WHO: Classification of Acute Leukemia

WHO four categories of AML

1. AML with recurrent abnormal karyotypes 2. AML with myelodysplasia related features 3. AML as a result of previous therapy-related myelodysplasias 4. AML not categorized (5) Acute leukemias of ambiguous lineage

Three types of myelodysplastic syndromes

1. Primary (de novo) 2. Therapy related 3. Hereditary

What are the 5 types of AML with myelodysplasia related features according to the FAB?

1. Refractory anemia 2. Refractory anemia with ringed sideroblasts 3. Refractory anemia with excess blasts 4. Refractory anemia with excess blasts in transformation 5. chronic myelomonocytic leukemia

WHO classification of myelodysplastic syndromes

1. Refractory cytopenia with unilineage dysplasia 2. Refractory anemia with ringed sideroblasts 3. Refractory cytopenia with multilineage dysplasia 4. Refractory anemia with excess type 1 blasts 5. Refractory anemia with excess type 2 blasts 6. Myelodysplastic syndrome, unclassified 7. Myelodysplastic syndrome associated wtih isolated del(5q)

What is the number of blasts in the bone marrow of refractory anemia with excess type 2 blasts?

10 & 19 %

What is the % blasts in the bone marrow of refractory anemia with excess type 1 blasts?

5-9%

t(15;17) causes

Acute Promyelocytic

What can cause AML due to therapy related myelodysplasias?

Alkylating agent exposure Radiation therapy

Bilineage acute leukemia express which antigens

Either myeloid or lymphoid

How are antigens categorized?

Flow cytometry

Myelodysplastic syndrome is characterized by __________________ bone marrow

Hypercellular

t(8;21) causes what?

Increased proliferation & blocked differentiation

Acute leukemias of ambigous lineage demonstrate cells from which cell lines?

Myeloid & Lymphoid

t(16;16) causes an increase in which cells?

Myeloid & monocytic

Biphenotypic acute leukemias express which antigens?

Myeloid and lymhpoid

Detection of various cytogenic abnormalities in AML has ____________________ implications

Prognostic

What dysplastic changes can occur in AML with MDS features?

Segs with hypogranular cytoplasm Segs with hyposegmented nuclei Megaloblastic RBCs Small megakaryocytes

Are auer rods seen in t(8;21)?

Yes

What percent blasts is required for a WHO diagnosis of acute leukemia?

at least 20%

Cytopenia in the peripheral blood indicates what?

cells are dying in the marrow

Refractory cytopenia with multilineage dysplasia has one or more ___________________ and dysplasia in two or more ______________ cell lines

cytopenias; myeloid

AML with myelodysplasia related features is an AML that evolves from previously documented ______________________ syndrome

myelodysplastic

What three abnormal karyotypes are included within the WHO #1 category of AML?

t(8;21) t(16;16) t(15;17)