2. a) Traditional therapy in APL includespharmacological concentration of retinoic acid (ATRA) andchemotherapy. What is the function of the chemotherapy component inthis treatment protocol? Eradicates the leukemic stem cells Induces maturation of the promyelocytes to maturegranulocytes Induces cytolysis of the malignant promyelocytes Binds with the target PML/RARA gene and represses genetranscription

  

b) A laboratory professional is reviewing a peripheralblood smear of a 10-year-old patient and notes that 35% blasts arepresent. Which of the following diagnoses is likely based on thesefindings?

Aplastic anemia

Acute leukemia*

Myelodysplastic syndrome

Chronic myeloid leukemia

  

c) A 45-year-old female was evaluated by her physicianbecause she had unexplained bruising on her upper torso. Patienthistory was unremarkable. Physical examination revealed a palpableliver and spleen. CBC results revealed: WBC count: 12 × 109/L Hb:8.7 g/dL Hct: 25% Normal indices PLT count: 5 109/L Differential:80% blasts and 15% promyelocytes present Bone marrow findings:hypercellular marrow with 47% myeloblasts present. Nucleatederythroblasts: 22%; promyelocytes: 28%; megakaryopoiesis appearsnormal. Cytogenetic analysis: t(15, 17) present.What is the mostlikely diagnosis?

AML without maturation

APL

AML minimally differentiated

AMML

d) According to the WHO classification, whendifferentiating myelodysplastic syndromes and acute leukemia, acuteleukemia's:

Blasts must be >20% in the bone marrow*

Bone marrow must contain fibrosis

Blast count is close to 100%

Blasts must be >20% in the bone marrow and contain Auerrods

e) A patient presents with bleeding and is found to bein DIC. The peripheral smear contains hypergranular promyelocytes.The white count is slightly elevated. The bone marrow containscells with multiple Auer rods with a clear blue cytoplasm. What isthe probable type of AML?

Microgranular APL variant

AML with 11q23 abnormalities

AML with multilineage dysplasia

AML with t(15;17) q22;q12)*

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