Rapid Review Heme/Onc

>20% blasts

Acute leukemia

Auer rods

AML

Treatment for ALL within CNS

Intrathecal methotrexate

Smudge cell (abundant)Suspect CLL

Bcl2
HTLV-1
Cyclin D1

Blocks apoptosis - overexpressed in Follicular

Lymphoma
Virus associated with Adult T-cell Lymphoma
Mantle Cell Lymphoma

Itching after hot shower

Polycythemia vera
Teardrop cell
Seen in myelofibrosis fibrotic obliteration of BM
Dzs assoc w/ EBV
Burkitt lymphoma, Hodgkins lymphoma
popcorn nuclei

Nodular lymphocyte predominant Hodgkin lymphoma

MPO

AML

TRAP

Hairy cell leukemia

Enlarged, painless rubbery LN

Lymphoma, chronic inflammation

B symptoms (list 3)

Drenching night sweats, fever, >10% weight lo

Important testing in lymphomas? Immunohistochemistry, flow cytometry

Cerebriform nuclei are seen in:

Sezary syndrome

Hyperviscosity
Retic count <2%

P. vera, Waldenstrom (due to large IgM

pentamers)

ATRA = Tx for:

Marrow/production problem

Cladribine

APML (promyelocytic)

Pautrier microabscesses

Treats Hairy Cell Lymphoma

Site of B cell somatic

hypermutation

Mycosis Fungoides

CALLA+
DIC upon treatment of:
punched out lesions on x-ray

Germinal Center (LN)

ALL
AML due to Auer rods
Multiple myeloma

Identify the cell and its associated cancer:

REED STERNBERG
CELL
HODGKINs
LYMPHOMA

CYTOGENETICS REVIEW
t(14;18)

Follicular cell lymphoma

t(9;22)

Philadelphia chromosome CML

t(8;21)

AML favorable prognosis

t(8;14)

Burkitt Lymphoma

t(15;17)

Acute Promyelocytic Leukemia (M3)

t(11;14)

Mantle Cell Lymphoma

t(2;5)

Anaplastic Large Cell Lymphoma (T cell)

Deletion 13q14 Most common karyotype abnormality in CLL

JAK2 kinase

Mutated in myeloproliferative disorders (except CML)

T(12;21)

B-ALL

MARKERS
CD20

Expressed on all B cells pan B cell

CD15, CD30

Hodgkins Lymphoma

CD3

Expressed on all T cells pan T cell

Kappa/lambda

Light chains of plasma cells

CD34

Hematopoietic Stem Cell

Is CD20 seen in Hodgkins

Lymphoma?

NO

CD38, CD138

Plasma cells

CD4

Marker for T cell lymphoma

TdT

B-ALL and T-ALL

CD2-8

T-ALL

CD10, CD19, CD20

B-ALL

TREATMENT
ALL induction?

Daunorubicin, vincristine, prednisone, asparaginase, CNS ppx

ALL CNS ppx?

Intrathecal methotrexate

ALL consolidation? CNS ppx, cyclophosphamide, vincristine, asparaginase, cytarabine, 6-MP

ALL maintenance? CNS ppx, prednisone, vincristine, 6-MP, weekly oral methotrexate
Methotrexate MOA? Inhibits dihydrofolate reductase
Incorporates itself into DNA and inhibits DNA synthesis apop
6-MP MOA?
Anthracycline MOA? Inhibit topoisomerase II DNA damage apop
Depolymerizes microtubules and destroys mitotic spindles
Vincristine MOA?
7+3
AML consolidation?
SE high dose ara-c?
ABVD
SE: cardiomyopathy
SE: pulmonary fibrosis
SE: neurotoxicity:
R-CHOP

AML induction tx: ara-c (cytarabine), 7 days + daunorubicin, 3 days

6 doses high dose ara-c over 6 days, 2-4 courses roughly 4-6 wks apart

Cerebellar toxicity, conjuncitivitis

Hodgkins tx: adriamycin, bleomycin, vinblastine, dacarbazine
Doxorubicin
Bleomycin
Vinblastine, vincristine
Diffuse Large B Cell Lymphoma Tx: Rituxan, Cyclophosphamide,
Hydroxydoxorubicin, Oncovin (vincristine), Prednisone

CELL TYPES

platelets
basophil
monocyte
lymphocytes

atypical lymphocyte
lymphocyte

segmented neutrophil

eosinophil