Lecture on Leukemias: ALL, CML, AML, CLL

Overview

• Focus on types of leukemias: Acute Lymphoblastic Leukemia (ALL), Chronic Myeloid Leukemia (CML), Acute Myeloid Leukemia (AML), and Chronic Lymphocytic Leukemia (CLL)
• Use of mnemonics and important points to remember the types

Hematopoiesis Cascade

• Hematopoietic stem cell differentiates into:
  • Myeloid progenitor
  • Lymphoid progenitor
• Myeloid progenitor gives rise to:
  • Red blood cells
  • Myeloblasts → Neutrophils, Eosinophils, Basophils, Monoblasts
  • Platelets
• Lymphoid progenitor gives rise to:
  • Lymphoblasts → T cells, B cells

Leukemia Types and Characteristics

• Myeloid Leukemia: Uncontrolled production of cells from myeloid lineage
• Lymphoid Leukemia: Uncontrolled production of cells from lymphoid lineage

Mnemonic for Leukemia Spectrum With Respect to Age

• Draw a straight line to show the spectrum of leukemia with respect to age
• Central/medial leukemia with 'M'
  • CML and AML in the middle
• Lateral leukemia with 'L'
  • ALL (Acute) on the left
  • CLL (Chronic) on the right

Age

• ALL: ~10 years
• CML: ~40 years
• AML: ~50 years
• CLL: ~80 years

Diagnostic Laboratory Findings

• ALL: TdT positive
• CML: Philadelphia Chromosome (translocation between chromosome 9 and 22)
• AML: Auer rods, Myeloperoxidase positive
• CLL: Smudge cells

Mnemonics for Diagnostic Features

• CML:
  • C: Chromosomes (Philadelphia, t(9;22))
  • M: Mesosplenomegaly, absence of lymphadenopathy
  • L: Leukocytosis (raised TLC)
• AML:
  • A: Auer rods (aggregation of myeloperoxidase)
  • M: Myeloperoxidase (cytoplasmic enzyme present in myeloblasts)
  • L: Leukocytosis (raised TLC), Lymphadenopathy
• CLL (mnemonic: shell):
  • S: Splenomegaly
  • H: Hepatomegaly
  • L: Lymphadenopathy
  • L: Leukocytosis
• CLL (mnemonic: cln):
  • C: Crushed
  • L: Little
  • L: Lymphocytes (Smudge cells)

Conclusion

• Summary and encouragement to like, subscribe, and share the content.