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Questions and Answers
What percent of blasts is required for a WHO diagnosis of acute leukemia?
What percent of blasts is required for a WHO diagnosis of acute leukemia?
- 30%
- 20% (correct)
- 10%
- 40%
Which of the following are categories of Acute Myeloid Leukemia (AML) according to WHO? (Select all that apply)
Which of the following are categories of Acute Myeloid Leukemia (AML) according to WHO? (Select all that apply)
- AML with no known origin
- AML with recurrent abnormal karyotypes (correct)
- Therapy-related AML (correct)
- AML with myelodysplasia related features (correct)
What three abnormal karyotypes are included within the WHO #1 category of AML?
What three abnormal karyotypes are included within the WHO #1 category of AML?
- t(15;17) (correct)
- t(16;16) (correct)
- t(8;21) (correct)
- t(9;22)
What does t(8;21) cause?
What does t(8;21) cause?
Are Auer rods seen in t(8;21)?
Are Auer rods seen in t(8;21)?
T(16;16) causes an increase in which cells?
T(16;16) causes an increase in which cells?
What does t(15;17) cause?
What does t(15;17) cause?
Detection of various cytogenic abnormalities in AML has ____________________ implications.
Detection of various cytogenic abnormalities in AML has ____________________ implications.
AML with myelodysplasia-related features evolves from previously documented ______________________ syndrome.
AML with myelodysplasia-related features evolves from previously documented ______________________ syndrome.
Myelodysplastic syndrome is characterized by __________________ bone marrow.
Myelodysplastic syndrome is characterized by __________________ bone marrow.
Cytopenia in the peripheral blood indicates what?
Cytopenia in the peripheral blood indicates what?
What are the 5 types of AML with myelodysplasia-related features according to FAB?
What are the 5 types of AML with myelodysplasia-related features according to FAB?
What are the three types of myelodysplastic syndromes?
What are the three types of myelodysplastic syndromes?
Which of the following is not a classification of myelodysplastic syndromes according to WHO?
Which of the following is not a classification of myelodysplastic syndromes according to WHO?
Refractory cytopenia with multilineage dysplasia has one or more ___________________ and dysplasia in two or more ______________ cell lines.
Refractory cytopenia with multilineage dysplasia has one or more ___________________ and dysplasia in two or more ______________ cell lines.
What is the percentage of blasts in the bone marrow of refractory anemia with excess type 1 blasts?
What is the percentage of blasts in the bone marrow of refractory anemia with excess type 1 blasts?
What is the number of blasts in the bone marrow of refractory anemia with excess type 2 blasts?
What is the number of blasts in the bone marrow of refractory anemia with excess type 2 blasts?
What dysplastic changes can occur in AML with MDS features?
What dysplastic changes can occur in AML with MDS features?
What can cause AML due to therapy-related myelodysplasias?
What can cause AML due to therapy-related myelodysplasias?
Acute leukemias of ambiguous lineage demonstrate cells from which cell lines?
Acute leukemias of ambiguous lineage demonstrate cells from which cell lines?
Bilineage acute leukemia express which antigens?
Bilineage acute leukemia express which antigens?
Biphenotypic acute leukemias express which antigens?
Biphenotypic acute leukemias express which antigens?
How are antigens categorized?
How are antigens categorized?
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Study Notes
WHO Classification of Acute Leukemia
- Diagnosis of acute leukemia requires at least 20% blasts in the bone marrow.
- Acute Myeloid Leukemia (AML) is categorized by the WHO into four groups:
- AML with recurrent abnormal karyotypes.
- AML with myelodysplasia-related features.
- Therapies-related AML from previous myelodysplastic syndromes.
- AML not categorized, including acute leukemias of ambiguous lineage.
Abnormal Karyotypes in AML
- The three notable aberrations in the first category of AML:
- t(8;21): Leads to increased proliferation and blocked differentiation along with the presence of Auer rods.
- t(16;16): Results in an increase of myeloid and monocytic cells.
- t(15;17): Characterized as Acute Promyelocytic Leukemia.
Clinical Features and Implications
- Detection of cytogenetic abnormalities in AML provides prognostic insights.
- AML with myelodysplasia-related features evolves from myelodysplastic syndromes, characterized by hypercellular bone marrow and peripheral blood cytopenias indicating marrow cell death.
Myelodysplastic Syndromes (MDS)
- MDS types include:
- Primary (de novo)
- Therapy-related
- Hereditary
- WHO classification of MDS comprises:
- Refractory cytopenia with unilineage dysplasia.
- Refractory anemia with ringed sideroblasts.
- Refractory cytopenia with multilineage dysplasia.
- Various forms of refractory anemia exhibiting excess blasts.
Specific MDS Characteristics
- Refractory cytopenia with multilineage dysplasia involves cytopenias and dysplasia in multiple myeloid lineages.
- Refractory anemia with excess blasts shows 5-9% blasts in type 1, whereas type 2 indicates 10-19% blasts.
Dysplastic Changes and Causes
- Dysplastic changes in AML featuring MDS may include:
- Hypogranular segmented cells.
- Hyposegmented nuclei in segments.
- Megaloblastic red blood cells and small megakaryocytes.
- Myelodysplasias leading to AML may be caused by exposure to alkylating agents or radiation therapy.
Acute Leukemias of Ambiguous Lineage
- These leukemias demonstrate characteristics of both myeloid and lymphoid lineages.
- Bilineage acute leukemia expresses either myeloid or lymphoid antigens, while biphenotypic acute leukemias express both.
Antigen Categorization
- Antigens associated with leukemias are categorized using flow cytometry techniques.
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