20 - Leukaemia Flashcards

1
Q

Leukaemia

A
  • Cancer of WBCs
  • Begins in bone marrow
  • Genetic defect
  • Acute and chronic
  • Myeloid or lymphoid
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2
Q

Acute Leukaemia

A
  • Any age
  • Mutation in primitive cell, continues to replicate
  • Cells do not mature
  • Replacement of marrow by immature (“blast”) cells (no function)
  • Reduction in normal cells
  • Can be cured with chemo or transplant
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3
Q

Two main types of leukaemia

A
  • Lymphoid (ALL) B or T
  • Myeloid (AML)
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4
Q

Clinical Features of AL

A
  • Anaemia
  • Leucopenia
  • Thrombocytopenia
  • Bone pain
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5
Q

ALL lymphoblasts

A
  • Small
  • Basophilic cytoplasm
  • Fine homogeneous nuclear pattern
  • Occasional vacuoles
  • Inconspicuous nucleoli
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6
Q

Genetic abnormalities of AML

A
  • Chromosomal changes and point mutations
  • t(8;21), t(15;17), inv(16); mutations NPM1
  • Monosomy (poor prognosis)
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7
Q

AML myeloblasts

A
  • Variable size
  • Nucleus may be indented
  • Granular chromatin
  • Several nucleolus
  • Auer rods
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8
Q

Acute Promyelocytic Leukaemia

A
  • A distinct type of AML
  • Serious bleeding, clotting
  • t(15;17)
  • Abnormal promyelocytes, auer rods
  • Good prognosis
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9
Q

Good prognosis of AML

A

NPM1

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10
Q

Poor prognosis of AML

A

FLT3

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11
Q

Acute leukaemia management

A
  • Cytotoxic therapy
  • Targeted therapy (antibodies)
  • Transfusion
  • Transplantation
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12
Q

Chronic leukaemia

A
  • Malignant proliferation of mature myeloid
    or lymphoid cells
  • Adults
  • Mutation in primitive cell, low replication rate
  • Cells mature
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13
Q

Chronic Myeloid Leukaemia

A
  • Male predominance
  • May be asymptomatic
  • Massive splenic enlargement and liver
  • Neutrophilia, Eosinophilia, Basophilia
  • Philadelphia chromosome, t(9,22)
  • BCR/ABL
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14
Q

CML treatment

A
  • TKI (imatinib)
  • Allosteric inhibitor
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15
Q

Chronic Lymphocytic Leukaemia

A
  • Neoplastic proliferation of mature B lymphoid cells
  • Elderly
  • Enlarged lymph nodes, spleen, liver
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16
Q

Good prognosis CLL

A

trisomy 12, del 13q

17
Q

Poor prognosis CLL

A

del(11q), del(17p)

18
Q

Immuno-flowFISH

A
  • Combines flow cytometry phenotype with FISH
  • Identify chromosome abnormalities in the CLL cells only
19
Q

CD10, CD19, CD34, CD45

A

Acute Lymphoblastic Leukaemia

20
Q

CD13, CD14, CD33, CD34

A

Acute Myeloid Leukaemia

21
Q

CD33++, CD34-

A

Acute Promyelocytic Leukaemia

22
Q

CD19, CD23, CD79, k/l restricted; CD5

A

Chronic Lymphocytic Leukaemia