Hoffbrand's Essential Haematology, 8e 7

Chapter 17 Acute lymphoblastic leukaemia
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17.1 Which ONE of the following markers is most commonly expressed on the surface of blast
cells in B-cell acute lymphoblastic leukaemia?
A CD3
B CD19
C CD20
D CD33
17.2 Which ONE of the following is the most likely clinical presentation of a child with acute
lymphoblastic leukaemia?
A A 6-month history of fatigue and repeated upper respiratory tract infection
B Poor appetite and abdominal pain resulting from swollen spleen
C Swollen gums in the mouth and red skin nodules
D Recent history of easy bruising, pallor and tiredness
17.3 Which ONE of these is TRUE regarding the aetiology of acute lymphoblastic leukaemia
(ALL)?
A There is an increased incidence of ALL in children who attend nursery care early in life
B Almost all children who develop the TEL-AML1 translocation go on to develop clinical ALL
C There is no increased familial incidence
D The first mutation is thought to occur in utero in most cases of ALL diagnosed before age 5 years
17.4 Which ONE of the following genes is most likely mutated in T-cell acute lymphoblastic
leukaemia?
A ABL1
B NOTCH1
C MYC
D TP53
17.5 Which ONE of the following cytogenetic patterns is associated with the best prognosis in
acute lymphoblastic leukaemia?
A Hyperdiploidy
:
B KDMT2A (MLL) gene translocation
C Philadelphia chromosome
D Hypodiploidy
17.6 For patients with acute lymphoblastic leukaemia, which ONE of the following is
associated with the highest likelihood of subsequent relapse?
A CD20 expression on blasts at diagnosis
B Extramedullary involvement at diagnosis
C Persistent anaemia at 6 weeks after initiation of therapy
D Minimal residual disease is detectable following first consolidation
17.7 A 44-year-old woman was diagnosed with B-cell acute lymphoblastic leukaemia 1 day ago
after presenting with fatigue and dyspnoea and bone pain. Her attending physician
wishes to enrol her in a clinical trial, but her serum transaminase levels (ALT and AST)
are just above the level of eligibility. Which ONE of the following therapies is most
appropriate at this time? (P)
A Corticosteroids
B Asparaginase
C Rituximab
D Daunorubicin
17.8 Which ONE of the following is the most common site of extramedullary relapse in acute
lymphoblastic leukaemia?
A Adrenal glands
B Lung
C Central nervous system
D Liver
17.9 Which ONE of the following statements is most accurate concerning acute lymphoblastic
leukaemia (ALL) associated with the Philadelphia chromosome? (P)
A Tyrosine kinase inhibitors must be used on their own and usually give long-term control
B Tyrosine kinase inhibitors have improved the prognosis
C Tyrosine kinase inhibitors prevent the need to consider allogeneic stem cell transplantation
D This subtype of ALL usually arises from chronic myeloid leukaemia
17.10 Which ONE of the following is necessary after chimeric antigen receptor (CAR)-T cell
therapy for relapsed acute lymphoblastic leukaemia? (P)
A 2 years of maintenance mercaptopurine

:
B Blinatumomab consolidation therapy
C Prophylactic antifungal therapy
D Lifelong immunoglobulin replacement therapy
17.11 Which ONE of the following drugs is effective in the treatment of T-cell acute
lymphoblastic leukaemia? (P)
A Blinatumomab
B Rituximab
C Methotrexate
D Inotuzumab ozogamicin
17.12 A 32-year-old woman was treated with acute lymphoblastic leukaemia 2 years ago. She
has now relapsed. Her blasts express CD10, CD22, terminal deoxynucleotidyl transferase,
CD20 (subset) and CD19 (dim, subset). Based on the mechanism of action, which ONE of
the following therapies is most appropriate for this patient? (P)
A Ibrutinib
B Anti-CD19 chimeric antigen receptor (CAR-)T cells
C Blinatumomab
D Inotuzumab ozogamicin
E Ofatumomab
17.13 Which ONE of the following statements is TRUE about B-cell acute lymphoblastic
leukaemia?
A It is more frequent in males than females
B Survival in children between age 2 and 10 years is now about 75%
C Peak age of onset is 2–4 years
D Females have a better prognosis than males
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Chapter 17 Acute lymphoblastic leukaemia

You have answered 0 questions correctly. You have scored 0%.

A A 6-month history of fatigue and repeated upper respiratory tract infection

B Poor appetite and abdominal pain resulting from swollen spleen

C Swollen gums in the mouth and red skin nodules

D Recent history of easy bruising, pallor and tiredness

C There is no increased familial incidence

A CD20 expression on blasts at diagnosis

B Extramedullary involvement at diagnosis

C Persistent anaemia at 6 weeks after initiation of therapy

D Minimal residual disease is detectable following first consolidation

C Central nervous system

B Tyrosine kinase inhibitors have improved the prognosis

D This subtype of ALL usually arises from chronic myeloid leukaemia

A 2 years of maintenance mercaptopurine

C Prophylactic antifungal therapy

D Lifelong immunoglobulin replacement therapy

B Anti-CD19 chimeric antigen receptor (CAR-)T cells

A It is more frequent in males than females

B Survival in children between age 2 and 10 years is now about 75%

C Peak age of onset is 2–4 years

D Females have a better prognosis than males

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