Question

2. a) 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? Eradicates the leukemic stem cells Induces maturation of the promyelocytes to mature granulocytes Induces cytolysis of the malignant promyelocytes Binds with the target PML/RARA gene and represses gene transcription

  

b) 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?

Aplastic anemia

Acute leukemia*

Myelodysplastic syndrome

Chronic myeloid leukemia

  

c) A 45-year-old female was evaluated by her physician because she had unexplained bruising on her upper torso. Patient history was unremarkable. Physical examination revealed a palpable liver and spleen. CBC results revealed: WBC count: 12 × 109/L Hb: 8.7 g/dL Hct: 25% Normal indices PLT count: 5 109/L Differential: 80% blasts and 15% promyelocytes present 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?

AML without maturation

APL

AML minimally differentiated

AMML

d) According to the WHO classification, when differentiating myelodysplastic syndromes and acute leukemia, acute leukemia's:

Blasts must be >20% in the bone marrow*

Bone marrow must contain fibrosis

Blast count is close to 100%

Blasts must be >20% in the bone marrow and contain Auer rods

e) 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?

Microgranular APL variant

AML with 11q23 abnormalities

AML with multilineage dysplasia

AML with t(15;17) q22;q12)*

Clear explanation and legible handwriting

Answer 1