Condition- Chronic Leukaemia (CLL,CML) Flashcards
What is CLL?
Accumulation of incompetent mature lymphocytes especially B cells. They are monoclonasl and escape apoptosis
Describe the presenting symptoms of CLL
- Symptoms of BM failure
- Lymphadenopathy
- Consitutional symptoms
State 3 complications of CLL
- 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
What might you see in the bloods of someone with CLL?
- Increased WCC
- Decreased RBC + Hb
- Decreased Platelets
- Decreased gamma globins
What might you see in a blood film of someone with CLL?
Smudge cells (abnormal B cells getting squished)
Small lymphocytes with thin rim of cytoplasm
What is CML
Uncontrolled proliferation of myeloid cells in the BM and blood
Slower progression than AML
State a common cause of CML
Philadelphia Chromosome (BCR-ABL gene)
How does the philadelphia chromosome t(9,22) cause CML?
- Increased TK activity => continuous cell proliferation
State some of the presenting symptoms of CML
- Symptoms of BM failure
- Hypermetabolic symptoms- lethargy, malaise, sweating
- Gout
- Hypreviscosity symptoms (increased RBC)
- MASSIVE SPLENOMEGALY
What would you see in an FBC of someone with CML?
- High WCC (all myeloid cells)
- Low Hb
- High/ normal/ low platelets
- High uric acid
- High B12 and trancobalamin
What would you see in a blood film of someone with CML?
Increased number of immature granulocytes
Which investigation could you conduct on CML other than Bloods and BM aspiration?
Cytogenetics to look for Philadelphia Chr
State a complication of CML
BLAST CRISIS = progression of CML to more aggressive AML/ ALL
