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Medicine

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Hematology

Question
4 out of 7
 

Poor prognosis in AML is indicated by (NEET 2013)



A Inversion 16
B Translocation 15/17 (tI5; 17)

C Normal cytogene city
D Monosomy 7

Ans. D

Monosomy 7

The likelihood of entering complete remission & hence the prognosis is determined by the following factors:

Age of Diagnosis:

1. > 60 years has a poor prognosis

2. Chronic intercurrent disease, acute medical problems with increasing age are associated with poor prognosis.

Chromosome findings:

Prognosis

Chromosome Findings

Good

t (8 : 21), t (15 : 17), inv (16)

Moderate

No cytogenetic abnormality

Poor

Monosomy 5 and 7, Complex karyotype, Inv(3)

Presenting Leucocyte count:

1. A high presenting Leucocyte count is an independent prognostic factor

2. Duration of CR is inversely related to presenting Leucocyte count

Among patients with hyperleukocytosis (>100,000mg) early central nervous system bleeding and pulmonary leukostasis and Late relapse contribute to poor outcome.

Prolonged symptomatic interval with cytopenia - Antecedent hematological disorder

1. Poor prognosis is seen in patients with anemia, Leukopenia, thrombocytopenia for duration of more than 1 month

2. before diagnosis.

2. Poor prognosis is seen in patients with secondary Leukemias developing after treatment with cytotoxic agents / irradiation.

Other Prognostic features:

1. F AB classification

2. Characteristics of Leukemic cells: e.g. Auer Rods - poor prognosis

3 Expression of MDRl Gene - poor prognosis

Cytogenic studies are most powerful prognostic factors

Good prognosis

Moderately favourable prognosis

Poor prognosis

- t (8:21)

- Inv (16) (p13, q22)

- t (15;17)

No cytogenic abnormality

- Complex karyotype

- Monosomy 7 (-7)

- Monosomy 5

- Del 5q

- 3q rearrangement

- Inv. (3)

- FLT3 internal tandem duplication

Hematology Flashcard List

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