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Haematology > Acute Leukaemia (Megan) > Flashcards

Acute Leukaemia (Megan) Flashcards

Acute myeloblastic leukaemia Acute lymphoblastic leukaemia

1
Q

How does every blood cell start?

A

In the bone marrow as a haematopoietic cell.

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2
Q

What 2 categories can a haematopoietic stem cell turn into?

A
  1. Lymphoblast - B lymphocyte or T lymphocyte

2. Myeloblasts - erythrocyte, thrombocyte/latelet, monocyte, granulocyte (neutrophil, basophil, eosinophil)

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3
Q

What predisposes you to mutations in the bone marrow?

A

Chemotherapy
radiation
downs syndrome
other genetic abnormalities

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4
Q

What is the pathophysiology behind acute leukaemia’s?

A

The immature cells lose the ability to differentiate. So they can proliferate but are stuck as a blast cell.

They divide uncontrollably and take up lots of space in the bone marrow - this causes lower levels of all other blood cells.

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5
Q

What is cytopenia?

A

A reduction in the other red blood cells - as a result of blast cells infiltrating the bone marrow and causing bone marrow failure.

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6
Q

What are the types of cytopenias?

A

Anaemia - reduced RBCs
Thrombocytopenia - reduced platelets
Neutropenia - reduced neutrophils

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7
Q

What are the symptoms of acute leukaemia’s?

A 
Anaemia: 
Fatigue
Pallor
Lethargy
Weakness 
Heart failure
Thrombocytopenia:
easier bleeding
petechiae 
purpura
bruising (in areas of pressure)
epistaxis
gum bleeds

Neutropenia:
Frequent Infections

Other:
Pain and tenderness
Hepatomegaly
Splenomegaly
Lymphadenopathy 
fever
testicular swelling
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8
Q

How is acute leukaemia diagnosed?

A

Peripheral blood smear: shows myeloblasts (In AML) and lymphoblasts (In ALL)
Bone marrow biopsy:
Shows increased number of blast cells

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9
Q

What are the 2 main types of acute leukaemia?

A

Acute lymphoblastic leukaemia

Acute myeloblastic leukaemia

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10
Q

How are ALL and AML differentiated?

A

Using immunotyping
OR
Using specially stained smears

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11
Q

What blast cell number indicates acute leukaemia?

A

Normal = 1-2% blast cells

Acute leukaemia = >20%

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12
Q

What is the treatment for acute leukaemia?

A

Chemotherapy
Biological therapy
Stem cell transplants
Bone marrow transplants

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13
Q

Who is most commonly diagnosed with acute lymphoblastic leukaemia?

A

Children

Accounts for 80% of childhood leukasmias

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14
Q

What is the peak age to get ALL?

A

2-5 yrs

Boys>girls

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15
Q

Which features are more common in ALL than in AML?

A

Hepatosplenomegaly

Lymphadenopathy

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16
Q

What type of ALL do you get?

A

B cell acute lymphoblastic leukaemia (most common).

T cell acute lymphoblastic leukaemia (least common).

17
Q

What is the pathophysiology of acute lymphoblastic leukaemia?

A

Proliferation of lymphoid cells WITHOUT differentiation.

18
Q

Which chromosome is often associated with ALL?

A

9 and 22 - the Philadelphia chromosome

19
Q

What is the most common acute leukaemia in adults?

A

Acute myeloblastic leukaemia

20
Q

How can acute myeloblastic leukaemia present?

A

As a primary disease

Secondary to myeloproliferative disorder

21
Q

When does myeloproliferative disease become acute myeloid leukaemia?

A

If the blasts are <20% its myeloproliferative disorder and it becomes AML when the blast cells are >20%.

22
Q

How does bone marrow failure occur in acute leukaemia?

A

The bone marrow is replaced with acute leukaemia cells (blasts).

23
Q

When is CSF testing done?

A

If there is suspected CNS involvement (more common in children).

24
Q

Which genes are associated with acute myeloblastic leukaemia?

A

FLT3

NPM1

25
Q

What is a complication of acute myeloblastic leukaemia?

A

Fungal infections

26
Q

What are the 3 stages of anti leukaemia chemotherapy?

A

Remission:
1-2 cycles

Consolidation:
1-3 cycles

Maintenance:
Using target therapies

27
Q

What is the most effective anti leukaemia treatment?

A

Allogenic transplant

28
Q

what is important in the treatment of acute myeloblastic leukaemia?

A

Age - increased age gives a poorer prognosis

29
Q

What is an example of a targeted antibody?

A

Gemtusumab

Haematology (27 decks)

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