Vancouver IM LMR

Laura Kim (PGY4 Hematology) presented a fantastic overview of hematologic malignancies on February 13, 2024. Thank you Laura for sharing the slide deck with us, which can be accessed here.

Laura reviewed the following:

• Myeloid disorders
  • Myeloproliferative disorders (MPNs): all can transform into AML!
    • BCR-ABL positive:
      • Chronic myelogenous leukemia (CML)
    • BCR-ABL negative:
      • Polycythemia vera (PV): typically presents with headache, aquagenic pruritus, hypertension, arterial & venous thrombosis, and splenomegaly. Labs show high Hb/ Hct, low EPO, and 95% are JAK2 positive. Treatment is with ASA, CV risk reduction, and phlebotomy to target Hct < 45% +/- hydroxyurea if high risk of thrombosis.
      • Essential thrombocythemia (ET): typically presents with bleeding, arterial & venous thrombosis, and erythromelalgia; less splenomegaly compared to PV. Labs show PLTs > 450 and 55% are JAK2 positive. Treatment is with ASA, CV risk reduction +/- hydroxyurea if high risk of thrombosis.
      • Primary myelofibrosis (PMF): can be de novo or post PV/ ET (worse prognosis); presents with B-symptoms, splenomegaly in almost all, and leukoerythroblastic blood film. Initially high PLT +/- high WBC that can decrease as fibrosis develops. Treatment depends on risk score.
  • Myelodysplastic syndrome (MDS)
  • Chronic myelomonocytic leukemia (CMMoL)
  • Acute myeloid leukemia (AML)
    • Acute promyelocytic leukemia (APL) is a unique AML subtype that has excellent prognosis with prompt treatment with all-trans retinoic acid (ATRA)!
• Lymphoid disorders
  • Acute lymphocytic leukemia (ALL)

Take a look at her excellent slide deck for more key clinical points about the above conditions.