16 Acute Leukemia
hallmark: increased WBC count in peripheral blood
lymphoma: increased WBC in lymph nodes
Classification
malignancy from myeloblasts: AML
progenitor cells become malignant and overproduces: myeloproliferative
red cell: polycythemia
granulocytes: CML, leukemia since WBC
platelets: thrombocytosis
CLL: more mature lymphocytes
ALL
nonspecific symptoms, just don't feel well and feel sick
bone pain: marrow expanding, filling up with blasts
organs enlarge: blasts leak out of marrow and fill up organs
large cells with large nucleus
understand development to understand special tests. Know markers
CD10, 19, 20, 21: B cell
TdT: developing cell
T lower number
B ALL
usually pre B
CD 10: CALLA, found on blasts in ALL
sanctuary sites: special treatment
ALL uncommon in adults, and worse outcome
12:21, common in children, thus good prognosis
trisomy 21
translocation less frequent in down syndrome
T ALL
older kids
thymus: where T develop
thymus usually involved and enlarged: widened mediastinal mass
tracheal obstruction: difficulty breathing
AML
gums: classic presentation of thrombocytopenia
see few RBC, platelets
blasts are myeloblasts: no lymphoblast surface antigens
MPO stain positive
if MPO from auer rods spill into blood, cause DIC
APML
high frequency of DIC
pts often thrombocytopenic from leukemia. If DIC occurs, can get very sick
suspect APML if blasts in periphery and DIC on presentation
MDS
minor versions of AML
no high number of blasts, not leukemia
symptoms of pancytopenia
blasts less than 20% in bone marrow
sideroblasts often seen in bone marrow biopsy
cancer treated with chemo
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