Leukemia Classification
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Leukemia Classification

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Questions and Answers

What is the result of leukemic blasts building up in the bone marrow?

  • Suppression of the development of healthy blood cells (correct)
  • Production of healthy blood cells is stimulated
  • Immature blast cells differentiate into healthy blood cells
  • Bone marrow function is enhanced

    • What is the term for a low number of healthy red blood cells, white blood cells, and platelets?

  • Pancytopenia (correct)
  • Thrombocytopenia
  • Neutropenia
  • Anemia

    • What is the term for small, red spots on the skin due to bleeding under the skin?

  • Purpura
  • Echymosis
  • Petechiae (correct)
  • Bruise

    • What is the term for a low number of platelets in the blood?

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

    What is the result of a DNA mutation in myeloid stem cells?

    <p>Immature blast cells are stuck in the earliest stages of cell development</p> Signup and view all the answers

    What is the term for a low number of white blood cells in the blood?

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

    What is the term for cancer that arises from prior myeloproliferative disorder or myelodysplastic syndrome?

    <p>Secondary AML</p> Signup and view all the answers

    What is the term for a rod-like structure found in leukemic blasts in AML?

    <p>Auer rod</p> Signup and view all the answers

    What can the accumulation of leukemic cells in peripheral blood and lymphoid organs lead to?

    <p>Anemia, thrombocytopenia, leukopenia, and organomegaly</p> Signup and view all the answers

    What is a common symptom experienced by adults with leukemia?

    <p>Shortness of breath</p> Signup and view all the answers

    What is the purpose of a comprehensive metabolic panel in the diagnosis of leukemia?

    <p>To evaluate electrolyte and acid-base status</p> Signup and view all the answers

    What is the role of immunophenotyping in the diagnosis of leukemia?

    <p>To detect certain proteins on a cell's surface</p> Signup and view all the answers

    What is the primary goal of therapy in the management of leukemia?

    <p>To initiate treatment based on the leukemia subtype and patient factors</p> Signup and view all the answers

    What is the purpose of a hematopoietic stem cell transplant in the treatment of leukemia?

    <p>To administer healthy hematopoietic stem cells to patients with dysfunctional or depleted bone marrow</p> Signup and view all the answers

    Which of the following is a characteristic of acute leukemias?

    <p>They require frequent monitoring of vitals and assessment for opportunistic infections</p> Signup and view all the answers

    What is the role of fluorescence in situ hybridization (FISH) in the diagnosis of leukemia?

    <p>To detect certain abnormal changes in chromosomes and genes</p> Signup and view all the answers

    Where do leukemias start in the body?

    <p>Blood-forming tissue, the bone marrow</p> Signup and view all the answers

    What is the main characteristic of acute leukemias in terms of cell maturity?

    <p>Cells are generally immature, poorly differentiated, and abnormal</p> Signup and view all the answers

    What is the result of malignant transformation of pluripotent hematopoietic stem cells in the body?

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

    What is the effect of blasts on normal blood cells in acute leukemias?

    <p>They replace and interfere with their development and function</p> Signup and view all the answers

    What is the main characteristic of chronic leukemias in terms of cell maturity?

    <p>Cells are partially mature and do not function effectively</p> Signup and view all the answers

    What is the role of blood stem cells in the body?

    <p>They are constantly dividing and changing into different types of blood cells</p> Signup and view all the answers

    What is the result of clonal expansion and proliferation of blasts in acute leukemias?

    <p>Replacement and interference with the development and function of normal blood cells</p> Signup and view all the answers

    What is the term for the abnormal leukocytes that can either be lymphoblasts or myeloblasts in acute leukemias?

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

    Study Notes

    Leukemia

    • Leukemias are cancers of blood cells that start in the blood-forming tissue, the bone marrow.
    • They can be classified as acute or chronic based on the rapidity of proliferation and myeloid or lymphoid based on the cell of origin.

    Main Subtypes

    • Acute Myeloid Leukemia (AML)
    • Acute Lymphoblastic Leukemia (ALL)
    • Chronic Myeloid Leukemia (CML)
    • Chronic Lymphocytic Leukemia (CLL)

    Acute Vs. Chronic Leukemias

    • Acute leukemias: rapid onset, immature blast cells, and poor prognosis.
    • Chronic leukemias: slow onset, partially mature cells, and relatively better prognosis.

    Etiology

    • Ionizing radiation
    • Benzene exposure (particularly AML)
    • Previous exposure to chemotherapy
    • A history of any hematologic malignancy
    • Viral infections (e.g., human T-cell leukemia virus, Epstein-Barr virus) (particularly ALL)
    • Several genetic syndromes (e.g., Down syndrome, Fanconi anemia, Bloom syndrome)

    Pathophysiology

    • Leukemia occurs due to the malignant transformation of pluripotent hematopoietic stem cells.
    • In acute leukemias, immature blast cells undergo clonal expansion and proliferation, leading to replacement and interference with normal blood cells.
    • In chronic leukemias, partially mature cells do not function effectively and divide too quickly.

    Signs and Symptoms

    • Anemia: fatigue, weakness, shortness of breath, dizziness or faintness
    • Neutropenia: frequent infections, fever
    • Thrombocytopenia: bruising easily, petechiae, prolonged bleeding from minor cuts
    • General Symptoms: loss of appetite, unexplained weight loss, discomfort in bones or joints, fullness or swelling in the abdomen

    Histology

    • Auer rods (AML)

    Classification - AML

    • Based on the etiology of the AML, it can be categorized into:
      • De novo AML
      • Secondary AML (s-AML), which evolves from prior MPD or MDS

    Clinical Presentation

    • Increased risk of infection and fever
    • Lethargy
    • Anemia-related symptoms
    • Symptoms related to thrombocytopenia

    Diagnosis

    • CBC
    • Comprehensive metabolic panel
    • Coagulation panel
    • Peripheral blood smear evaluation
    • Bone marrow biopsy and aspiration
    • Cell Examination:
      • Immunophenotyping (Flow Cytometry)
      • Cytogenetic Analysis (Karyotyping)
      • Fluorescence In Situ Hybridization (FISH)
      • Molecular (Biomarker) testing

    Management

    • Patients with leukemia should be referred to a hematologist-oncologist to initiate treatment.
    • Therapy varies significantly based on the leukemia subtype and patient factors.
    • Acute leukemias are treated predominantly as an in-patient needing significant support and frequent monitoring.
    • Hematopoietic stem cell transplant (HPSCT) or bone marrow transplant is a treatment option.

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    Description

    Learn about the different types of leukemia, including acute and chronic forms, and their classification based on cell origin and proliferation rate.

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