Haematological cancers Flashcards
Myeloma describes a…
Malignancy of plasma cells leading to the abnormal production of immunoglobulins
_____________ is a premalignant myeloma
Smouldering myeloma
_________ is a single type of immunoglobulin produced by cancerous plasma cells in myeloma
Monoclonal paraproteins
______________ are light chains of immunoglobulins excreted in the kidneys, seen in myeloma.
Bence-Jones proteins
Myeloma accounts for ____% of all cancers.
1%
CRAB presentation of myeloma
C- hypercalcaemia
R- Renal dysfunction
A- Anaemia
B- Bone metastasis (lytic lesions)
Anaemia, _______ and _______arises in myeloma due to…
Anaemia, thrombocytopenia, neutropenia
Abnormal proliferation of plasma cells in bone marrow
- Disrupts many haematopoietic lines.
Myeloma bone disease typically occurs in which bones?
- Skull
- Long bones
- Spine
- Ribs
The increased osteoclast acitivity in myeloma leads to ________ and ________
Osteolytic bone lesions and hypercalcaemia.
People with myeloma can develop _______ which are plasma cell tumours in bone/soft tissue,
Plasmacytoma
Renal dysfunction occurs in myeloma due to…
Immunoglobulins blocking the tubules and hypercalcaemia from osteolytic bone activity
Risk factors for myeloma
Increasing age
Male
Black, African
Obese
Family history
Bruising, bleeds and visual impairment can occurs in myeloma due to…
Raised plasma viscosity arising from increased plasma proteins (immunoglobulins)
Specific investigations for myeloma (BLIP)
B- Urine Bence-Jones proteins (electrophoresis)
L- Serum Free light-chain assay
I- Serum immunoglobulins
P- Serum protein electrophoresis
Myeloma is definitely diagnosed via _______
Bone marrow biopsy and histology
X-ray findings for myeloma
Lytic bone lesions
- Punched out
Raindrop skill
Acute treatment for myeloma
Dexamethasone
- Suppresses Ig production
Chemotherapy
Definite treatment for myeloma
Stem cell transplant
Treatment for myeloma bone disease
- Bisphosphonates
- Palliative radiotherapy
- Surgery for fractures
- Cement augementation
The most common form of non-Hodgkins lymphoma in adults is…
Diffuse large B cell lymphoma (DLBCL)
Burkitt’s lymphoma is associated with which genetic mutation
Translocation 8:14 (t(8:14)) of c-myc gene
MALT lymphoma is associated with which infection
H pylori
______ is a drug used in low grade, localised non-Hodgkins lymphoma. It works by inducing apoptosis via CD20
Rituximab
Hodgkin lymphoma are characterised by ______ cells
Reed-Sternberg cells
The most common type of Hodgkin lymphoma is…
Nodular sclerosis
- Contains collagen bands separating cellular nodules.
_______ is the least common type of Hodgkin lymphoma with the worse prognosis
Lymphocyte deplete
- Contains diffuse fibrosis.
________ population are at high risk of Hodgkin lymphoma
Jewish
Symptoms of lymphoma
Painless lump
B symptoms
- Weight loss
- Night sweats/ Fever
- Fatigue
Pruritis
Recurrent infections
Intolerance to alcohol (Hodgkin)
Signs of lymphoma
Lymphadeopathy
Pale conjuctiva, pallor
Hepatomegaly
Splenomegaly
______ is non-specifically raised in lymphoma
LDH
_____ is an inflammatory marker than is used as a prognostic factor in lymphoma
ESR
________ is carried out for staging lymphoma
Bone marrow trephine and aspirate
What infections are associated with lymphoma
HIV
EBV
Lymphoma is staged using what classification?
Ann Arbor staging
In Ann Arbor staging of lymphoma,
Stage 1=
Stage 2=
Stage 3=
Stage 4=
1= Lymphoma in one region
2= Affects >1 region on one side of the diaphragm
3= Affects above and below diaphragm
4= Widespread, non-lymphatic organs affected.
Auer rods are associated with…
Acute myeloid leukaemia
Philadelphia chromosome is associated with…
Chronic myeloid leukaemia (most common)
ALL
A myeloproliferative disorder can progress into what type of malignancy?
Acute myeloid leukaemia
Deletions in chromsome 5 or 7 is associated with which haematological malignancy
Acute myeloid leukaemia
Tumour lysis syndrome can be treated using…
Allopurinol
Rasburicase
Tumour lysis syndrome occurs when…
Uric acid is released into blood during cell breakdown from chemotherapy
- causing crystalisaiton in kidnyes
Tumour lysis syndrome presents with elevated ______, _______ and _______ in the blood
Uric acid
Potassium
Phosphate
Downs syndrome is associated with which haematological malignancy?
Acute lymphoblastic leukaemia
Warm autoimmune haemolytic anaemia is associated with which haematological malignancy?
Chronic lymphocytic leukaemia
Transformation of ______ into high grade lymphoma is called ______
CLL transformation = Richter’s transformation
_________ is the most common first line agent for chronic myeloid leukaemia and acts by ______
Imatinib
- Tyrosine kinase inhibitor (of ACL-BCR oncogene)
The most common leukaemia in adults is…
Chronic lymphocytic leukaemia
Smear/ smudge cells are associated with which haematological malignancy?
Chronic lymphocytic leukaemia
Hypogammaglobulinaemia is associated with ______ leukaemia
Chronic lymphocytic
