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)