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Earliest identifiable cell in the bone marrow.
Blast cells
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Which type of leukemia has Auer rods?
AML
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Stains:
Nonspecific esterases
monocytoid
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2 ways to differentiate AML vs. ALL
- Stains
- CD markers and flow
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What type of cell has many nucleoli?
Blasts
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Clinical presentation of AML:
Anemia, Thrombocytopenia, High WBC
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What type of leukemia has larger than normal lymphoblasts?
ALL
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ALL affects:
AML affects:
- ALL = children
- AML = older patients
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Which type of cancer do you need to get a sample of CNS to assess for involvement?
ALL
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Treatment for AML and ALL?
What does ALL require that AML does not?
Treat both with 1) leukophoresis, 2) chemo, 3) Bone marrow transplant
ALL also requires CNS tx or prophylaxis and maintenance thereapy (for 2 years)
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Describe the X shaped pattern for describing blood.
WBC, Hct, platelets
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What type of leukemia have super-segmented neutrohpils, blasts, and lots of basophils in the periphery?
Chronic leukemia
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How do you differentiate between CML and CLL?
- Peripheral Smear
- Flow cytometry
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Which type of leukemia presents with mature myeloid cells on smear with full spectrum of cells in peripheral blood? (including eosinophils and basophils)
CML
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Which type of leukemia presents with fatigue, hypermetabolic symptoms (fever, weight loss), early satiety, splenomegaly or asymptomatic?
CML
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What type of translocation does CML have?
What else does it have?
- 9:22
- Philadelphia chromosome (first chromosomal abnormality clearly linked to development of leukemia)
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How do you treat CML?
- Tyrosine Kinase Inhibitors (imatinib, nilotinib, dasatinib)
- Hydrea, interferon, ara-c
- Bone marrow transplant
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Most common leukemia in the western hemisphere?
CLL
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What type of leukemia has mature lymphoid cells see on peripheral smears?
CLL
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CML affects?
CLL affects?
CML & CLL affect elderly
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What leukemia presents with weight loss/night sweat, lymphadenopathy, splenomegaly or asymptomatically?
CLL (basically both chronic leukemias present with splenomegaly)
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How do you treat CLL?
Do you always treat it?
- Don't always treat CLL because ppl can live a long time with it.
- Treat with: Observation, Steroids, Chemotherapy, Monoclonal Ab therapy (ratuximab= anti-CD20)
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Which leukemia do you treat with monoclonal antibody therapy?
CLL
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Myeloma clinical presentation?
- Asymptomatic
- Anemia
- Renal failure
- Hypercalcemia
- Pathologic fracture/Plasmacytoma
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Difference between Smoldering MM and MM?
Smoldering MM has no symptoms
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Globulin Gap =
GG = Total Protein - Albumin (should be less than 3.5)
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Lots of plasma cells, binucleate plasma cells, rouleaux stacking all point towards?
MM
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Smoldering MM & MM:
M?
PC?
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How do you treat MGUS or Smoldering MM?
Observation
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Tx of MM?
- Chemo
- Steroids
- Radiation tx
- Bone marrow transplant
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How do you diagnose a lump in throat?
Biopsy, use flow and stains to differentiate between certain types of lymphoma
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How do you differentiate NHL vs. HL?
Flow, stains, H&E appearance (Reed-Sternberg cells)
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Reed-Sternberg cells are found in _____ and they are ______.
Hodgekin's Lymphoma, binucleate
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Name 3 B Symptoms
- Fever
- Night sweats
- Weight loss
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Clinical Presentation: Lymphadenopathy, B-symptoms, Pruritis
Hodgekin's Lymphoma
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What do you do after Hodgekin's lymphoma diagnosis?
Staging (CT, PET, Marrow)
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How do you treat HL?
Radiation, Chemo, Combined modality
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2 main stages of NHL?
- Low grade/ indolent
- High grade/ aggressive
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Low grade NHL:
Usually found in?
Lower or higher stage disease?
More or fewer B symptoms
- Old people
- Higher stage disease
- Fewer B-symptoms
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High grade NHL:
Found in?
Lower stage or higher stage?
More or fewer B symptoms?
- Younger patients
- Lower stage
- More B symptoms
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Which grade of NHL do you treat with a curative intent?
High grade
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