2. Leukaemia and Lymphoma Flashcards
Haematological malignancies result in (2)
Clonal proliferation
Formation of cancer cells
How do cancer cells form (3)
Uncontrolled proliferation
Loss of apoptosis
Loss of normal function/products
Causes of haematological malignancies
Abnormalities during cell divisions, specifically DNA mutations (translocation)
Types of acute lymphoid malignancies
Acute lymphoblastic leukaemia
Types of chronic lymphoid malignancies (4)
Chronic lymphoblastic leukaemia
Hodgkin’s lymphoma
Non-Hodgkin’s lymphoma
Multiple myeloma
Types of acute myeloid malignancies
Acute myeloid leukaemia
Types of chronic myeloid malignancies (2)
Chronic myeloid leukaemia
Myeloproliferative disorders
What are myeloproliferative disorders
Pre-neoplastic overproduction of blood cells/components
Definition of leukaemia (2)
Group of cancers of the bone marrow
Prevent normal manufacture of blood
Patogenesis of leukaemia (3)
Clonal proliferation
Replacement of marrow
Increasing marginalisation of productive normal marrow (marrow failure, organ infiltration)
Clinical presentation of leukaemia (6)
Anaemia Neutropenia Thrombocytopenia Lymphadenopathy Splenomegaly, hepatomegaly Bone pain (especially in kids)
Progressive symptoms of anaemia (4)
Breathlessness
Tiredness
Easily fatigued
Chest pain/angina
Signs of anaemia (3)
Pallor
Signs of cardiac failure (ankle swelling, breathlessness)
Nail changes (brittle nails, koilonychia)
Clinical presentations of neutropenia (2)
Infections associated with portals of entry
Reactivation of latent infections
Symptoms of neutropenia (2)
Recurrent infection
Unusual severity of infection
Signs of neutropenia (3)
Unusually patterns of infection with rapid spread
Response to treatment but then recurrence of infection
Signs of systemic involvement (fever, rigorous, chills)
Neutropenia investigations
Unusual pathogens, usually bacterial (usually low pathogenicity organisms)
Symptoms of thrombocytopenia (4)
Bruise easily/spontaneously
Minor cuts fail to clot
Gingival/nose bleeding
Menorrhagia
Signs of thrombocytopenia (4)
Bruising
Petechiae
BoP
Bleeding/bruising following procedures
Features of acute lymphoblastic leukaemia, ALL (3)
Results in a catabolic state (fever, sweats, malaise)
Lymphadenopathy
Tissue infiltration
Features of acute myeloid leukaemia, AML (3)
Similar to ALL
Results in a catabolic state (fever, sweats, malaise)
Lymphadenopathy
Tissue infiltration
Features of chronic lymphocytic leukaemia, CLL (3)
B-cell clonal lymphoproliferative disease
Mostly asymptomatic
Usually slow progression, not requiring treatment
Features of chronic myeloid leukaemia, CML (3)
Occurs in neutrophils and their precursors
95% of patients have ‘Philadelphia’ chromosome
Fatigue, weight losses eating, anaemia, bleeding, splenomegaly
Definition of lymphoma (2)
Clonal proliferation of lymphocytes arising in a lymph node or associated tissue
Usually a solid tumour but contains some blood cells
Types of lymphoma (2)
Hodgkin lymphoma
Non-Hodgkin lymphoma
Lymphoma investigations (3)
CT
PET
MRI
Requirements of lymphoma staging (3)
Number of nodes involved and site
Extra-nodal involvement
Systemic symptoms
Presentation of Hodgkin lymphoma, HL (3)
Painless lymphadenopathy (typically cervical)
Fever, night sweats, weight loss, itching
Infection
Presentation of Non-Hodgkin lymphoma, NHL (3)
Causes - microbial factors strongly implicated, autoimmune disease, immunosuppression
Lymphadenopathy (often widely disseminated)
Extra-nodal disease more common (Waldeyer’s ring)
Symptoms of marrow failure
Definition of multiple myeloma
Malignant proliferation of plasma cells
Features of multiple myeloma (3)
Monoclonal paraprotein in blood and urine
Lytic bone lesions –> pain and fracture
Excess plasma cells in bone marrow –> bone marrow failure
Clinical presentation of multiple myeloma (4)
Infection
Bone pain
Renal failure
Amyloidosis
Treatment of haematological malignancies (4)
Chemotherapy
Radiotherapy
Monoclonal antibodies
Haematopoietic stem cell transplantation
Haematological malignancies usually undergo the process of (4)
Induction
Remission
Maintenance and consolidation
Relapse
Function of chemotherapy
Target cells with a high turnover rate
Side effects of chemotherapy (5)
Hair loss Vomiting Nausea Tiredness Risk of oncogenesis in surviving patients
Function of radiotherapy (2)
Cytotoxic effect of ionising radiation
Irradiation of tumour cells and adjacent healthy tissue
Advantage of monoclonal antibodies
Specific to cancer cell antigens
Types of haematopoietic stem cell transplantation (2)
Allogenic (from liver donor)
Autologous (self-transplant)
