Condition- Chronic Leukaemia (CLL,CML) Flashcards

1
Q

What is CLL?

A

Accumulation of incompetent mature lymphocytes especially B cells. They are monoclonasl and escape apoptosis

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2
Q

Describe the presenting symptoms of CLL

A
  • Symptoms of BM failure
  • Lymphadenopathy
  • Consitutional symptoms
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3
Q

State 3 complications of CLL

A
  • Hypogammaglobinaemia (increased infection rate). CLL cells don’t produce enough
  • RICHTER’S SYNDROME: aggregation of abnormal lymphocytes in lymph nodes progresses to NHL
  • AIHA: AI abnormality in CLL cells
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4
Q

What might you see in the bloods of someone with CLL?

A
  • Increased WCC
  • Decreased RBC + Hb
  • Decreased Platelets
  • Decreased gamma globins
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5
Q

What might you see in a blood film of someone with CLL?

A

Smudge cells (abnormal B cells getting squished)

Small lymphocytes with thin rim of cytoplasm

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6
Q

What is CML

A

Uncontrolled proliferation of myeloid cells in the BM and blood

Slower progression than AML

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7
Q

State a common cause of CML

A

Philadelphia Chromosome (BCR-ABL gene)

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8
Q

How does the philadelphia chromosome t(9,22) cause CML?

A
  • Increased TK activity => continuous cell proliferation
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9
Q

State some of the presenting symptoms of CML

A
  • Symptoms of BM failure
  • Hypermetabolic symptoms- lethargy, malaise, sweating
    • Gout
  • Hypreviscosity symptoms (increased RBC)
  • MASSIVE SPLENOMEGALY
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10
Q

What would you see in an FBC of someone with CML?

A
  • High WCC (all myeloid cells)
  • Low Hb
  • High/ normal/ low platelets
  • High uric acid
  • High B12 and trancobalamin
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11
Q

What would you see in a blood film of someone with CML?

A

Increased number of immature granulocytes

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12
Q

Which investigation could you conduct on CML other than Bloods and BM aspiration?

A

Cytogenetics to look for Philadelphia Chr

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13
Q

State a complication of CML

A

BLAST CRISIS = progression of CML to more aggressive AML/ ALL

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