Page 397 - Clinical Hematology_ Theory _ Procedures ( PDFDrive )

21 Acute Leukemias

CHAPTER

KEY TERMS

Auer rods erythroleukem ia microRNA

azurophilic granules French-Am erican-British (FAB) next generation sequencing
blasts classi cation relapse

chlorom a leukostasis stem cells
cytogenetic analysis m egakaryoblastic leukem ia World Health Organization (WHO)

LEARNING OUTCOMES

General characteristics of acute leukemias Discuss treatment options and strategies in AML, including induc-

■ Name three examples of conditions that are considered to be tion and consolidation therapy.

genetic lesions. De ne and describe characteristics of a relapse.

■ Describe the fundamental characteristics of blood and bone marrow ■ Discuss the purpose, advantages, and concerns related to alloge-

cells in acute leukemias. neic hematopoietic-cell transplantation.

■ List and describe basic characteristics of classi cations recognized Summarize various types of new therapies in AML.

by the French-American-British (FAB) and World Health Organization Acute lymphoblastic leukemia

(WHO) systems.

■ Discuss general prognostic factors and the importance of moni- ■ Discuss the epidemiology of acute lymphoblastic leukemia (ALL) in

toring minimal residual disease on the survival of acute leukemia the United States.

patients. ■ Summarize the pathogenesis of ALL.
■ Name and brie y describe the FAB classi cation of ALL.
Acute myeloid leukemias Using FAB and WHO criteria, describe subtypes of B lineage, early B

■ Discuss the concept of clonal heterogeneity in acute myeloid leu- precursors, “common” CALLA (CD10) positive, pre-B, T-cell lineage,
,
,
,
kemia (AML). and early T precursor (pro-T pre-T cortical-T medullary-T) and pre-
■ Coordinate factors related to epidemiology and long-term survival cursor lymphoid neoplasms
of AML patients. List cytogenetic and molecular abnormalities commonly associated

Discuss the importance of cytogenetic and molecular analysis to with the major acute leukemic subtypes.

identi cation and treatment of AML. ■ Describe the clinical symptoms, laboratory ndings, and special

Describe the 2016 World Health Organization classi cation revi- identi cation techniques in ALL.

sions related to AML. ■ Summarize treatment strategies and prognosis in ALL.

Interpret ndings from immunophenotypic, cytogenetic, and molecu- Life-threatening emergencies

lar ndings, and apply to criteria used by WHO.

■ Discuss factors associated with the prognosis in AML. ■ Name and describe ve life-threatening emergencies.

■ Explain the importance of microRNAs. Future trends

■ Describe the utility of monoclonal antibodies in differentiating ■ Discuss future trends in the treatment of leukemia.
between various leukemias.

■ Explain the chromosomal alterations that may be observed in vari- Case studies
ous AML. Analyze the patient history, clinical signs and symptoms, and labo-

■ Summarize and apply the diagnostic blood and bone marrow labora- ratory data for the stated case studies, answer the related critical
tory ndings of each of the AML subgroups. thinking questions, and conclude the most likely diagnosis.

De ne the reactivity of leukemic cells with various cytochemical

stains: Sudan black B stain, myeloperoxidase (MPO), and the peri- NOTE:

odic acid–Schiff test. indicates MLT and MLS core content

Compare the two common esterase procedures in terms of their ■
indicates MLT (optional) and MLS advanced content
purposes.

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