Term
| Ddx leukoerythroblastosis (3) |
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Definition
Marrow stress
Myelophthisis = met. tumor or granuloma
MPDs esp. CIM |
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Term
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Definition
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Term
| Characteristics of MPDs (3) |
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Definition
Proliferation
Hypercellular BM
Pancytosis |
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Term
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Definition
Splenomegaly
Absolute basophilia
Inc. serum B12 |
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Term
| MPDs must be distinguished from... |
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Definition
| Benign cell proliferations |
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Term
| CML: age range, symptoms (3) |
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Definition
25-60
Anemia, fatigue, weakness
Anorexia, weight loss
Ab pain from splenomegaly |
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Term
| CML labs: WBC, RBC, plt, BM |
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Definition
WBC >50,000
RBC mild anemia
Plt elevated
BM 100% cellular w/ myelopoiesis dominating |
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Term
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Definition
Myeloid precursors
Absolute basophilia |
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Term
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Definition
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Term
| CML: cytogenetics, prognosis, tx |
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Definition
t(9;22) BCR/ABL tyrosine kinase
Blast crisis 3-5 years
BM transplant, imatinib/Gleevec |
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Term
| CIM: age range, symptoms (2) |
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Definition
Older folks
Anemia
Splenomegaly from myeloid metaplasia |
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Term
| CIM labs: WBC, RBC, plt, BM |
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Definition
WBC elevated but <25,000
RBC anemia
Plt nl/elevated
BM hypercellular w/ fibrosis and megakaryocyte clusters |
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Term
| CIM morphology: WBC, RBC, plt |
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Definition
Leukoerythroblastosis
RBC tear-drop cells
Plt large, hypogranular |
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Term
| CIM: cytogenetics, prognosis, tx |
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Definition
JAK2 mutation
5-10 years, most will gradually replace BM w/ fibrosis, die of BM failure = anemia, hemorrhage, infection
Some will have blast crisis
Tx: none |
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Term
| PV: age range, symptoms (6) |
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Definition
Older folks
HTN, dizziness, cyanosis, ab pain
Thrombosis, hemorrhage |
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Term
| PV labs: WBC, RBC, plt, BM |
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Definition
WBC mildly elevated
Hct >55%
Plt nl/elevated
BM: panmyelosis |
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Term
| PV: EPO, cytogenetics, prognosis, tx |
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Definition
EPO decreased from negative feedback
JAK2 mutation
10-15 years, most enter "spent phase"
Some will have blast crisis
Tx: decrease RBC mass |
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Term
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Definition
Relative: dehydration, spurious
Absolute: primary (PV), secondary |
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Term
| Ddx secondary absolute polycythemia |
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Definition
Appropriate: high altitude, Hb-opathies, cardio-pulm disease
Inappropriate: renal cyst, neoplasms, paraneoplastic syndrome |
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Term
| EPO levels in secondary absolute polycythemia are... |
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Definition
| Increased either appropriately or inappropriately |
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Term
| Essential thrombocytopenia: age range, symptoms |
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Definition
Least common
Older folks
Thrombosis, hemorrhage |
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Term
| Essential thrombocytopenia labs: WBC, RBC, plt, BM |
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Definition
WBC nl/elevated
RBC anemia
plt >450,000
BM hypercellular w/ inc. megakaryocytes |
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Term
| ET morphology: plt, megakaryocytes |
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Definition
Plt nl or large and/or hypogranulalr
Megakaryocytes may be in clusters, may be large w/ immature nuclei |
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Term
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Definition
ET, other MPD
Chronic inflamm
TB
Neoplasms |
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Term
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Definition
Anemia, fatigue, DOE
Recurrent infections
Inc. bruising/bleeding
Hepatosplenomegaly rare! |
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Term
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Definition
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Term
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Definition
RA
RARS
Refractory cytopenia w/ multilineage dysplasia
Refractory anemia w/ excess blasts 1
RAEB2
C-myelomonocytic-L |
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Term
| Characteristics of MDSes (3) |
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Definition
Hypercellular marrow
Dyspoiesis
Intramedullary cell death, cytopenias |
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Term
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Definition
| Earliest myeloid progenitor |
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Term
| MDS erythroid morphology: peripheral, BM |
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Definition
Macro-ovalocytic anemia, basophilic stippling
Megaloblastic appearance w/ nuclear-cytoplasmic dys-synchrony, multi-nucleation, nuclear fragmentation
Maybe ringed sideroblasts |
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Term
| MDS leukocytic morphology: peripheral, BM |
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Definition
Pseudo-pelger-Huet neutrophils, abnl/immature monocytes, blasts
BM same + hypogranulation |
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Term
| MDS megakaryocytic morphology: peripheral, BM |
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Definition
Large, hypogranular plt
Dec. #s, separate/individual nuclei or non-lobated, microkaryocytes |
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Term
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Definition
| Partial or total chromosomal deletions |
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Term
| Refractory anemia characteristics |
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Definition
<15% ringed sideroblasts
Erythroid dysplasia only
<5% BM blasts
<1% peripheral blasts |
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Term
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Definition
>15% ringed sideroblasts
Erythroid dysplasia only
<5% BM blasts
<1% peripheral blasts |
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Term
| Refractory cytopenia w/ multilineage dysplasia characteristics |
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Definition
<15% ringed sideroblasts
Dysplasia in 2 or more cell lines
<5% BM blasts
<1% peripheral blasts |
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Term
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Definition
5-9% BM blasts
<5% peripheral blasts |
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Term
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Definition
10-19% BM blasts
5-19% peripheral blasts
Can have Auer rods |
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Term
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Definition
5-20% BM blasts
<5% peripheral blasts
>1000 monocytes |
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Term
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Definition
RA/RARS have better prognosis
RAEB1/2 have the worst
Tx: none, will die due to complications of BM failure |
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Term
| Characteristics of acute leukemias (2) |
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Definition
>20% blasts
Little/no maturation |
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Term
| Acute leukemias: age range, symptoms |
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Definition
ALLs usually in kids
AMLs usually in older adults
Anemia, recurrent infections, bleeding issues, local symptoms/signs |
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Term
| Acute leukemia general blast morphology |
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Definition
High nucleus:cytoplasm, fine chromatin
No granules
Auer rod indicates AML |
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Term
| Acute leukemia cytochemical stains (4) |
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Definition
Sudan: my/mono primary granule membrane
Myeloperoxidase: my/mono primary granule content
Specific esterase: myeloid enzymes
Non-specific esterase: monocytic enzymes |
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Term
| Acute leukemia myeloid cell markers (4) |
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Definition
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Term
| Acute leukemia pre-B cell markers (4) |
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Definition
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Term
| Acute leukemia T-cell markers (3) |
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Definition
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Term
| Acute leukemia B-cell markers (4) |
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Definition
19, 20
10
Monoclonal surface Ig |
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Term
| AML 4 major classifications |
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Definition
Recurrent genetic abnormalities
Multilineage dysplasia
Therapy related
Other |
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Term
| AML t(8;21): age range, morphology, genes, prognosis |
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Definition
Younger
Maturation + Auer rods
AML1/ETO: inactivation of former stops WBC maturation
Good |
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Term
| AML t(16;16) or inv(16): age range, morphology, genetics, prognosis |
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Definition
Younger
Maturation, abnormal eosinophils and precursors
CBFB/MYHII: inactivation of the former stops WBC maturation
Better |
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Term
| AML t(15;17): age range, morphology, genetics, prognosis, tx |
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Definition
Middle-aged
Kidney-bean nucleus, hypergranular, multiple Auer rods
PML/RARa:latter can't receive vitA to stimulate WBC maturation
Prognosis: at risk for thrombosis/DIC
Tx: vitA |
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Term
| AML t(9;11) or t(11;19): morphology, genetics, prognosis |
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Definition
Monocytic differentiation, can have neutrophilic as well
MLL rearrangement
Intermediate |
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Term
| AML with multilineage dysplasia: age range, morphology, prognosis |
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Definition
Older folks
Dysplasia in >50% of BM in 2 or more cell lines
Poor |
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Term
| AML, MDS tx related: etiology, morphology, prognosis |
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Definition
Topo w/in 12-130 mo, alkylating w/in 5-6 yrs
Dysplasia in all 3 cell lines
Poor |
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Term
| AML minimally differentiated: morphology, cytochemistry, immunophenotyping |
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Definition
No Auer rods
Neg. cytochemistry stains
Pos. myeloid markers |
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Term
| AML w/o maturation: morphology |
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Definition
| <10% myeloid maturation, Auer rods |
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Term
| AML w/ maturation: age range, morphology, prognosis |
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Definition
Younger folks
>10% myeloid maturation, Auer rods
Better |
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Term
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Definition
| >20% but <80% MM differentiation |
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Term
| Acute monoblastic, acute monocytic leukemia: morphology, other findings |
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Definition
>80% monoblastic/monocytic differentiation
Tissue infiltration esp. gingival hypertrophy |
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Term
| Acute erythroid leukemia: morphology, prognosis |
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Definition
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Term
| Acute megakaryoblastic leukemia: morphology, other findings |
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Definition
Megakaryoblasts, abnormal megakaryocytes
Associated w/ fibrosis |
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Term
| ALL B lymphoblastic: morphology, prognosis |
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Definition
Homogenous small blasts w/ minimal cytoplasm, immature chromatin, no nucleoli
OR heterogenous somewhat larger blasts w/ moderate cytoplasm, 1-2 nucleoli
Good if hyperdiploid, poor with hypodiploid and most translocations |
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Term
| ALL T lymphoblastic: morphology, prognosis |
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Definition
Homogenous small blasts w/ minimal cytoplasm, immature chromatin, no nucleoli
OR heterogenous somewhat larger blasts w/ moderate cytoplasm, 1-2 nucleoli
High risk |
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