Oncology - Leukemias

*Leukemias

  • 2 classes with their own subtypes from different WCC cell lines and acute vs chronic
    --> A / C = Acute vs. chronic
    --> LL = lymphoid leukemias
    --> ML = myeloid leukemias

Acute and Chronic Lymphoid lines

  • ALL and CLL --> ALL LYMPH...
  • "CALLIN ALL Hairy, CLLassy Ladies"

Acute and Chronic Myeloid line

  • AML and CML -->
  • "All MY LITTLE AUERS... CMute by BKR-ABL"
  • "ALL MY LITTLE AUERS are GROWN UP up to ages 9 and 22 in PHILLY... they are imiginative and BIKE READY and ABLe"
    --> BCR-ABL on Philadelphia chromosome T(9,22)


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Myeloid Leukemias

  • M = Myelogenious
  • "ALL MY LITTLE AUERS are GROWN UP up to ages 9 and 22 in PHILLY... they are imiginative and BIKE READY and ABLe"
  • "ARE GROWN UP" (older adults only)
    --> AML = All My Little AUERS
    --> CML
    --> both adults

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AML = Acute Myelogenious Leukemia

  • Auer rods present
    • Vit. A treatment

Clinical Cases

APL = Acute promyelocytic Leukemia

Notes:

  • APL have translocation mutation at chromosome 14 and 15
    --> t(14,15)
  • APL has unique AUER rods in the cytoplasm of promyelocytes of blood smears that also have large folded nuclei

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Clinical Case

Notes:

  • note that

Clinical Case

CML = Chronic Myelogenious Leukemia

  • Philadelphia chromosome t(9,22)
    • genes BCR - ABL
    • imatinib tyrosine kinase inhibitor

"ALL MY LITTLE AUERS are ALL GROWN UP...
growing up in PHILI at ages 9 and 22...
they were IMAGINATIVE and BIKE READY and ABLe"

  • ALL MY LITTLE AUERS = AML / myeloid leukemias are called myelogenious
    --> either acute or chronic
    --> Auer = Auer rods in acute AML
    --> Vit. A responsive = retinoic acid
  • ages 9 and 22 PHILI = translocation at 9 and 22 for CML
    --> Philadelphia Chromosome
  • BIKE READY and ABLe = genes in Phili are BCR-ABL
    --> 9 = BCR
    --> 22 = ABL
  • IMAGINATIVE = Imatinib is Tyrosine Kinase inhibitor for Philadelphia BCR-ABL

Lymphoid Leukemias

  • "Long LYMPH ALL Hairy, CLLassy Ladies"

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"Long LYMPH ALL Hairy Berry, CLLassy Ladies"

  • LYMPH Ladies = lymphoid leukemias
  • ALL = Acute lymphoblastic leukemia
    --> spreads to ALL your manhood = brain (CNS) and testes
    --> check for in ALL Down's Syndrome
  • Hairy Berry = Hairy Cell leukemia
    --> Hairy B cells
  • CLLassy Ladies = Chronic lymphocytic leukemia
    --> CLL = crushed little lymphocytes = smudge cells
    --> think chronic pressure --> crushes them

*Bone Marrow Transplants

Clinical Cases

Bone Marrow Transplantation
(for Leukemia)

Notes:

  • note that bone marrow transplant may be one of the only reasons where you could get a different karyotype for a peripheral blood karyotype
  • as long as the HLA = human Leukocyte Antigens are the same for the recipient and the donor, the karyotype can be completely different

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Clinical Case

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Clinical Case

Notes:

  • note that

Clinical Case