type of adult ALL

Pre-B cell- 20%

Common ALL- 50%

Mature B-cell- 5%

Pre-t cell- 10%

Maure t-cell- 15%

Variables that affect ALL prognosis

younger>older

T cell>B cell

Treatment of ALL in adults and side effect

2 years of chemo leads to treatment-induced AML

Adult AML cases vs deaths

20830 cases/10460 deaths

Adult AML case number to mortality rate

high number of cases with high mortality

How to treat adult AML

chemo then stem cell transplant

Survival rate of adult AML

65%

Exposures that can lead to adult AML

smoking, chemo, benzene

Genes associated with adult AML

3 ONCOGENES:

Receptors: FLT3, c-KIT

Signalling- RAS

Concern with treatment of AML

GvHD- donor cells attack recipient because recipient is foreign to donor cells

CLL cases and deaths

14620/4650

Who is primarily affected by CLL

elderly

Treatment of CLL

chemo, monoclonal antibodies like rituximab and alemtuzumab, and leukapheresis

Leukapheresis

filter out WBCs and return RBCs and platelets

CLL survival rate with leukapheresis

80%

CML cases and deaths

6660 cases/1140 deaths

What causes CML

Philadelphia chromosome- breaks and fusion between chr 9 and chr 22 BCR-ABL

What is ABL

kinase

What is the function of BCL in BCR-ABL

allows BCR-ABLs to dimerize and activate

Progression of CML

Chronic < Accelerated < Blast Phases

What drug treats CML

gleevec (ABL inhibitor) for life

Survival rate of CML with gleevec

90% survival

Symptom of CML

fullness in the belly

Cases vs deaths of hodgkin lymphoma in adults

9050 cases/1150 deaths

Ages of hodgkin lymphoma in adults

15-40 yrs

Survival rate of hodgkin lymphoma in adults

85%

Diagnosis of hodgkin lymphoma in adults

lymph node biopsy

Treatment of hodgkin lymphoma in adults

chemo, radiation, antibodies (anti-CD30 or anti-CD20)

What percent of adult non-hodgkin lymphomas are b cell

85%

Three types of cells in non hodgkin b-cell lymphoma

• Anaplastic large cell

• Follicular

• Hairy cell

Cases and deaths of adult non-hodgkin lymphoma

71850 cases/19790 deaths

Ages of adult non-hodgkin lymphoma

older than 66

Percent survival of adult non-hodgkin lymphoma

75% of 30%

Diagnosis of adult non-hodgkin lymphoma

lymph node biopsy

Treatment of adult non-hodgkin lymphoma

chemo, radiation, antibodies (anti-CD30 or anti-CD20)

What is this cancer

Non-hodgkin lymphoma with anaplastic large cell (atypical shape)

What is this cancer

Non-hodgkin lymphoma with follicular cells

What is this cancer

Non-hodgkin lymphoma with hairy cells

Bloom syndrome frequency in which population

1/50,000 Ashkenazi jewish

Bloom syndrome gene and inheritance

BLM mutations (bloom helicase unwinds DNA in replication) and autosomal recessive

Result of bloom syndrome

multiple cancers

Werner’s syndrome frequency in USA and Japan

1/200,000 in USA

1/20,000 in Japan

Werner’s gene and inheritance pattern

WRN gene mutations and autosomal recessive

Result of Werner’s synfrome

Progeria (premature aging) and multiple rare cancers

Ataxia telangiectasia frequency

1/100,000 worldwide

Ataxia telangiectasia gene involved and inheritance

ATM gene mutations and autosomal recessive

What does Ataxia telangiectasia cause

chronic infections and leukemias

Xeroderma pigmentosum frequency and where

1/1,000,000 in Japan, Northern Africa, Middle East

Presentation of Xeroderma pigmentosum

dry skin and freckling

Cancer result of Xeroderma pigmentosum

skin cancer by age 10

Genes involved in Xeroderma pigmentosum

genes involved in DNA replication- XPC/ERXX2 or POLH gene mutations >50%

Inheritance pattern of Xeroderma pigmentosum

Autosomal recessive