Pathology Ranking Question

Name: Charlotte Levene

Theme: Leukaemia

A patient has a leukaemia with a 9;22 translocation. Rank the following diagnoses given this information, with the most likely diagnosis given first.

A) AML

B) ALL

C) CML

D) Acute promyelocytic leukaemia

Answers:

(C) Is the likeliest diagnosis as it the translocation is found in 95% of patients with CML. First line therapy is Imatinib, ABL kinase inhibitor, which would be started in the chronic phase of the CML. (B) Philadelphia chromosome is found in around 25-30% of ALL patients and is associated with a poor prognosis. (A) AML with Philadelphia chromosome is a rare aggressive acute leukaemia, fewer than 1% of new cases. t(8:21) may be found.  (D) Acute Promyelocytic leukaemia is associate with t(15:17) translocation in 95% of cases.