Exam 26: Acute Myeloid Leukemias

Patients with acute myelomonocytic leukemia are at higher risk of infection compared with individuals with acute myelocytic leukemia with differentiation.Explain why there is a higher risk of infection in patients diagnosed with acute myelomonocytic leukemia.

A laboratory professional is reviewing a peripheral blood smear of a 10-year-old patient and notes that 35% blasts are present.Which of the following diagnoses is likely based on these findings?

The WHO classification system of AML incorporates which of the following?

A patient presents with a morphological smear examination revealing >20% blasts with prominent granules and Auer rods,MPO,and SBB positive.A 25% monocyte count was seen in the peripheral smear.There were no recurrent cytogenetic abnormalities observed.Under which classification of acute leukemia,not otherwise specific,does this diagnosis fall?

A patient presents with bleeding and is found to be in DIC.The peripheral smear contains hypergranular promyelocytes.The white count is slightly elevated.The bone marrow contains cells with multiple Auer rods with a clear blue cytoplasm.What is the probable type of AML?

A PAS stain is ordered on a leukemic patient.The test is performed,and the technologist confirms that the PAS stain is positive with coarse granularity.Based on these findings,from what is the patient most likely suffering?

Use the following case to answer these questions: A 57-year-old male was admitted to the hospital with suspicion of AML.Preliminary CBC results show a high WBC count with 47% blasts present.Cytochemical staining shows negative reactions with MPO,SBB,and NSE.Platelet peroxidase staining was positive.Immunophenotyping was also ordered. -Predict the results of the immunophenotyping panel based on the information already given.

An APL patient has been undergoing ATRA therapy for the last 5 weeks.A repeat bone marrow and cytogenetic analysis is performed at the end of the treatment cycle.Bone marrow shows no evidence of leukemic cells,and cytogenetic anomalies were not detected.Based on this information,what is the patient's status?

The M:E ratio of a patient with AML typically displays which of the following?

A laboratory professsional reviewed the CBC of a patient who had a WBC count of 5 × 103/μL with 32% blasts present.Follow up testing with cytogenetics revealed t(15;17) ( q22;q12).Which of the following is a likely diagnosis for the patient?

A bone marrow sample is sent to the lab for cytochemical staining.MPO,SBB,and nonspecific esterase (NSE)have been ordered.Staining results come back as follows: MPO: positive SBB: positive NSE: positive Based on these findings,what lineage(s)is(are)most likely affected?

Traditional therapy in APL includes pharmacological concentration of retinoic acid (ATRA)and chemotherapy.What is the function of the chemotherapy component in this treatment protocol?

List the common cytochemical stains used in the detection of AML,and predict their results in AML.

A laboratory professional notes single azurophilic needlelike inclusions in the cytoplasm of many of the circulating blasts while reviewing a blood smear of an AML patient.What is the most probable identification of the inclusion?

Which of the following markers are positive for monoblasts?

Use the following case to answer these questions: A 57-year-old male was admitted to the hospital with suspicion of AML.Preliminary CBC results show a high WBC count with 47% blasts present.Cytochemical staining shows negative reactions with MPO,SBB,and NSE.Platelet peroxidase staining was positive.Immunophenotyping was also ordered. -What is the most likely diagnosis?

Which of the following confirms that a blast of unknown lineage is myeloid?

All of the following AML subtypes have positive reactivity with myeloperoxidase stain except:

Why are Auer rods seen only in myeloblasts?

Explain how bone marrow analysis helps establish an AML diagnosis.