Exam 23: Acute Myeloid Leukemias

Use this case to answer the following questions: A 45-year-old female sees her physician because of unexplained bruising on her upper torso. The physician takes a history, and nothing remarkable is noted. Physical examination reveals a palpable liver and spleen. CBC results reveal a platelet count of 5,000/µL and WBC count of 12,000/µL with 80% blasts and 15% promyelocytes present. Additional CBC findings include: Hgb: 8.7 g/dL and Hct: 25% normal indices. Bone marrow findings: hypercellular marrow with 47% myeloblasts present. Nucleated erythroblasts: 22%; promyelocytes: 28%; megakaryopoiesis appears normal. Cytogenetic analysis: t (15, 17) present. -What is the most likely diagnosis?

Use the case below to answer the following questions: A 57-year-old male is admitted 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.

A patient presents with 25% blasts (nonerythroid), 34% monocytic cells, and 31% granulocytic cells in the bone marrow.The peripheral blood smear has 10% monocytes.The alpha-naphthyl esterase and chloroacete esterase are positive.What is the probable diagnosis based on these findings?

A patient presents with acute leukemia, with blasts identified by a positive CD34, CD13, and CD33.Less than 3% of the blasts stain positive for MPO and SBB.Which category of AML is the most likely diagnosis for this patient?

The FAB classification nomenclature for acute leukemia also appears under which WHO classification group?

A patient presents with a morphological smear examination revealing greater than 20% blasts with prominent granules and ++ Auer rods, MPO, and Sudan Black 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 categorized, does this picture fall?

Why are Auer rods seen only in myeloblasts?

The presence of which of the following findings with a blast of unknown lineage confirms that the lineage is myeloid?

Use the case below to answer the following questions: A 57-year-old male is admitted 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?

What is the definition of acute leukemia, according to the World Health Organization?

Predict the typical platelet concentration of a patient with AML.

Use this case to answer the following questions: A 45-year-old female sees her physician because of unexplained bruising on her upper torso. The physician takes a history, and nothing remarkable is noted. Physical examination reveals a palpable liver and spleen. CBC results reveal a platelet count of 5,000/µL and WBC count of 12,000/µL with 80% blasts and 15% promyelocytes present. Additional CBC findings include: Hgb: 8.7 g/dL and Hct: 25% normal indices. Bone marrow findings: hypercellular marrow with 47% myeloblasts present. Nucleated erythroblasts: 22%; promyelocytes: 28%; megakaryopoiesis appears normal. Cytogenetic analysis: t (15, 17) present. -Which of the following laboratory findings would be most consistent with this clinical picture?

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

The patient presents with acute leukemia.The blast morphology is of neutrophil lineage with Auer rods and pseudo-Pelger-Huët nuclei; the immunophenotype is positive for CD33, CD13, CD34, and CD56 with a positive TdT, myeloperoxidase, and Sudan Black B.Cytogenetic analysis reveals a t(8;21)(q22;q22) translocation in the majority of the blasts.Which classification of AML best fits this morphology, immunophenotyping, and cytotechemistry?

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

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

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

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

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?

Which acute leukemia is characterized by a blast population with both myeloid and lymphoid markers on the same cell?