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Haematology > Chronic Leukaemia > Flashcards

Chronic Leukaemia Flashcards

1
Q

what is CML

A

clonal myeloproliferative disorder- incr in neutrophils in peripheral blood, increased cellularity of the marrow

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2
Q

what is the chromosome in CML

A

Philadelphia. BCR-ABLE1. translocation t(9,22)

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3
Q

what cell is increased in CML

A

neutrophils

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4
Q

what happens in blast transformation

A

may transform from relatively stable chronic phase to acute leukaemia phase

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5
Q

clinical features CML

A

at all ages peak 25-45. weight loss, night sweats, itching, left hypochondrial pain, gout. splenomegaly

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6
Q

what can hyperviscosity cause in CML

A

priapism, visual disturbance, headaches

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7
Q

lab findings CML

A

raised WCC, anaemia may be present, platelets can do anything, raised uric acid. hypercellular BM

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8
Q

what is the course of CML

A

most patients are well in chronic phase, death is from transformation to acute leukaemia

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9
Q

what % of blast transformation in CML is to AML

A

80% (20 to ALL)

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10
Q

what drug can be given for incr WCC

A

hydroxycarbamide

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11
Q

treatment CML

A

imatinib- tyrosine kinase inhibitor

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12
Q

what is given to prevent hyperuricaemia

A

allopurinol

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13
Q

what can be used to treat CML if patient doesn’t respond

A

allogeneic stem cell transplant

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14
Q

therapy for acute phase CML

A

as for AML and ALL with tyrosine inhibitor. but prognosis is poor

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15
Q

what is CLL

A

lymphoproliferative disorder. B cell clonal disease. lymphocytes accumulate in blood, bone marrow, lymph nodes, spleen

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16
Q

what is the most common leukaemia in the west

A

CLL

17
Q

what is stage dependent on in CLL

A

extent of lymphadenopathy

18
Q

stage A CLL

A
19
Q

stage B CLL

A

> 3 lymphoid areas involved.

20
Q

stage C CLL

A

anaemia and thrombocytopenia present

21
Q

features stages B and C CLL

A

lymphadenopathy- symmetrical, painless), night sweats, weight loss, symptoms from bone marrow failure

22
Q

lab findings CLL

A

incr blood lymphocytes.

23
Q

favourable prognostic features CLL

A

female, stage A, lymphocyte doubling time >1y, AIHA absent

24
Q

what is Richters syndrome

A

local lymphoblastic transformation in CLL- poor prognosis

25
Q

treatment for stage A patients CLL

A

observation for asymptomatic patients

26
Q

treatments for stage B and C CLL

A

fludarabine, cyclophosphoramide, ritixumab

27
Q

what can you give for bone marrow failure

A

corticosteroids

28
Q

what can be used in late stage CLL

A

alemtuzumab. splenectomy

29
Q

what is prolymphocytic leukaemia

A

resembles CLL but occurs in older patients, WCC high, poor response to treatment

Haematology (12 decks)

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