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Haematology > Acute Lymphoblastic leukaemia > Flashcards

Acute Lymphoblastic leukaemia Flashcards

1
Q

What is acute lymphoblastic leukaemia?

A

Malignant change in one of the lymphocyte precursor/progenitor cells.

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2
Q

What does Acute Lymphoblastic Leukaemia cause?

A

Acute proliferation of a single type of lymphocyte, usually B-lymphocytes.

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3
Q

What does acute proliferation of the lymphocytes cause?

A

Causes them to replace the other cell types being created in the bone marrow, leading to a pancytopenia.

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4
Q

Who is this type of cancer most common in?

A

Children

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5
Q

What age is the peak incidence for this cancer?

A

2-5 years

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6
Q

What genetic condition is acute lymphoblastic leukaemia associated with?

A

Down’s syndrome

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7
Q

What age of adults can be affected by acute lymphoblastic leukaemia?

A

Adults over 45

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8
Q

What chromosome is acute lymphoblastic leukaemia associated with in adults?

A

Philadelphia chromosome (t(9:22) translocation)

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9
Q

What are the three types of acute lymphoblastic leukaemia?

A
  • Common ALL pre-B phenotype
  • T-cell ALL
  • B-cell ALL
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10
Q

What is the most common type of acute lymphoblastic leukaemia?

A

• Common ALL, pre-B phenotype

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11
Q

What are the features of acute lymphoblastic leukaemia predictable by?

A

Bone marrow failure

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12
Q

What are the features of bone marrow failure?

A
  • Anaemia: lethargy and pallor
  • Neutropenia: frequent or severe infections
  • Thrombocytopenia: easy bruising, petechiae
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13
Q

What are the other possible features of acute lymphoblastic leukaemia?

A
  • bone pain (secondary to bone marrow infiltration)
  • splenomegaly
  • hepatomegaly
  • fever is present in up to 50% of new cases
  • testicular swelling
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14
Q

How is acute lymphoblastic leukaemia diagnosed?

A
  • Blood results show leukocytosis
  • Blast cells on blood film
  • Bone marrow analysis
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15
Q

What would you find in the blood test of someone with ALL?

A

Leukocytosis
(raised WCC)

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16
Q

What would you find on a blood film of someone with ALL?

A

Blast cells

17
Q

What is characteristic of B cells?

A

Express CD10

18
Q

What is the management of ALL?

A

Induction chemotherapy

19
Q

What is the management of ALL if there is a high risk of relapse?

A

Stem cell transplant

20
Q

What are poor prognostic factors for ALL?

A 
age < 2 years or > 10 years
WBC > 20 * 109/l at diagnosis
T or B cell surface markers
non-Caucasian
male sex
21
Q

What is an usual way that anaemia can present?

A

Soft systolic murmur

Shortness of breath of exertion

22
Q

What is a differential of ALL with no fever?

A

Immune thrombocytopenia

Haematology (36 decks)

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