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    Leukemia

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    AyeshaArif
    1. Leukemia can be divided into ALL (acute lymphoblastic leukemia, more common in children) and AML (acute myeloid leukemia, more common in adults). Key diagnostic markers and treatments differ between the subtypes. 2. CML (chronic myeloid leukemia) occurs most often in adults and is characterized by the Philadelphia chromosome translocation. Imatinib is the primary treatment. 3. Lymphomas can be Hodgkin's or non-Hodgkin's. Hodgkin's contains Reed-Sternberg cells while non-Hodgkin's is more heterogeneous and can involve extra nodal sites. Staging and treatments vary between subtypes such as follic

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    Leukemia

    Uploaded by

    AyeshaArif
    180 views2 pages
    1. Leukemia can be divided into ALL (acute lymphoblastic leukemia, more common in children) and AML (acute myeloid leukemia, more common in adults). Key diagnostic markers and treatments differ between the subtypes. 2. CML (chronic myeloid leukemia) occurs most often in adults and is characterized by the Philadelphia chromosome translocation. Imatinib is the primary treatment. 3. Lymphomas can be Hodgkin's or non-Hodgkin's. Hodgkin's contains Reed-Sternberg cells while non-Hodgkin's is more heterogeneous and can involve extra nodal sites. Staging and treatments vary between subtypes such as follic

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    USMLE

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    1. Leukemia can be divided into ALL (acute lymphoblastic leukemia, more common in children) and AML (acute myeloid leukemia, more common in adults). Key diagnostic markers and treatments differ between the subtypes. 2. CML (chronic myeloid leukemia) occurs most often in adults and is characterized by the Philadelphia chromosome translocation. Imatinib is the primary treatment. 3. Lymphomas can be Hodgkin's or non-Hodgkin's. Hodgkin's contains Reed-Sternberg cells while non-Hodgkin's is more heterogeneous and can involve extra nodal sites. Staging and treatments vary between subtypes such as follic

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    © All Rights Reserved
    Download as PDF, TXT or read online from Scribd
    Download as pdf or txt
    180 views2 pages

    Leukemia

    Uploaded by

    AyeshaArif
    1. Leukemia can be divided into ALL (acute lymphoblastic leukemia, more common in children) and AML (acute myeloid leukemia, more common in adults). Key diagnostic markers and treatments differ between the subtypes. 2. CML (chronic myeloid leukemia) occurs most often in adults and is characterized by the Philadelphia chromosome translocation. Imatinib is the primary treatment. 3. Lymphomas can be Hodgkin's or non-Hodgkin's. Hodgkin's contains Reed-Sternberg cells while non-Hodgkin's is more heterogeneous and can involve extra nodal sites. Staging and treatments vary between subtypes such as follic

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    of 2

    Phillip Alanis M.D.

    LEUKEMIA
    ALL (agranular) B lymph>>>>T lymph AML (granular)
    General: General:
    MC Leukemia in Kids (0-15), blast crisis- patient will present Ages 15-30, also a blast crisis so patient will present with
    with fever, bone pain, infection, bleeding anemia and infection, similar symptoms as in ALL, however look for DIC, also
    Associated with Downs Syndrome. Can present with associated with Downs. Very high WBC (50,000-100,000)
    mediastinal mass causing SVC-syndrome
    KEYS: KEYS:
    TDT - marker of lymphoblast cytoplasm Myeloperoxidase- we are in myeloid lineage
    CALLA - in cells that are CD10+ (early B-cells) LAP score DECREASED vs. leukemoid rxn
    PAS - this detects polysaccharide, ALL blasts have large t(15;17)-> M3 subtype, if these cells are destroyed the Auer
    vacuoles full of sugars Rods can wreck havoc on the patient leading to DIC

    Rx: Rx:
    Chemo- Doxorubicin-topo II inhibitor (cardio toxicity) Chemo- Doxorubicin-topo II inhibitor (cardio toxicity),
    Has the propensity to hide in the CNS so patients should be treated
    Prednisone and allopurinol due to high incidence of Tumor
    prophylactically with intrathecal MTX (folic acid analog) or Ara-C
    Lysis Syndrome.
    (pyrimidine analog) M3- All-Trans Retinoic Acid
    CML (granular) CLL (agranular) B lymph>>>> T lymph
    General: General:
    Ages 30-50. Patients usually asymptomatic and it is found Old patients >60 yo, Patients are also usually asymptomatic
    incidentally. Peripheral increase of WBCs leading to average survival w/o rx is ~12 years
    hyperviscosity syndrome. May develop blast crisis if it goes Well differentiated with elevated WBC (20,000)
    on years w/o rx Also prone to hyperviscosity syndrome
    KEYS: KEYS:
    Philadelphia Chromosome: t(9;22) translocation leading to Smudge Cell- cytoskeleton of cell is fragile
    over activity of tyrosine kinase (BCR-ABL). CD 19, CD 20, and CD 21 mature B-cell markers
    LAP score DECREASED vs. leukemoid rxn CD 5 unique as this is usually seen in t-cells
    Absolute lymphocyte count > 50
    Diffuse Lymphadenopathy
    Rx: Rx:
    Imatinib- tyrosine kinase inhibitor If old or Donor = No Rx
    If old and symptomatic = Chemo (Chlorambucil alkylation in
    dna)
    If young and donor = BM Transplant
    Phillip Alanis M.D.

    LYMPHOMA B-Symptoms = Fever, night


    sweats and/or wt loss
    Nontender Lymphadenopathy (
    B symptoms)

    Excisional Biopsy

    + RS - RS

    Hodgkins Non-Hodgkins
    Lymphoma Lymphoma

    RS cells have 2 Owls Eyes


    Extra nodal disease more
    Bimodal distribution (15-35 common (Similar to CLL)
    and >55)
    Staging Spreads Non-contiguously
    Associated with EBV
    Possible CD20 +
    Spreads anatomically
    CD 15 x 2 owl eyes= CD 30

    Follicular Lymphoma Burkitts Lymphoma


    I One group of lymph
    Older patient Younger patient
    nodes involved
    BCL-2 C-myc
    II >one group of lymph
    t(14;18) leading to t(8;14)
    nodes involved on
    same side inhibition of apoptosis Starry sky appearance
    III >one group of lymph Associated with EBV
    nodes involved on
    opposite side
    IV Diffuse Disease in
    Hodgkins Lymphoma Non-Hodgkins Lymphoma
    (blood and bone marrow)
    Adriamycin/Doxorubicin Rituximab

    Bleomycin Cyclophosphamide
    A = No B Symptoms
    B = Positive B Symptoms Vinblastine Hydroxydoxorubicin

    Dacarbazine Oncovorin

    Prednisone

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