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Clin Haem > Chronic Leukemias > Flashcards

Chronic Leukemias Flashcards

1
Q

Which translocation is found in CML?

A

t(9;22) Philadelphia chromosome

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2
Q

True or false
the Philadelphia chromosome has a good prognosis in AML and a bad prognosis in CML

A

False- good prognosis in CML, bad prognosis in AML

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3
Q

What are the clinical features of CML?

A

fatigue
weight loss
sweating
painless lymphadenopathy
massive splenomegaly > 15 cm below costal margin

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4
Q

What is seen on the peripheral blood film in CML?

A

normocytic, normochromic cells
increased uric acid
increased LDH
WBC: 10,000 - 600,000
leukemic cells
basophilia

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5
Q

Basophilia occurs as a result of blast crisis in CML. What are the clinical features resulting from basophilia?

A

diarrhea, pruritus, flushing

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6
Q

Which tests definitively diagnose CML?

A

Cytogenetics and BM biopsy

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7
Q

What are the side effects of imatinib?

A

nausea
fluid retention (e.g. periorbital oedema, CHF)
prolonged QT interval on ECG
muscle cramps
rash
myelosuppression

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8
Q

What are the side effects of dasatinib?

A

myelosuppresion especially thrombocytopenia
CHF
pulmonary HTN
prolonged QT interval

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9
Q

In CML with T3151 mutation which TKI drug is given?

A

ponatinib

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10
Q

Which type of leukemia presents with lymphocytosis with smudge cells?

A

CLL

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11
Q

Which stage in the Rai System has lymphocytosis + hepatosplenomegaly?

A

Stage 2

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12
Q

True or false
A 13q deletion in CLL has a poor prognosis

A

False: favorable prognosis

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13
Q

What is the main cause of death in CML?

A

Transformation to a blast phase

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14
Q

What is the clinical presentation of CML?

A

hyper metabolism symptoms (weight loss, lethargy, anorexia or night sweats)
splenomegaly
anaemia symptoms (pallor, dyspnea, tachycardia)
abnormal platelet function
gout or renal impairment

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15
Q

What is the main treatment for CML?

A

Tyrosine kinase inhibitors

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16
Q

What are the lab findings in CML?

A

leucocytosis (main feature)
increased circulating basophils (characteristic feature)
normocytic, normochromic anaemia
platelet count mostly increased (may be normal or decreased)
hypercellular BM (granulocytic predominance)
BCR-ABL1 gene fusion
increased serum uric acid

17
Q

Which TKI is associated with the highest risk of thrombotic events?

A

ponatinib

18
Q

Which treatment is used for CML in pregnancy?

A

a-inteferon

19
Q

What are the features of the accelerated phase in CML?

A

anaemia
thrombocytopenia
basophilia (>20%)
marrow blast cells (10-19%)
spleen may be enlarged
marrow may be fibrotic
new clonal chromosomal or molecular abnormalites may appear

20
Q

What is acute tranformation in CML?

A

transformation into acute leukemia (mainly AML)

Clin Haem (3 decks)

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