00:02
Ultimately, this table
gives you the highlights
of what you need to know
for your leukemias.
00:07
We’ve walked through every
single one in great detail,
and now at this point,
let’s quickly walk through
what you need to know from
comparing one from the other.
00:15
Age:
Children affected
by leukemia, ALL.
00:20
The oldest patient to be
affected with leukemia, CLL.
00:25
Forties, CML.
00:28
AML, all over the
place, 15 to 60.
00:32
Onset, acute/acute.
00:35
What does that mean?
In your bone marrow, you'll
find greater than 20% blasts.
00:39
What was that pre-leukemia
that I told you about AML?
That was myelodysplastic
syndrome.
00:44
Do not forget that.
00:46
And in RBC pathology,
I’d also discussed it.
00:49
There’s a variant that you want to
know known as refractory anemia,
a ring sideroblast.
00:54
Chronicity, well, chronic.
00:56
You would have less than 10%
blast in the bone marrow.
01:00
CLL associated with SLL,
aggressive form, Richter
transformation.
01:06
CML, aggressive fashion.
01:08
What is that called?
Blast crisis.
01:11
Symptoms, acute: bone,
bone, bone pain.
01:15
That’s what you pay attention to because
of infiltration of bone marrow.
01:18
If it’s chronic,
many times, nonspecific but
anemia type of symptoms.
01:24
Prognosis:
ALL, excellent.
01:28
What kind?
Pre-B type.
01:31
Pre-T, a killer.
01:33
AML, moderate.
01:35
If you’re dealing with
M3, 30% cured, by?
ATRA.
01:40
CML, pretty decent, especially
when you can use imatinib.
01:44
The trade name is Gleevec,
the generic name is imatinib.
01:49
And CLL, poor and
slowly progressing,
unless it goes into Richter transformation,
which is now known as your
diffuse large B-cell lymphoma.
02:01
Here, we have hairy
cell leukemia.
02:02
Allow the name to speak to you.
02:04
This is once again of B-cell
origin but it is rare.
02:07
Older males, splenomegaly.
02:09
I’m going to give you the highlights
of what you want to take a look at.
02:12
You want to specifically
look for monocytopenia.
02:15
That is an interesting
and unique description
that you do not find
with most leukemias.
02:20
Monocytopenia.
02:22
Complications include opportunistic
infections and vasculitis.
02:26
It is quite responsive to
purine nucleoside analog.
02:30
And also keep in mind
that the molecular
trigger or what’s known as the molecular
marker for this will be called B-Raf,
and do not forget that.
02:40
Of course, TRAP as well,
tartrate-resistant acid phosphatase.
02:44
But then B-Raf, you’re going to
find almost 100% of your patients.
02:48
If you take a look at the cell
here, there was no other cell.
02:52
With leukemia, a B-cell
that looks like this
in which it looks like
hair-like projections.
02:57
Hence, it’s called
hairy cell leukemia.
02:59
This is a B-cell, please
do not forget that.
03:04
Our topic here is adult
T-cell leukemia/lymphoma.
03:08
Remember, please,
that you could have
development of the cancer
within your bone marrow.
03:13
Spills over into circulation, and then you
go on to then affect your lymph node.
03:17
Here, we have adult
T-cell leukemia/lymphoma.
03:20
You pay attention to T.
03:22
When you have a T-cell type of cancer, this
would mean that you have skin involvement.
03:26
That’s exactly what happens here.
03:27
Not only would you have skin involvement
but then you also have bone involvement,
as we should describe
in a second.
03:34
There’s a retrovirus that you need
to make sure that you know of
called your human T-cell
lymphotropic virus.
03:40
This is a virus that is
then going to cause damage,
and may then give
rise to your patient.
03:46
The endemic areas of HTLV-1 include
Japan, Caribbean, and Central Africa.
03:51
There are some other places but
those are the three big regions.
03:55
The disease is long latency,
and decades after infection may will
then result in the leukemia/lymphoma
There is going to be widespread
involvement of lymph nodes,
and adenopathy and peripheral blood,
and the skin is oftentimes involved.
04:10
In addition,
there’s also a bone involvement as well
with adult T-cell leukemia/lymphoma.
04:14
Unfortunately, the prognosis is quite poor.
04:18
Opportunistic infections are usually
what the patient is going to die from.
04:22
Adult T-cell leukemia/lymphoma,
T-cell,
HTLV-1,
tax, molecularly, if you remember,
and we’re looking at
skin issues, endemic.