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Jason's MD2 Intersession 3 > Acute & Chronic Leukaemia > Flashcards

Acute & Chronic Leukaemia Flashcards

1
Q

etiology of leukaemia?

A

mostly unknown

prev cytotoxic therapy
ionizing radiation
benzene

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2
Q

Trisomy 21 risk of what leukaemia?

A

AML

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3
Q

acute leukaemia presentation?

A

Anaemia
Neutropenia
thrombocytopenia
B-symptoms

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4
Q

what are B-symptoms?

A

fevers, sweats, weight loss

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5
Q

what’s a real night sweat?

A

need to change clothes and sheets

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6
Q

hyperleucocytosis presents how?

A

stroke, MI, ischaemic symptoms

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7
Q

What can present with mediastinal mass?

A

Acute lymphoblastic leukaemia

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8
Q

key Ix of acute leukaemia?

A 
FBE and film
bone marrow biopsy
immunophenotyping
cytogenetics
molecular studies
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9
Q

what do you see on blood film in acute leukaemia?

A

blasts

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10
Q

how many blasts needed to have acute leukaemia

A

> 20% blasts = acute leukaemia

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11
Q

Auer Rods?

A

acute myeloid leukaemia

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12
Q

what is flow cytometry for?

A

find out lineage commitment to see if myeloid/lymphoid

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13
Q

primitive cells have what surface markers for flow cytometry for AML?

A

CD34, CD33, CD11

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14
Q

what means good prognosis for AML?

A

cure with standard chemo without bone marrow transplant

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15
Q

when do molecular testing?

A

ppl with AML and in the intermediate risk group

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16
Q

AML mutations, what is good what is poor prognosis? molecular testing?

A

Poor: FLT3
Good: nucleophosmin 1, CEBPA, PML-RARA

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17
Q

what is morphological remission in bone marrow re: blasts?

A
18
Q

ALL therapies different how?

A

younger people age 18-30 get the paediatric protocol for ALL

19
Q

crucial drug in ALL ?

A

L-asparaginase

20
Q

APML is what?

A

a good prognosis of AML

21
Q

How does APML present?

A

bleeding and bruising, cytopaenia
DIC

low fibrinogen , high INR, high APTT, due to release of procoagulants from malignant prothrombocyets

22
Q

what kind of cells in APML?

A

Faggot cell filled with Auer Rods

23
Q

APML cytogenetics?

A

t(15,17)

get’s PML-RARA

24
Q

how to treat APML in country?

A

platelets, pryoprecipitate, fibrinogen

THen get to a centre to use:
use All trans retinoic acid (ATRA) and arsenic (induce promyelocyte differentiation)

25
Q

CML cytogenetics? treatment?

A

t9:22, philedelphia chromosone, BCR-ABL, treated with imitinib, glivec

26
Q

Chronic leukaemia 3 stages natural history

A

chronic: usu. present here. big spleen, raised WBC
accelerated: hepatosplenomegaly, B-symptoms
blasts: (3-5 yrs): then get acute leukaemia

27
Q

CML blood film see what?

A

full spectrum of neutrophils, blasts, mature, mature, nucleated RBCs, basophils, eosinophilia

28
Q

CML cytogenetics see what? rx how?

A

BCR-ABL fusion: t(9:22)

Tyrosine kinase inhibitors

29
Q

how to monitor CML response to therapy?

A

PCR 3/12 bcr-abl

30
Q

2 second generation tyrosine kinase inhibitors?

A

dasatinic

niltoinib

31
Q

Chronic lymphocytic leukaemia presentation?

A

picked up on FBE

32
Q

Chronic lymphocytic leukaemia anaemias?

A

auto-immune hemolytic anaemia

33
Q

Chronic lymphocytic leukaemia on blood film?

A

smear cells, small mature lymphocytes

CD19 - B-cell marker
CD5 - T-cell marker
coexisting: they should coexist

34
Q

Nasty CLL deletions?

A

17p (loss of p53) or 11q deletion

35
Q

indolent CLL markers?

A

13q

36
Q

when do you treat CLL?

A

only when symptomatic:

B-cells, bulky glands, big spleen

37
Q

management of Chronic lymphocytic leukaemia?

A

FCR: fludarabine, cyclophosph, rituximab

also alemtuzumab

38
Q

cure for Chronic lymphocytic leukaemia?

A

alllograft

39
Q

rituximab monoclonal antibody to what?

A

CD20

40
Q

leukaemia classifications?

A

Acute or chronic

Myeloid or lymphoid

Jason's MD2 Intersession 3 (11 decks)

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