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acute leukemias - myeloid


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How many myeloid acute leukemias are there?
8 (including zero)
what is M0?

what's its big feature?
-Minimally differentaited acute myeloid
-Doesn't have blasts;
what is M1?

what's its big feature?
-Acute myeloblastic without maturation

-Cells are so young they haven't matured at all; 90% of cells that aren't erythroid are blasts! Some auer rods are seen.
what is the difference between
-Type 1 Myeloblasts
-Type 2
-Type 3
1: no primary granules, no Auers
2: some granules; auers present
3: >20 primary granules; NO GOLGI
how do you differentiate a myeloblast from a promyelocyte?
Promyelocyte has a golgi region and smaller nucleus that's more condensed.
What is M2?
What is its big feature?
What type of cells are they NOT?
Acute Myeloblastic Leukemia with maturation.
-some myeloblasts matured; only 30-89% of noneryth cells are blasts.
-NOT monoblasts; only 20% of cells are monocytic
What is M3?
What is its big feature?
Comment on the cell features.
how do these cells stain?
-Acute Promyelocytic
-30% or more noneryth cells are HYPERGRANULAR PROGRANS.
-have faggots of auer rods.
-Intensely Peroxidase positive
what is M3m?
What is its big feature?
Acute promyelocytic variant
-The same as M3, but HYPOgranular prograns are seen peripherally.
what is M4?
What is its big feature?
Acute Myelomonocytic
-BM blasts are 30% or greater; 20-80% of those are MYELO, 20-80% are MONO.
peripheral blood = monocytosis
What special stain is seen in M4? Why?
NONSPECIFIC ESTERASE - because now the monocytic component has kicked in.
what is M4EO?
What is its big feature?
Acute myelomonocytic with eosinophilia.
-Same as M4, but 5% or more of nonerythroid are abnormal eosinophils.
What is M5?
What is its big feature?
-greater than 80% of noneryth cells are MONOCYTIC. Rare auers.
What is M5a?

What is M5b?
A = 80% or greater of monocytes are blasts.

B = less than 80% of monocytes are blasts.
what cell inclusion is common in myeloid blasts but not monocyte?
Auer rods.
What is M6?
What is its big feature?
-MORE than 50% of ANC are erythroblasts.
-Also, 30% or more of noneryth are blasts.
what special stain shows up in M6?
PAS (periodic acid schiff's)
what is M7?
What is its big feature?
What's unique about how it's diagnosed?
Acute megakaryoblastic
30% of ANC (not just the noneryth component) are LEUKEMIC BLASTS.
-Can diagnose from PB because marrow is too full.
what funky cells can be seen in M7 that phyllis just loves?
Micromegakaryocytes - bizarre platelets and blasts.
what is NCE?
What does it stain?
What AMLs is it + in?
Naphthol chloroacetate esterase
Aka, SPECIFIC esterase.
-Stains Myeloblasts thru PMN
What is Peroxidase/SBB?
What does it stain?
What AMLs is it + in?
Peroxidase and Sudan Black B.
Stains Myeloblasts thru PMN.
What three stains are positive in M1,2,3,4?
NCE- Specific esterase, Peroxidase, and SudanBlack B
What is NSE?
What does it stain?
What AMLs is it + in?
Nonspecific esterase.
-Stains monoblasts
-M4 and M5.
How do you remember what stains positive in Acute myelomonocytic and Acute monocytic leukemia?
Nono mono
What is TdT?
What does it stain?
What is it + in?
Terminal deoxynucleotidyl transferase
-Stains lymphoblasts
-Positive in L1, L2, sometimes 3
what is PAS?
What does it stain?
What AMLs is it + in?
Periodic acid schiff
-glycogen, just about everything.
-M6 for erythroblasts.

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