Leukemias (Introduction, AML, ALL)

Is acute or chronic leukemia more common in adults?

chronic

If the peripheral smear shows a increased blast population, is this characteristic of a chronic or acute leukemia?

Acute

If the peripheral smear shows a increased WBC with the population being mostly more mature cells, is this characteristic of a chronic or acute leukemia?

chronic

true or false: Leukemic cells themselves are harmful

False! Leukemic cells are abnormal and don't work, the crowding out of other healthy cells is dangerous

Which leukemia is most prominent in children?

ALL

How can low cell counts cause death? ( In terms of red cells and normal WBC)

Low red cells= low oxygen carrying capacity

Low WBC= low ability to fight infections

Why can we see lymphadenopathy and/or hepatosplenomegaly in some cases of leukemia?

Leukemic cells spill over into lymph nodes, spleen and liver; they lodge and proliferate in these spots

___% blasts in either BM or PB is diagnostic for AML

20

Acute Myeloblastic leukemias are M?-M?

M0-M2

Acute Promyelocytic Leukemias are M?

M3

Acute Myelomonocytic Leukemias are M?

M4 ( M4 and M4Eo)

Acute Monocytic Leukemias are M?

M5 (M5a and M5b)

Acute Erythroid Leukemia is M?

M6

Acute Megakaryoblastic Leukemia is M?

M7

This type of AML has very immature blasts that cannot be differentiated by morphology or staining, there are no auer rods or granules present. CD markers are 33, 13, 117

M0

This type of AML has blasts that are still very early, but can be stained and differentiated. We can start to see auer rods and granules in this AML. CD markers are 33, 13, 117

M1

This AML is the most common AML. We can start to see pros and other more mature cells at this stage ( at least 10%). MPO and SBB are positive. CD markers are 22, 13, 117

M2

This AML we see heavy granulated pros with lots of cytoplasm. The patient can have high incidence of DIC. Translocation 15;17 is common in patients with this type of AML. CD markers are 33,13 no HLA-DR blast markers

M3

In this AML, bilobed nuclei are prominent. We see pros, but they appear to have no granules. Because of this, cells can look monocytic.

M3m

In this AML, we see monocytic and myelocytic cells. Stains show MPO, SBB, AS WELL AS NSE positive. CD markers are 14, 64,4 11b, 11c

M4

This AML is known for clinical presentation of gingival hypertrophy/ skin and gum involvement, because the type of WBC clone can get into tissues. There are two variants, where the "a" subtype has monoblastic cell populations and where "b subtype displays monocytic populations. NSE stain is a strong postive

M5 ( M5a and M5b)

This type of AML has presence of abnormal myeloid and erythroid precursors. PAS is positive in erythroid cells. Erythroid precursors can have weird multinucleation and vaculoles

M6

This type of AML has a blast population that is 50% megakaryocytic lineage. It is PAS positive and MPO and SBB negative

M7

what is TdT stain?

Stains DNA enzymes that are present in all stages of lymphocytes

This type of acute lymphoblastic leukemia has cells that have barely any cytoplasm, are small to intermediately sized, has a round nucleus and not a whole lot of nucleoli

L1

This type of ALL has cells that have very small amounts of cytoplasm, have distinct and centrally located nucleoli, the nucleus can be clefting or indented

L2

This type of ALL displays cells that have multiple vacuoles and very blue-purple cytoplasm

L3

L3 ALL is also known as _____ lymphoma

Burkitts

How can you tell L1 cells from L2 cells?

Nucleoli and cytoplasm (none in L1)

L3 ALL/ Burkitts lymphoma is a mature ______ cell ALL

mature B cell ALL

In Burkitts Lymphoma, there is a mature B cell proliferative disorder. If this is a mature cell, why do L3 cells look like blasts?

This cell is abnormal in nature, it phenotypes as a mature cell with its markers( CD19, 20, HLA-DR), but ultimately still looks like a blast

What virus is associated with L3 ALL?

EBV

What translocations are common is L3 ALL?

(8;14. 2;8. 8;22

Auer rods are only present in ______ lineage

myelocytic

Why in chronic leukemia can we see more mature cells?

this is chronic, so disease has time to progress over time