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Leukemia: Types of Leukemia incl. Hairy Cell Leukemia (HCL) and Adult T-Cell Leukemia/Lymphoma (ATLL) – White Blood Cell Pathology

by Carlo Raj, MD
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    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.


    About the Lecture

    The lecture Leukemia: Types of Leukemia incl. Hairy Cell Leukemia (HCL) and Adult T-Cell Leukemia/Lymphoma (ATLL) – White Blood Cell Pathology by Carlo Raj, MD is from the course Leukemia – White Blood Cell Pathology (WBC).


    Included Quiz Questions

    1. Acute lymphoblastic leukemia
    2. Acute myeloid leukemia
    3. Hairy cell leukemia
    4. Chronic myeloid leukemia
    5. Chronic lymphocytic leukemia
    1. Acute lymphoblastic leukemia
    2. Chronic lymphocytic leukemia
    3. Acute myeloid leukemia
    4. Acute T-cell leukemia
    5. Hairy cell leukemia

    Author of lecture Leukemia: Types of Leukemia incl. Hairy Cell Leukemia (HCL) and Adult T-Cell Leukemia/Lymphoma (ATLL) – White Blood Cell Pathology

     Carlo Raj, MD

    Carlo Raj, MD


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