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Medicine

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Hematology

Question
16 out of 16
 

Which of the following is Poor Prognosis in ALL: (AIIMS Nov 2009)



A TLC 4000-10000

B Age < 2 yrs

C Presence of testicular involvement at presentation

D Presence of Blasts in peripheral Smear

Ans. B

Age <2yrs

Poor Prognostic Factors

1. High white cell count at presentation (> 100,000/μL)

2. Male sex

3. Age <2 or > 10 years

4. Chromosomal abnormalities

Philadelphia chromosome (15% of adults) – poor prognosis

Ph chromosome is most commonly found in non – T, non – B – cell ALL, and is never found in T – cell ALL and hence there is a better prognosis in the latter variety

5. Pre – B – cell ALL with t(1: 19) translocation – poor prognosis

6. Mature B – cell ALL with t(8 : 14) translocation – very poor prognosis

7. CNS involvement

8. L2 and L3 stages.

Good prognostic factors.

1. Low WBC count <50,000/μL

2. Age 2 -10 yrs

3. Female sex

4. No dissemination

5. Hyperdiploidy

6. DNA index >.16

7. Early pre B cell stage

8. 70% of patients survive for 5 years when they have good prognostic indices (curable)

Hematological evidence of remission.

1. No evidence of leukemia in blood or bone marrow.

2. BM blast cell < 5%.

Hematology Flashcard List

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