Leukemia - Revision history

Mark: further tidy

2018-05-26T20:06:18Z

further tidy

← Older revision		Revision as of 20:06, 26 May 2018
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	*Lymphoma = discrete mass(es), usu. [[lymph node]].		*Lymphoma = discrete mass(es), usu. [[lymph node]].
	**Classic presentation: non-tender lymph nodes		**Classic presentation: non-tender lymph nodes

			Leukemias may present as discrete massess, e.g. in the skin ([[leukemia cutis]]) or at other sites, where it is known by various names ([[myeloid sarcoma]], chloroma, etc.).

	Most leukemias are typically classified into acute or chronic. As a general rule, the designation of '''acute''' signifies a more immature and aggressive phenotype, whilst '''[[chronic]]''' leukemias generally show a more differentiated phenotype and run a more indolent course. There are exceptions, of course, and some chronic leukemias may transform into acute lymphomas.		Most leukemias are typically classified into acute or chronic. As a general rule, the designation of '''acute''' signifies a more immature and aggressive phenotype, whilst '''[[chronic]]''' leukemias generally show a more differentiated phenotype and run a more indolent course. There are exceptions, of course, and some chronic leukemias may transform into acute lymphomas.
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	=Leukemia classification=		=Leukemia classification=
	*[[Acute myeloid leukemia]] (AML):		*[[Acute myeloid leukemia]] (AML). In this context, myeloid is used broadly to refer to non-lymphoid precursors rather than the more limited meaning granulopoietic:
	*#AML.		*#AML.
	*#AML with recurrent cytogenetic abnormalities, e.g.		*#AML with recurrent cytogenetic abnormalities, e.g. t(8;21), inv(16) and t(15;17).
	**#t(8;21).
	**#inv(16).
	**#t(15;17).
	*#AML arising from [[MDS]].		*#AML arising from [[MDS]].
	*#AML in the setting of [[Down syndrome]].		*#AML in the setting of [[Down syndrome]].
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	*#T cell (sometimes abbreviated to T-ALL)		*#T cell (sometimes abbreviated to T-ALL)

	*T-ALL should not to be confused with [[adult T-cell leukemia/lymphoma]] (ATLL)		*T-ALL should not to be confused with [[adult T-cell leukemia/lymphoma]] (ATLL) - this is associated with HTLV-1 infection

	*[[Chronic lymphocytic leukemia]] (CLL) - usually classified with lymphomas		*[[Chronic lymphocytic leukemia]] (CLL) - usually classified with lymphomas
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	A few fall under the umbrella of '''[[myeloproliferative neoplasm]]s''':		A few fall under the umbrella of '''[[myeloproliferative neoplasm]]s''':
	*[[Chronic myeloid leukemia]] (CML)		*[[Chronic myeloid leukemia]] (CML)
	*[[Chronic neutrophilic leukemia]]		*[[Chronic neutrophilic leukemia]] (rare)
	*[[Chronic eosinophilic leukemia]]		*[[Chronic eosinophilic leukemia]] (rare)

	And others under the myeloproliferative/myelodysplastic overlap syndromes:		And others under the myeloproliferative/myelodysplastic overlap syndromes:
	*[[Chronic myelomonocytic leukemia]]		*[[Chronic myelomonocytic leukemia]]

	Other ~~Rarer~~ leukemias:		Other less common leukemias:
			*Hairy cell leukemia
			*T-cell prolymphocytic leukemia
			*T-cell large granular lymphocyte leukaemia (T-LGL)
	*Plasma cell leukaemia		*Plasma cell leukaemia
	*Mast cell leukemia		*Mast cell leukemia
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	*Chemotherapy?		*Chemotherapy?
	*[[Down syndrome]]?		*[[Down syndrome]]?


	=Prognosis=		=Prognosis=
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	#lymphoid leukaemia: 52.4% (Colombia) to 91.6% (Germany)		#lymphoid leukaemia: 52.4% (Colombia) to 91.6% (Germany)
	#acute myleoid leukemia: 33.3% (Bulgaria) to 78.2% (Germany)		#acute myleoid leukemia: 33.3% (Bulgaria) to 78.2% (Germany)

	~~=Specific diagnoses=~~
	*[[Acute myeloid leukemia]]
	*[[Acute lymphoblastic leukemia]]
	*[[Chronic myeloid leukemia]]
	*[[Chronic lymphocytic leukemia]]

	=See also=		=See also=

Mark: add to list of leukemias

2018-05-26T19:16:15Z

add to list of leukemias

← Older revision		Revision as of 19:16, 26 May 2018
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	*Lymphoma = discrete mass(es), usu. [[lymph node]].		*Lymphoma = discrete mass(es), usu. [[lymph node]].
	**Classic presentation: non-tender lymph nodes		**Classic presentation: non-tender lymph nodes

			Most leukemias are typically classified into acute or chronic. As a general rule, the designation of '''acute''' signifies a more immature and aggressive phenotype, whilst '''[[chronic]]''' leukemias generally show a more differentiated phenotype and run a more indolent course. There are exceptions, of course, and some chronic leukemias may transform into acute lymphomas.

	=Definition=		=Definition=
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	#Morphologic abnormalities.		#Morphologic abnormalities.
	#>20% blasts ''or'' recurrent cytogenetic abnormality.		#>20% blasts ''or'' recurrent cytogenetic abnormality.

	~~Some recurrent cytogenetic abnormalities:~~
	*t(8;21).
	*inv(16).
	*t(15;17).

	=Leukemia classification=		=Leukemia classification=
	*[[Acute myeloid leukemia]] (AML):		*[[Acute myeloid leukemia]] (AML):
	*#AML.		*#AML.
	*#AML with recurrent cytogenetic abnormalities.		*#AML with recurrent cytogenetic abnormalities, e.g.
	*#AML from [[MDS]].		**#t(8;21).
			**#inv(16).
			**#t(15;17).
			*#AML arising from [[MDS]].
	*#AML in the setting of [[Down syndrome]].		*#AML in the setting of [[Down syndrome]].

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	*#T cell (sometimes abbreviated to T-ALL)		*#T cell (sometimes abbreviated to T-ALL)

	*~~Not~~ to be confused with [[adult T-cell leukemia/lymphoma]] (ATLL)		*T-ALL should not to be confused with [[adult T-cell leukemia/lymphoma]] (ATLL)

			*[[Chronic lymphocytic leukemia]] (CLL) - usually classified with lymphomas

			A few fall under the umbrella of '''[[myeloproliferative neoplasm]]s''':
	*[[Chronic myeloid leukemia]] (CML)		*[[Chronic myeloid leukemia]] (CML)
	*[[Chronic ~~lymphocytic~~ leukemia]] ~~(CLL) - usually classified with lymphomas~~		*[[Chronic neutrophilic leukemia]]
			*[[Chronic eosinophilic leukemia]]

			And others under the myeloproliferative/myelodysplastic overlap syndromes:
			*[[Chronic myelomonocytic leukemia]]

	Rarer leukemias:		Other Rarer leukemias:
	*Plasma cell leukaemia		*Plasma cell leukaemia
	*Mast cell leukemia		*Mast cell leukemia

Mark: some rearranging + classification

2018-05-26T19:00:29Z

some rearranging + classification

Show changes

Mark: subclude CML

2018-05-26T16:54:45Z

subclude CML

← Older revision		Revision as of 16:54, 26 May 2018
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	==Chronic myeloid leukemia==		==Chronic myeloid leukemia==
	*Abbreviated ''CML''.		{{:Chronic myeloid leukemia}}
	*[[AKA]] ''chronic myelogenous leukemia''.
	~~===General===~~
	*Adults - usu. 50s or 60s.

	~~Clinical - commonly:<ref>~~{{~~Ref PCPBoD8\|336}}</ref>~~
	*Leukocytosis - neutrophils, myelocytes, metamyelocytes, +/-eosinophilia, +/-basophilia.

	~~Progression~~:
	#Chronic ~~phase - potentially curable.~~
	~~#Accelerated phase.~~
	~~#Blast crisis.~~

	~~Treatment:~~
	*[[Imatinib]].

	~~Notes:~~
	*Myeloblast (common granulocyte precursor) -> promyelocyte -> metamyelocyte -> myelocyte -> band -> mature myelocyte.<ref name=hemechart>URL: [http://commons.wikimedia.org/wiki/File:Hematopoiesis_%28human%29_diagram.png http://commons.wikimedia.org/wiki/File:Hematopoiesis_%28human%29_diagram.png]. Accessed on: 14 January 2012.</ref>

	~~===Microscopic===~~
	~~Features:~~
	*Bone marrow with too many granulocytes/granulocyte precursors.
	**Granulocyte precursors:<ref name=hemechart>URL: [http://commons.wikimedia.org/wiki/File:Hematopoiesis_%28human%29_diagram.png http://commons.wikimedia.org/wiki/File:Hematopoiesis_%28human%29_diagram.png]. Accessed on: 14 January 2012.</ref>
	**#Myeloblast (common granulocyte precursor) ~ 90% nucleus, multiple nucleoli.
	*#Should be less than 10%.
	**#Promyelocyte (committed to a specific linage ([[neutrophil]], basophil or [[eosinophil]])) - dia. 2x mature, 40-50% nucleus, one [[nucleolus]].
	**#Metamyelocyte - dia. 2x mature, 30-40% nucleus, no nucleolus.
	**#Myelocyte - dia. 1x mature, 50-60% nucleus - kidney bean shape, no nucleolus.
	**#Band - dia. 1x mature, 30-40% nucleus - C shape/irregular, no nucleolus.

	~~===IHC===~~
	Features:<ref>{{Cite journal \| last1 = Muñoz \| first1 = L. \| last2 = Bellido \| first2 = M. \| last3 = Sierra \| first3 = J. \| last4 = Nomdedéu \| first4 = JF. \| title = Flow cytometric detection of B cell abnormal maturation in chronic myeloid leukemia~~. \| journal = Leukemia \| volume = 14 \| issue = 2 \| pages = 339-40 \| month = Feb \| year = 2000 \| doi = \| PMID = 10673756 \|URL = http://www.nature.com/leu/journal/v14/n2/full/2401549a.html~~ }}~~</ref> (???)~~
	*Chronic:
	**CD20+ CD19+ CD10-.
	*Accelerated:
	**CD20+ CD19+ CD10+.
	*Blast:
	**CD20- CD19+ CD10+.
	**CD34+ TdT+.<ref>URL: [http://path.upmc.edu/cases/case271.html http://path.upmc.edu/cases/case271.html]. Accessed on: 14 January 2012.</ref>

	~~===Molecular===~~
	*t(9;22) BCR-ABL - '''required for diagnosis'''.
	**May be found in other leukemias.

	=See also=		=See also=

Jensflorian: /* Leukemia classification */ Latest progn

2017-04-19T08:34:56Z

Leukemia classification: Latest progn

← Older revision		Revision as of 08:34, 19 April 2017
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	Chronic myeloid leukemia (CML).		Chronic myeloid leukemia (CML).

			=Prognosis=
			Highly dependent on health care system and treatment available<ref>{{Cite journal \| last1 = Bonaventure \| first1 = A. \| last2 = Harewood \| first2 = R. \| last3 = Stiller \| first3 = CA. \| last4 = Gatta \| first4 = G. \| last5 = Clavel \| first5 = J. \| last6 = Stefan \| first6 = DC. \| last7 = Carreira \| first7 = H. \| last8 = Spika \| first8 = D. \| last9 = Marcos-Gragera \| first9 = R. \| title = Worldwide comparison of survival from childhood leukaemia for 1995-2009, by subtype, age, and sex (CONCORD-2): a population-based study of individual data for 89 828 children from 198 registries in 53 countries. \| journal = Lancet Haematol \| volume = \| issue = \| pages = \| month = Apr \| year = 2017 \| doi = 10.1016/S2352-3026(17)30052-2 \| PMID = 28411119 }}</ref>
			*5-year overall survival in children ranges:
			#lymphoid leukaemia: 52.4% (Colombia) to 91.6% (Germany)
			#acute myleoid leukemia: 33.3% (Bulgaria) to 78.2% (Germany)

	=Specific diagnoses=		=Specific diagnoses=

Michael: /* Acute myeloid leukemia */

2015-07-28T00:13:09Z

Acute myeloid leukemia

← Older revision		Revision as of 00:13, 28 July 2015
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	*May be classified by morphology, using the (old) French-American-British (FAB) classification (M0-M7).		*May be classified by morphology, using the (old) French-American-British (FAB) classification (M0-M7).

	Image:		====Image====
	*[http://commons.wikimedia.org/wiki/File:Auer_rods.PNG Auer rods in an AML (WC)].		<gallery>
			Image:Auer_rods.PNG \| Auer rods in an AML. (WC)
			</gallery>
			www:
	*[http://path.upmc.edu/cases/case344.html AML - several images (upmc.edu)].		*[http://path.upmc.edu/cases/case344.html AML - several images (upmc.edu)].

Michael at 00:12, 28 July 2015

2015-07-28T00:12:04Z

← Older revision		Revision as of 00:12, 28 July 2015
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			[[Image:Acute leukemia-ALL.jpg \| thumb\|right\|A bone marrow of an individual with precursor B-cell lymphoblastic leukemia. [[Wright stain]]. (WC)]]
	The article addresses '''leukemia''', which is uncommonly seen by anatomical pathologists. It is a subset of [[hematopathology]].		The article addresses '''leukemia''', which is uncommonly seen by anatomical pathologists. It is a subset of [[hematopathology]].

Michael: /* Acute myeloid leukemia with t(15;17) */ re-arrange

2015-07-27T21:26:21Z

Acute myeloid leukemia with t(15;17): re-arrange

← Older revision		Revision as of 21:26, 27 July 2015
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	**Fusion transcripts: PML<ref name=omim102578>{{OMIM\|102578}}</ref>-RARA.<ref name=omim180240>{{OMIM\|180240}}</ref>		**Fusion transcripts: PML<ref name=omim102578>{{OMIM\|102578}}</ref>-RARA.<ref name=omim180240>{{OMIM\|180240}}</ref>

			====General====
			Clinical:
			*Associated with [[DIC]].
			*Treatment: all-trans retinoic acid (ATRA).

			Variants:
			*t(11;17) -- ATRA doesn't work.<ref>{{Ref APBR\|623 Q2}}</ref>
			*t(17;17) -- ATRA doesn't work.
			*t(5;17). (???)

			====Microscopic====
	Comes in two flavours.		Comes in two flavours.

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	*Absence of granules on light microscopy.		*Absence of granules on light microscopy.

	Images:		=====Images=====
			<gallery>
			Image:Faggot cell in AML-M3.jpg \|Faggot cell in AML-M3. (WC)
			</gallery>
			www:
	*[http://path.upmc.edu/cases/case457/images/fig01.jpg AML - showing Auer rods (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case457.html http://path.upmc.edu/cases/case457.html]. Accessed on: 21 January 2012.</ref>		*[http://path.upmc.edu/cases/case457/images/fig01.jpg AML - showing Auer rods (upmc.edu)].<ref>URL: [http://path.upmc.edu/cases/case457.html http://path.upmc.edu/cases/case457.html]. Accessed on: 21 January 2012.</ref>
	*[http://path.upmc.edu/cases/case705.html APML - several images (upmc.edu)].		*[http://path.upmc.edu/cases/case705.html APML - several images (upmc.edu)].

	IHC:		====IHC====
	*CD2 +ve, CD34 +ve/-ve, CD56 +ve/-ve.		*CD2 +ve, CD34 +ve/-ve, CD56 +ve/-ve.

	[[Flow cytometry]]:		====[[Flow cytometry]]====
	*CD34 -ve, HLA-DR -ve.		*CD34 -ve, HLA-DR -ve.
	*CD33 +ve, CD13 +ve/-ve, CD117 +ve (weak), CD56 +ve/-ve.		*CD33 +ve, CD13 +ve/-ve, CD117 +ve (weak), CD56 +ve/-ve.

	~~Clinical:~~
	*Associated with [[DIC]].
	*Treatment: all-trans retinoic acid (ATRA).

	~~Variants:~~
	*t(11;17) -- ATRA doesn't work.<ref>{{Ref APBR\|623 Q2}}</ref>
	*t(17;17) -- ATRA doesn't work.
	*t(5;17). (???)

	===Acute myeloid leukemia with t(9;11)===		===Acute myeloid leukemia with t(9;11)===

Michael: /* Microscopic */

2015-07-27T21:11:23Z

Microscopic

← Older revision		Revision as of 21:11, 27 July 2015
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	===Microscopic===		===Microscopic===
	Features:		Features:
	*Auer rods present		*[[Auer rods]] present
	*Cytoplasmic granularity.		*Cytoplasmic granularity.
	*Large cells.		*Large cells.

Michael at 08:02, 13 September 2014

2014-09-13T08:02:32Z

← Older revision		Revision as of 08:02, 13 September 2014
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	IHC:		IHC:
	*CD34+, CD13+, MPO+ (cytoplasm), CD33+ (weak).		*CD34+, CD13+, MPO+ (cytoplasm), CD33+ (weak).
	*CD56+, CD117+.		*[[CD56]]+, CD117+.
	**Usu. assoc. with a bad prognosis.		**Usu. assoc. with a bad prognosis.