Acute Myelogenous Leukemia (AML) Quiz
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Questions and Answers

What is the most common malignancy in children under the age of 15 in the United States?

  • Lymphoma
  • Acute Myelogenous Leukemia (AML)
  • Chronic Lymphocytic Leukemia (CLL)
  • Acute Lymphoblastic Leukemia (ALL) (correct)

    • Which of the following is a poor prognostic indicator for Acute Lymphoblastic Leukemia (ALL)?

  • WBC <50/mm3
  • Age 5
  • CNS involvement
  • Age 9 (correct)

    • What is the primary treatment for Acute Promyelocytic Leukemia (APL)?

  • All-trans retinoic acid (ATRA) with concurrent chemotherapy (correct)
  • Surgery
  • Radiation therapy
  • Very high-dose chemotherapy with bone marrow transplantation

    • What is a common symptom of Acute Lymphoblastic Leukemia (ALL)?

    <p>Anemia and associated symptoms</p> Signup and view all the answers

    Which of the following is associated with an increased risk for CNS involvement in Acute Lymphoblastic Leukemia (ALL)?

    <p>All of the above</p> Signup and view all the answers

    What is a characteristic of Acute Myelogenous Leukemia (AML)?

    <p>Neoplasm of myelogenous progenitor cells</p> Signup and view all the answers

    What is a common feature of Acute Myeloid Leukemia (AML)?

    <p>Pancytopenia</p> Signup and view all the answers

    Which of the following is a risk factor for Acute Myelogenous Leukemia (AML)?

    <p>Exposure to radiation</p> Signup and view all the answers

    What is the typical age range of patients with Chronic Myeloid Leukemia (CML)?

    <p>Older than 40 years of age</p> Signup and view all the answers

    What is the primary goal of chemotherapy in treating Chronic Lymphocytic Leukemia (CLL)?

    <p>To provide symptomatic relief and reduce infection</p> Signup and view all the answers

    What is the characteristic of the peripheral blood smear in CLL diagnosis?

    <p>Presence of smudge cells</p> Signup and view all the answers

    What is the term for the 'fragile' leukemic cells that are broken when placed on a glass slide?

    <p>Smudge cells</p> Signup and view all the answers

    What is the usual course of Chronic Lymphocytic Leukemia (CLL)?

    <p>Chronic and indolent</p> Signup and view all the answers

    What is the significance of the presence of anemia or thrombocytopenia in CLL patients?

    <p>It is a bad prognostic indicator</p> Signup and view all the answers

    What is the term for the clonal proliferation of myeloid stem cells?

    <p>Chronic Myeloid Leukemia (CML)</p> Signup and view all the answers

    What is the typical outcome of the disease course in CML patients?

    <p>Acute phase (blast crisis)</p> Signup and view all the answers

    What is the characteristic age distribution of Hodgkin's Lymphoma?

    <p>Bi-modal age distribution, peaking at 15-30 and &gt;50 years</p> Signup and view all the answers

    What is the percentage of Lymphocyte predominance in Hodgkin's Lymphoma?

    <p>5%</p> Signup and view all the answers

    Which of the following tests is used to determine the extent of disease spread and patient's response to treatment?

    <p>Computed Tomography (CT) scan</p> Signup and view all the answers

    What is the 5-year survival rate for indolent forms of NHL?

    <p>75%</p> Signup and view all the answers

    What is the treatment approach for intermediate and high-grade NHLs?

    <p>Aggressive combination chemotherapy and radiation therapy</p> Signup and view all the answers

    Which of the following is an indication for liver involvement in Hodgkin's Lymphoma?

    <p>Elevated bilirubin</p> Signup and view all the answers

    What is the purpose of serum LDH and b2 microglobulin in Hodgkin's Lymphoma diagnosis?

    <p>As indirect indicators of tumor burden</p> Signup and view all the answers

    What is the minimum duration of lymph node enlargement that should be biopsied?

    <p>4 weeks</p> Signup and view all the answers

    Study Notes

    Acute Myelogenous Leukemia (AML)

    • AML is a neoplasm of myelogenous progenitor cells
    • Accounts for 80% of adult acute leukemias
    • Risk factors: exposure to radiation, myeloproliferative syndromes, Down's syndrome, and chemotherapy (e.g., alkylating agents)
    • Response to therapy is not as favorable as in acute lymphoblastic leukemia
    • Acute promyelocytic leukemia (APL) is a variant of AML, characterized by t(15;17), often presents with pancytopenia
    • Treatment: all-trans retinoic acid (ATRA) without delay, along with concurrent chemotherapy once the diagnosis is confirmed

    Acute Lymphoblastic Leukemia (ALL)

    • ALL is a neoplasm of early lymphocytic precursors
    • Histology reveals a predominance of lymphoblasts
    • Most common malignancy in children under 15 in the United States
    • Most responsive to therapy
    • Poor prognostic indicators: age > 9, WBC > 105/mm3, CNS involvement
    • Clinical features:
      • Anemia and associated symptoms
      • Increased risk of bacterial infections due to neutropenia
      • Abnormal mucosal or cutaneous bleeding due to thrombocytopenia
      • Splenomegaly, hepatomegaly, lymphadenopathy
      • Bone and joint pain due to invasion of periosteum
      • CNS involvement, diffuse or focal neurologic dysfunction
      • Testicular involvement, anterior mediastinal mass (T-cell ALL)
      • Skin nodules (AML)

    Chronic Lymphocytic Leukemia (CLL)

    • CLL is a neoplasm of mature B cells
    • Indolent NHL B-cell neoplasm, small lymphocytic leukemia
    • Clinical features:
      • Usually asymptomatic at time of diagnosis
      • Generalized painless lymphadenopathy, splenomegaly
      • Frequent respiratory or skin infections due to immune deficiency
      • Fatigue, weight loss, pallor, skin rashes, easy bruising, bone tenderness, and/or abdominal pain in advanced disease
    • Diagnosis:
      • Laboratory findings: CBC, WBC: 50,000 to 200,000, anemia, thrombocytopenia, and neutropenia are common
      • Peripheral blood smear: absolute lymphocytosis, presence of smudge cells
      • Flow cytometry of peripheral blood: clonal population of B cells
      • Bone marrow biopsy: presence of infiltrating leukemic cells in bone marrow
    • Treatment:
      • Chemotherapy has little effect on overall survival, but is given for symptomatic relief and reduction of infection
      • Patients are often observed until symptoms develop
      • Prognosis is variable depending on the number of lymph node sites involved and the presence or absence of anemia/thrombocytopenia

    Chronic Myeloid Leukemia (CML)

    • Neoplastic, clonal proliferation of myeloid stem cells
    • Patients are usually older than 40 years of age
    • CML follows an indolent course for many years before it transforms to acute leukemia
    • The end point of the disease course is usually an acute phase (or blast crisis), which is an accelerated phase of blast and promyelocyte production

    Hodgkin's Lymphoma

    • Bimodal age distribution: 15-30 years of age and >50 years of age
    • Lymph node histology divides the disease into four subtypes:
      • Lymphocyte predominance, nodular sclerosis, mixed cellularity, and lymphocyte depletion
    • Diagnosis:
      • Biopsy of lymph node or other affected tissue
      • CXR: may reveal hilar or mediastinal adenopathy
      • CT scan: to determine extent of disease spread and patient's response to treatment
      • Serum LDH and b2 microglobulin are indirect indicators of tumor burden
      • Other tests: alkaline phosphatase, liver function tests, bilirubin, CBC, serum electrolytes, and renal function tests
      • Bone marrow biopsy
    • Treatment:
      • Varies depending on the stage and subtype of NHL
      • Indolent forms of NHL are not curable, but have a 5-year survival rate of 75%
      • Intermediate and high-grade NHLs may be curable with aggressive treatments

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    Test your knowledge on acute myelogenous leukemia, a type of cancer that affects the blood and bone marrow. Learn about its risk factors, response to therapy, and variants like acute promyelocytic leukemia.

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