Acute and Chronic Lymphoblastic Leukaemia (ALL and CLL)

Question 1

What does ALL stand for?

Answer 1

Acute Lymphoblastic Leukaemia

Question 2

What is ALL?

Answer 2

Neoplastic lymphoblast proliferation.
Decreased production of RBCs, WBCs and platelets.
Most common type of leukaemia in children.

Question 3

What % of cases of ALL are childhood (under 7 y/o) malignancies?

Answer 3

75%

Question 4

ALL mostly affects which cell lineage?

Answer 4

B cell

Question 5

What chromosome is translocated in ALL?

Answer 5

t(12:21)

Has a good prognosis

Question 6

What other condition increases the risk of ALL by 30 times?

Answer 6

Down’s

Question 7

What other factor increases the risk of ALL other than Down’s?

Answer 7

Radiation

Question 8

What group of ALL patients won’t show general leukaemia symptoms?

Answer 8

6 year olds with Down’s

Question 9

Other than general leukaemia symptoms, what is present with ALL?

Answer 9

Hepatosplenomegaly

Question 10

How would you diagnose ALL?

Answer 10

FBC:
pancytopenia

Blood film:
Increased lymphoblasts

Bone marrow biopsy:
At least 20% lymphoblast

Immunofluorescence:
TdT positive lymphoblast

Question 11

What is treatment for ALL?

Answer 11

Chemotherapy
Consider allopurinol

Question 12

What does CLL stand for?

Answer 12

Chronic Lymphocytic Leukaemia

Question 13

What is CLL?

Answer 13

Neoplastic proliferation of lymphocytes, mostly B cells.

Question 14

True or false: CLL is the most rare leukaemia overall

Answer 14

False
It is the most common

Question 15

75% of CLL patients have a _ year survival

Answer 15

5

Question 16

Does CLL mainly affect children or adults or older adults?

Answer 16

older adults (70 y/o)

Question 17

What are symptoms of CLL?

Answer 17

General anaemia
Lymphadenopathy (non-tender lymph node swelling)
Hepatosplenomegaly

Question 18

How do you diagnose CLL?

Answer 18

FBC:
Pancytopenia (except lymphocytes)

Blood film:
Smudge cells (ruptured CLL cells)

Immunoglobulins:
Hypogammaglobulinemia (low levels of IGs in blood)

Question 19

Why is there hypogammaglobulinemia with CLL?

Answer 19

Many B lymphocytes but don’t function properly/ mature to plasma cells in CLL so don’t fewer immunoglobulins produced

Question 20

What is treatment for CLL?

Answer 20

Chemotherapy
Consider allopurinol

Perhaps palliative if old

IV Immunoglobulins for hypogammaglobulinemia

Question 21

What is a complication of CLL?

Answer 21

Richter transformation.

B cell massively accumulates in lymph nodes leading to massive lymphadenopathy.
Can transform into an aggressive lymphoma.