Chronic Leukaemia

Question 1

Types of chronic leukaemia?

Answer 1

Chronic myeloid leukaemia

Chronic lymphoblastic leukaemia

Question 2

What happens in CML?

Answer 2

Uncontrolled clonal proliferation of myeloid cells

Question 3

When does CML usually present?

Answer 3

40-60 years old

Question 4

What chromosome is associated in >80% CML cases?

Answer 4

Philadelphia chromosome

Question 5

Those without the Philadelphia chromosome in CML have a better / worse prognosis?

Answer 5

Worse

Question 6

Signs and Symptoms of CML?

Answer 6

Weight loss, tiredness fevers, sweats 
Maybe gout
Bleeding 
Abdo discomfort 
Splenomegaly, hepatomegaly 
Anaemia 
Bruising

Question 7

WBC increased or decreased in CML?

Answer 7

Increased

Question 8

In CML what happens to urate and B12?

Answer 8

Increase

Question 9

Marrow cellularity in CML?

Answer 9

Hypercellular

Question 10

Treatment of CML?

Answer 10

BCR-AML inhibitors - eg imatinub

Stem cell transplantation

Question 11

What happens on CLL?

Answer 11

Accumulation mature B cells which have escaped programmed cell death and now in cell arrest in G0/G1 phase

Question 12

What is the commonest leukaemia?

Answer 12

CLL

Question 13

Signs and symptoms of CLL?

Answer 13

Often asymptomatic 
Anaemia/ infection prone 
If severe - weight loss, sweats, anorexia 
Enlarged , rubbery , non tender nodes 
Splenomegaly, hepatomegaly

Question 14

feature on CLL bloods?

Answer 14

Raised lymphocytes

Question 15

Treatment of CLL?

Answer 15

Drugs- fludarabine + cyclophosphamide + rituximab
Radiotherapy
Supportive - transfusions, IV human Ig
Relapse - R-DEX (rituximab + dexamethasone)