Chronic Lymphoblastic and Myeloid Leukaemia

Question 1

What is CLL?

Answer 1

progressive accumulation of malignant clone of functionally incompetent B cells in the blood

Question 2

How does CLL present?

Answer 2

60-80yrs old
enlargement of cervical, axillary or inguinal lymph nodes
features of anaemia and thrombocytopenia
immunosupression
splenomegaly + hepatomegaly

Question 3

What is seen on blood film in CLL?

Answer 3

lymphocytosis - B cell lymphocytes > 5x109

Question 4

What is CLL treatment?

Answer 4

symptom control

hard to cure

Question 5

What is CML?

Answer 5

uncontrolled clonal proliferation of myeloid cells (granulocytes, precursors, platelets)

Question 6

What is a genetic predisposition to CML?

Answer 6

philadelphia chromosome on the BCR-ABL-1 gene

Question 7

What is the only way to treat CML?

Answer 7

Tyrosine kinase inhibitors or

bone marrow or stem cell transplant

Question 8

What are the features of CML?

Answer 8

asymptomatic
splenomegaly
hypermetabolic syndrome
gout
priapism

Question 9

What is seen on blood count in CML?

Answer 9

thrombocytosis
leucocytosis with neutrophillia
myelocytes
eosinophillia
basophillia

Question 10

What is the implications of the philadelphia chromosome on the BCR-ABL-1 gene?

Answer 10

results in tyrosine kinase production which causes abnormal phosphorylation/signalling leading to haematological changes in CML

Question 11

Name a tyrosine kinase inhibitor?

Answer 11

Imatinib