5. Cancer case studies - chronic myeloid leukaemia

Question 1

What is meant by a ‘myeloproliferative disorder’?

Answer 1

Where blood cells proliferate and develop with no control and they can accumulate

Question 2

What is the cell of origin in CML?

Answer 2

Pluripotent stem cells

Question 3

How can CML be recognised from a blood smear?

Answer 3

Increase in granulocytes

Hypersegmented nuclei

Question 4

What are granulocytes?

Answer 4

WBCs with granules within them e.g. oesinophils and basophils

Question 5

What are the two types of cell proliferation in CML?

Answer 5

Increased erythropoiesis - RBCs

Increased WBCs - leukaemia

Question 6

Why is there hepatosplenomegaly in CML?

Answer 6

Because of the increased erythropoiesis - cell production shifts from the bone marrow to the spleen and the liver

Question 7

What is the treatment for CML?

Answer 7

Chemotherapy (toxicity)
Stem cell transplant (risk of rejection)
Small molecule targeted therapy - tyrosine kinase inhibitors

Question 8

What is the main TKI used to treat CML?

Answer 8

Imatinib

Question 9

What are the three main TKIs used to treat CML?

Answer 9

Imatinib
Nilotinib
Dasatinib

Question 10

What is the most common mutation responsible for CML?

Answer 10

Reciprocal mutation - chromosomes 9 and 22 - PHILADELPHIA CHROMOSOME