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Haematology Week 3 2018/19 > 3: Concepts in malignant haematology > Flashcards

3: Concepts in malignant haematology Flashcards

1
Q

How are

a) lymphoid
b) non-lymphoid white cells identified?

A

a) Immunophenotyping

b) Morphology

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2
Q

How are progenitor blood cells identified?

A

Immunophenotyping

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3
Q

What occurs in malignant haemopoiesis?

A

Increased numbers of dysfunctional cells

Loss of normal activity

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4
Q

What problems occur in acute leukaemia?

A

Proliferation of ABNORMAL PROGENITOR CELLS

which DON’T DIFFERENTIATE OR MATURE

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5
Q

Which two processes fail to occur in acute leukaemia?

A

Differentiation

Maturation

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6
Q

What is the difference between acute leukaemia and chronic myeloproliferative disorders?

A

Acute leukaemia - proliferation of progenitor cells, NO DIFFERENTIATION OR MATURATION

Chronic myeloproliferative disorder - proliferation of progenitor cells, continued differentiation and maturation

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7
Q

What is a clone?

A

Population of cells derived from a single parent cell

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8
Q

A clone will have the same genetic ___ as its parent cell.

A

markers

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9
Q

How is normal haemopoiesis described in terms of clones?

A

Polyclonal

Blood cells come from a variety of parent cells

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10
Q

How is malignant haemopoiesis described in terms of clones?

A

Monoclonal

Cells derived from one abnormal parent cell

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11
Q

Malignant haemopoiesis has a strong __ component.

A

genetic component

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12
Q

What are the two lineages of haematological malignancy?

A

Myeloid

Lymphoblastic

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13
Q

What are malignant blood cancers called when the

a) blood
b) lymph nodes are involved?

A

a) Leukaemia

b) Lymphoma

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14
Q

What is myeloma?

A

Plasma cell malignancy IN the bone marrow

unfortunate naming not to be confused with myeloid leukaemias

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15
Q

Acute leukaemias tend not to involve the ___ ___.

A

lymph nodes

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16
Q

Chronic lymphoid leukaemias affect the ___ and ___ ___.

A

blood

bone marrow

but otherwise leukaemia means blood and lymphoma means lymph nodes

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17
Q

Acute leukaemia causes the ___ ___ to fail.

A

bone marrow failure

because differentiation and maturation stop dead

18
Q

Describe the speed of onset of acute and chronic haematological malignancies.

A

Acute leukaemia - quick onset

Chronic - onset over weeks to months

19
Q

Which cells are affected in

a) myeloid malignancy
b) lymphoblastic malignancy
c) myeloma?

A

a) Non-lymphoid cells and their progenitors

b) Lymphoid cells and their progenitors

c) Plasma cells

20
Q

Which type of blood cancer is aggressive and rapidly progressing?

A

Acute leukaemia

21
Q

Acute leukaemia causes a LOSS OF HAEMOPOIETIC RESERVE.

Which investigation gives this away?

A

FBC

low platelets, white cells and RBCs

22
Q

Which malignancy affects primitive lymphoid cells?

A

Acute lymphoblastic leukaemia

23
Q

What is the most common childhood cancer?

A

Acute lymphoblastic leukaemia (ALL)

24
Q

What are the signs and symptoms of bone marrow failure caused by acute leukaemia?

A

Anaemic symptoms (fatigue, pallor, SOB, syncope, palpitations)

Abnormal bleeding

Increased infection risk

25
Q

What is unique about the presentation of ALL?

A

Involvement of CNS, gonads i.e structures outwith the bone marrow

26
Q

Which acute blood malignancy primarily affects

a) children
b) adults?

A

a) Acute lymphoid leukaemia

b) Acute myeloid leukaemia

27
Q

Which coagulation problem is associated with acute myeloid leukaemia?

A

DIC

28
Q

How is acute leukaemia investigated?

A

Full blood count

Blood film

Coagulation screen (PT, APTT)

Bone marrow aspirate

29
Q

What do primitive progenitor cells look like on a blood film?

A

High nuclear:cytoplasmic ratio

Dodgy looking

30
Q

What is a blood film finding specific to AML?

A

Auer rods

31
Q

AML and ALL look similar morphologically.

How do you tell them apart?

A

Immunophenotyping

32
Q

How might you tell the difference between AML and ALL morphologically?

A

Auer rods specific to AML

but not there all the time

33
Q

Why is it important to determine whether a leukaemia is myeloid or lymphoblastic?

A

Different treatments

34
Q

How is acute leukaemia (ALL or AML) treated?

A

Chemotherapy

35
Q

Acute leukaemia AND the chemotherapy used to treat it cause bone marrow suppression.

What are the complications of this?

A

Anaemia

Neutropaenia > Infection

Thrombocytopaenia > Bleeding

36
Q

Patients undergoing chemotherapy for acute leukaemia are susceptible to which infection?

A

Gram negative bacteria

E. coli, Pseudomonas, Neisseria, Haemophilus, Chlamydia…

37
Q

Apart from bone marrow suppression, what are the generalised side effects of chemotherapy?

A

N&V

Hair loss

Lethargy

Hepatic and renal dysfunction

38
Q

What is tumour lysis syndrome?

A

Metabolic and electrolyte disturbances caused by tumour lysis in chemotherapy

39
Q

What do you do if a patient undergoing chemotherapy has neutropaenia and a fever?

A

Empirical antibiotic treatment

Empirical anti-fungal treatment if they don’t respond to that

40
Q

What is an important side effect of anthracycline chemotherapy?

A

Cardiomyopathy

41
Q

A subtype of which acute leukaemia is associated with coagulopathy?

Which specific coagulopathy?

A

AML

DIC

Haematology Week 3 2018/19 (10 decks)

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