11.5 Investigation of Haematologic Malignancies Flashcards
Blood film showing increased population of mature white blood cells. Likely diagnosis?
- Chronic (mature)
- Myeloid (lineage)
- Leukaemia
Smudge cells and excess of lymphocytes in peripheral blood film. Likely diagnosis?
Chronic lymphocytic leukaemia
What can cause rouleax or “coin stacking” on peripheral blood smear
- Severe inflammation
- Abnormal protein production
Abundant plasma cells on peripheral blood smear. Likely diagnosis?
- Multiple Myeloma
If an abnormality is detected on a peripheral blood smear, what is the usual next investigation? Why?
- Bone marrow biopsy
- This is to assess the underlying functionality of bone marrow
List some indications for bone marrow biopsy
- Blasts
- Poikilocytosis/anisocytosis
- Dysplasia (abnormal cells)
- Staging investigation
- Fever investigation
What is dysplasia? What can it precede?
- Presence of abnormal cells
- Can precede cancer
What is a trephine bone marrow biopsy?
Cross section of a fragment of bone, including the bone marrow that’s inside the bone
Summarise the process of flow cytometry
- Antibodies are used that bind to specific surface markers of cells
- The antibodies are bound to fluorochromes of specific colours
- When interrogated with a laser, the colours emitted tells us what kind of surface marker (and therefore cells) are present
What is cytogenetics in blood investigations?
Basically, analyzing a karyotype
What can next-generation sequencing be used to determine?
- Prognosis
- Inheritable disease risks
Describe the three steps of treatment of haematological malignancies (induction, consolidation, maintenance/stem cell transplant)
Step 1 - Induction: Intense chemotherapy
Step 2 - Consolidation: Ongoing treatment to ensure disease does not re-worsen
Step 3 - Maintenance/stem cell transplant: In high risk cases, stem cell transplant is done to ensure longer remission
What type of chemotherapy is indicated if the patient is not responsive to inductive chemotherapy
Salvage
