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

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.