20. hematologisk malginiteter Flashcards

1
Q

BM-svikt

A

3 linker påverkade (normocytär anemi, låga retikulocyter, LPK/TPK)

diffar: akut leukemi, MDS, lymfom, infektion (EBV, CMV, HPV B19), LM, HRA, solid tumör

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2
Q

hematologisk cancer

A

vanliagste cancerformen hos barn
- 100 fall/år
- 1/3 av alla cancerformer hos barn

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3
Q

peak ålder

A

2-4 år
- AML 1-2 år
- fler fliockor

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4
Q

riskfkatorer leukemi

A

okänd
- gentetik: downs ökad risk, Li-fraumeni, neurofibromatos typ 1
- miljö: strålning, kemo, kemikalier, pestecider

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5
Q

symtom leukemi

A

ospecifika men viktiga
- feber
- blekhet
- palpabel lever/mjälte
- blåmärken

annat
- dålig ork, trött
- upprepad feber, oklar infektion
- blödningar petekier/hematom, slemhinnor
- skelettsmärta
- stora lymfkörtlar
- testikelförstoring
- leuemiska hudinfiltrat

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6
Q

fynd vid us leukemi

A

lymfkörtelförstoring > 1-2 cm vanligt
- oömma, fasta/hårda, ej försjutbara, adherenta

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7
Q

basal utredning leukemi

A
  1. blodstatus med diff
    - blaster ökar risk för leukemi
    - normal diff utesluter ej lukemi
  2. urat, SR, CRP, LD
  3. lung-rtg: förstorad mediastinum
  4. ulj buk: hepatosplenomegali
  5. BMasp/biopsi
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8
Q

diff till leukemi

A

JRA

EBV

IPT, TEC, aplastik anemi, lymeom

andra malginiteter med BM engangemang t.ex. neuroblastom

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9
Q

indelning leukemi

A

ALL: 90%

AML: 10%

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10
Q

ALL

A
  1. B-ALL –> pre-B-ALL (burkitt) –> mogen B-ALL
    - 85%
  2. T-ALL
    - 15%, lite äldre barn, oftare pojkar
  3. NK-cells ALL
  4. blandformer ALL/AML
    - mixed phenotyp acute leukemi
    - ovanligt
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11
Q

beh leukemi

A

kortison (ALL, ej AML)

systemisk/po kemoterapi

CNS-terapi (intratekal mtx)

ev SCT

ev radioterapi

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12
Q

överlevnad leukemi

A

ålder spelar roll
- 5 års överlevnad ALL 90%

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