acute leukaemias

Question 1

two main types

Answer 1

ALL

AML

Question 2

location of leukaemias

Answer 2

Bone marrow origin.

Question 3

acute leukaemias path

Answer 3

bone marrow replaced by proliferating undifferentiated neoplastic progenitor cells - blast cells - leading to bone marrow failure

rapidly fatal if untreated

Question 4

chronic leukaemias path

Answer 4

proliferation of differentiated cells - does not lead to bone marrow failure

Question 5

diagnosis from histology of AML/ALL

Answer 5

> 20% blasts present in bone marrow or peripheral blood screen

Question 6

signs of bone marrow failure

Answer 6

anaemia
thrombocytopenic bleeding
neutropenia

Question 7

ALL aetio

Answer 7

most common paediatric cancer

> 6yo

Question 8

ALL PC

Answer 8

2-3wk hx of bone marrow failure

• bony pain, joint pain
• bleeding
• infection
• fever
• lymphadenopathy

visual problems because of haemorrhage

Question 9

tests for ALL

Answer 9

blood count + blood film

bone marrow aspirate (liquid) + trephine (core in situ)

Question 10

standard treatment for ALL

Answer 10

supportive: blood products, RBCs, platelets, a/bs, antifungals

Chemo:
- intrathecal methotrexate (hidden malignancies in PNS, CNS)

Stem cell transplant: if high risk - allogenic donor stem cells
high risk high gain
(never done in children)

Question 11

poor prognostic factors for ALL?

Answer 11

adult >60yo
WBC <300
slow or poor response to tx

Question 12

children prognosis with ALL

Answer 12

5 yr survival 95%

Question 13

PC of AML

Answer 13

over 65yo

due to Bauer rods

• leukostasis
• CNS symptoms
• DIC