AML

Question 1

Difference b/w PARA- & PERI- centric inverson of chromosome

Answer 1

Para: swap in one arm (p OR q)
Peri: swap in b/w centromere (in p AND q arm)

Question 2

definition of Acute Myeloid Leukaemia

Answer 2

accumulation of clonal immature cells (blast) from myeloid lineage
AML >=20% blast

Question 3

pathobiology of Acute Myeloid Leukaemia

Answer 3

1. Totipotent differentiates (& self renew)
2. Pluripotent differentiates (& self renew)
3. Blood stem cells differentiates
4. WBC (myeloid & lymphoid stem cell) & RBC

Question 4

3 scenarios/theories AML/cancer develops

Answer 4

*2 hit multi-step process
#1: stem cell mutate => loss of regulated cell division
#2: Mutated progenitor => """""
#3: Differentiated cell de-differentiates & self-renewal genes on => """""

Question 5

Laboratory investigations

Answer 5

1. Morphology: PB, BM aspirate & BM trephine
2. Cagulation studies:
3. Immunophenotyping (flow cytometry)
4. Human Leukocyte Ag (HLA) testing
5. Cytogenetics

Question 6

Role of cytogenetics in confirming diagnosis/establishing disease status (6)

Answer 6

• confirm diagnosis
• Classify haematological malignancies & the subsets
• Determine disease status
• Stratify patients for treatment protocols & clinical trials
• MRD: minimum residual disease
• Predictive factors for prognosis