CPHON REVIEW 2026 QUESTIONS AND ANSWERS
SURE A+
✔✔Juvenile myelomonocytic leukemia (JMML) is quite rare, occurring almost
exclusively in children ____ years of age or younger. - ✔✔2
* You will see high HbF. Leukocytosis muted compared to CML.
✔✔Peak incidence of ALL is ____ years of age. More common in males. - ✔✔2-5
✔✔Radiation performed during pregnancy--especially 1st trimester--increases risk of
____. - ✔✔ALL
Risk lasts until child is 12 years old
*Parental cigarette smoking prior to conception is also associated with increased risk.
Increased birth weight associated with higher risk.
✔✔What are the 2 most important factors when determining prognoses in a child with
ALL? - ✔✔1. Age of child (2-10 most favorable)
2. WBC count (<50k most favorable)
*Children in time of rapid growth (i.e. infancy, adolescence have poorer prognoses.
Infants have least favorable outlook.
*Higher the WBC count, worse the prognosis.
*Hyperdipoidy: >46 but <50 chromsomes=good prognosis
✔✔Induction for ALL includes....
What do you add for high risk? - ✔✔-Goal is to eliminate blasts (<5%)
-Prednisone and vincristine
-Asparaginase or doxorubicin may be added
-CNS prophylaxis (cytarabine, MTX, hydrocortisone)
, -High risk add anthracycline
✔✔Consolidation for ALL includes... - ✔✔-asparaginase, HD methotrexate,CNS prophy
-If CNS positive, may get craniospinal radiation as well
✔✔Leukemia is the most common childhood cancer, with ALL being the most common.
- ✔✔
✔✔Maintenance for ALL - ✔✔6MP, MTX
✔✔What is the peak age of AML? - ✔✔First year of life
Risk decreases to age 4, then stabilizes
✔✔Induction for AML - ✔✔-Cytarabine (aka Ara-C), Doxorubicin, Prednisone,
Etoposide, 6TG
-Antibiotics and antifungals
-CNS prophylaxis (IT chemo)
-6 months therapy of induction like courses,
- Transplant if matched related donor
✔✔When you treat for AML, you need to observe for bleeding from... - ✔✔DIC
✔✔Diploid - ✔✔46 chromosomes
✔✔Hyperdiploid - ✔✔>46 chromsomes, good prognosis
✔✔Pseudodiploid - ✔✔46 chromosomes with structural change, poor prognosis
✔✔Hypodiploid - ✔✔<46 chromosomes, poor prognosis
✔✔4 small round blue cell - ✔✔1. Rhabdomyosarcoma
2. Ewings sarcoma
3. Non-Hodgkin lymphoma
4. Neuroblastoma
✔✔2 chemotherapeutic agents associated with high risk of anaphylaxis -
✔✔Asparaginase
Etoposide (plant derivative)
✔✔2 chemo agents with lifetime dose limits - ✔✔Doxorubicin (anthracycline)
Bleomycin (anthracyline)
✔✔Asparaginase - ✔✔Can cause DVTs and *pancreatitis*
SURE A+
✔✔Juvenile myelomonocytic leukemia (JMML) is quite rare, occurring almost
exclusively in children ____ years of age or younger. - ✔✔2
* You will see high HbF. Leukocytosis muted compared to CML.
✔✔Peak incidence of ALL is ____ years of age. More common in males. - ✔✔2-5
✔✔Radiation performed during pregnancy--especially 1st trimester--increases risk of
____. - ✔✔ALL
Risk lasts until child is 12 years old
*Parental cigarette smoking prior to conception is also associated with increased risk.
Increased birth weight associated with higher risk.
✔✔What are the 2 most important factors when determining prognoses in a child with
ALL? - ✔✔1. Age of child (2-10 most favorable)
2. WBC count (<50k most favorable)
*Children in time of rapid growth (i.e. infancy, adolescence have poorer prognoses.
Infants have least favorable outlook.
*Higher the WBC count, worse the prognosis.
*Hyperdipoidy: >46 but <50 chromsomes=good prognosis
✔✔Induction for ALL includes....
What do you add for high risk? - ✔✔-Goal is to eliminate blasts (<5%)
-Prednisone and vincristine
-Asparaginase or doxorubicin may be added
-CNS prophylaxis (cytarabine, MTX, hydrocortisone)
, -High risk add anthracycline
✔✔Consolidation for ALL includes... - ✔✔-asparaginase, HD methotrexate,CNS prophy
-If CNS positive, may get craniospinal radiation as well
✔✔Leukemia is the most common childhood cancer, with ALL being the most common.
- ✔✔
✔✔Maintenance for ALL - ✔✔6MP, MTX
✔✔What is the peak age of AML? - ✔✔First year of life
Risk decreases to age 4, then stabilizes
✔✔Induction for AML - ✔✔-Cytarabine (aka Ara-C), Doxorubicin, Prednisone,
Etoposide, 6TG
-Antibiotics and antifungals
-CNS prophylaxis (IT chemo)
-6 months therapy of induction like courses,
- Transplant if matched related donor
✔✔When you treat for AML, you need to observe for bleeding from... - ✔✔DIC
✔✔Diploid - ✔✔46 chromosomes
✔✔Hyperdiploid - ✔✔>46 chromsomes, good prognosis
✔✔Pseudodiploid - ✔✔46 chromosomes with structural change, poor prognosis
✔✔Hypodiploid - ✔✔<46 chromosomes, poor prognosis
✔✔4 small round blue cell - ✔✔1. Rhabdomyosarcoma
2. Ewings sarcoma
3. Non-Hodgkin lymphoma
4. Neuroblastoma
✔✔2 chemotherapeutic agents associated with high risk of anaphylaxis -
✔✔Asparaginase
Etoposide (plant derivative)
✔✔2 chemo agents with lifetime dose limits - ✔✔Doxorubicin (anthracycline)
Bleomycin (anthracyline)
✔✔Asparaginase - ✔✔Can cause DVTs and *pancreatitis*
