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Haematology > 2: ALL > Flashcards

2: ALL Flashcards

1
Q

What is ALL

A

Malignant proliferation lymphoblasts

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2
Q

What classification system is used to distinguish types of ALL

A

French-American-British (FAB)

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3
Q

What is the commonest cancer of childhood

A

ALL

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4
Q

What age does ALL usually onset

A

2-5 Years-Old

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5
Q

What gender is ALL more common in

A

Male

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6
Q

What are 5 RF for ALL

A
  • Chemoradiotherapy
  • Irradiation in utero
  • Down Syndrome
  • Ataxic telangiectasia
  • NF1
  • Philidelphia chromosome (9:22)
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7
Q

What are the ‘general’ symptoms of leukaemia

A

Bone marrow failure

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8
Q

How does RBC deficiency present in leukaemia

A
  • Lethargy
  • Pallour
  • Dyspneoa
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9
Q

How does WBC deficiency present in leukaemia

A
  • Recurrent Infections

- Fever

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10
Q

How does platelet deficiency present in leukaemia

A
  • Bleeding gums
  • Epistaxis
  • Non-blanching Petechial rash
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11
Q

what are constitutional symptoms in children

A
  • Night sweats
  • Fever
  • Weight Loss
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12
Q

what are other symptoms of ALL in children

A
  • Painless lymphadenopathy
  • Bone pain: limping child
  • Hepatomegaly
  • Testicular enlargement
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13
Q

what can T cell ALL cause

A

mediastinal enlargement

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14
Q

how can mediastinal enlargement present

A

airway obstruction

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15
Q

how will FBC present in ALL

A
  • Low Hb and Thrombocytopenia

- WCC High

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16
Q

how will a blood smear present in ALL

A
  • Blast cells
17
Q

what is diagnostic of ALL

A

Bone marrow aspiration and biopsy

18
Q

what is diagnostic on bone marrow biopsy of ALL

A

> 20% lymphoblasts

19
Q

what is looked for on bone marrow biopsy and why

A

Philadelphia chromosome - poor prognostic factor

20
Q

why may CXR and CT Chest be ordered in ALL

A

T-ALL is associated with mediastinal lymphadenoapthy

21
Q

why is LP ordered in ALL

A

Determine CNS involvement

22
Q

why are cytogenetics ordered in ALL

A

Philadelphia chromosome

23
Q

what should be performed in all boys with ALL and why

A

Testicular exam, as those where crossed blood-testes barrier has poorer outcomes

24
Q

what is the haematological regimen children are put on at the start of ALL treatment depend on

A
  • Age
  • WCC
  • Cytogenetics
25
Q

what are indications for regimen A

A
  • Under 10

- Low WCC

26
Q

what are indications for regimen B

A
  • Over 10

- High WCC

27
Q

explain regimen C

A
  • No child starts on regimen C. Children may be stepped up due to not enough WCC destruction on A or B. Or, due to philadelphia chromosome.
28
Q

what is the total treatment time in boys

A

3-years

29
Q

what is the total treatment time in girls

A

2-years

30
Q

what are the 5 stages

A 
Induction 
Consolidation 
Interim maintenance 
Delayed intensification 
Maintenance
31
Q

what is the aim of induction

A

To eliminate as many immature blast cells as possible

32
Q

what is CNS prophylaxis in ALL

A

Intrathecal methotrexate

Cranial Irradiation

33
Q

What are 5 adverse prognostic factors

A
  • Male
  • Age: 1-9 years = better outcomes
  • African- American
  • Poor response end of induction
  • WCC >100
  • Philadelphia chromosome
  • Spread to CNS

Haematology (19 decks)

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