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Leukemia - Coggle Diagram

- - - - Peripheral Smear
        
        Auer Rod
        
        fused lysosomes, granules
      - Histochemical Staining
        
        Myeloperoxidase Stain Positive
        
        primary granules and Auer rods and is lineage specific for myeloid differentiation
        
        Sudan Black Stain
        
        Stains phospholipids and lipoprotein complexes
        
        Combined esterase stain positive
        
        Granulocytes stain red
        Monocytes stain black
    - - CD13, CD33, myeloperoxidase
    - - Supportive Therapy: Blood Transfusions, antibiotics, hydration
      - Specific: Multi-agent Chemotherapy
        
        Steps
        
        Induction:
        Rapidly Kill all leukemia Cells
        
        Consolidation: Eliminate hidden leukemic cell population
      - Stem Cell: Allogenic from donors
  - - - Periodic acid-schiff stain
        
        Lymphoblasts stain
        Carbohydrates Stain
      - Terminal deoxynucleotidyl transfer stain
        
        Positive in lymphoblasts not myeloblasts
    - - B cell: CD19, CD22, CD10
      - T Cell: CD7, CD3
    - - More likely to have adenopathy
      - More likely to have CNS involvement
    - - Favourable
        
        WBC <50, 1<age<10
        
        trisonomy 4, 10
        t (12;21)
        high hyperdiploid
      - Unfavourable
        
        WBC >50
        Age >10, <1
        T Cell
        CNS Disease
        
        t-cell
        BCR-ABL-t(9;22)
        involvement of 11q23
        Hypodiploid
    - - Induction,consolidation, maintenance chemotherapy
      - Tyrosine kinase inhibitor
      - CNS Prophylaxis
      - Allogenic Stem cells
  - - - Typically t(15;17) abnormality
      - Most curable
    - - Non-traditional chemotherapy: Arsenic, ATRA
- - - - Clonal expasion of mature-looking, functionally defective lymphocytes
    - - High WBC, Unremarkable Physical Exam
      - Symptoms
        
        Weight loss
        Fevers and sweats
        Recurrent Infections
      - Signs
        
        Lymhadenopathy
        Hepatomegaly
        Splenomegaly
    - - Lymphocytosis: Smudge Cells
        Bone Marrow Failure: Pancytopenia
        Hypogammaglobinemia
    - - CBC: High Lymphocytes
        Typical Morphology
        Flow Cytometry: CD5, CD23, CD19 and 20, Light chain restriction
    - - More mutated is better
        FISH: 17q, 11p, 12q trisomy, 13q deletions
    - - No Therapy if asymptomatic
      - If symptomatic (Cytopenia, symptomatic lymphadenopathy, reccurent infections, richter's transformation)
        Chemotherapy