Haematological conditions Flashcards
What is haematology?
the branch of medicine concerned with the study of the cause, prognosis, treatment, and prevention of diseases related to blood
What is lymphoma?
a type of blood cancer that develops within the lymphatic system and lymphocytes
this can lead to uncontrolled growth of lymphocytes
Name the four types of lymphoma.
Hodgkin lymphoma (2,107 people each year)
non-Hodgkin lymphoma (14,100 people each year)
small lymphocytic
lymphoma skin and CNS lymphoma
What is the prevalence of lymphoma compared to other cancers?
6th most common cancer
What is myeloma?
a blood cancer arising from plasma cells
Name two types of myeloma.
light chain myeloma
non-secretory myeloma
What is the prevalence of myeloma in the UK?
24,000
accounts for 15% of blood cancers, and 2% of all cancers
mainly affects people over 65 years
What is leukaemia?
cancer of the body’s blood-forming tissues, including the bone marrow and the lymphatic system
Name the four types of leukaemia.
acute myeloid (myelogenous) leukaemia (AML) chronic myeloid (myelogenous) leukaemia (CML) acute lymphocytic (lymphoblastic) leukaemia (ALL) chronic lymphocytic leukaemia (CLL)
What is the incidence and prevalence of leukaemia in the UK?
10,084 cases each year
12th most common cancer
What are myelodysplastic syndromes?
a group of cancers in which immature blood cells in the bone marrow do not mature
Name the five myelodysplastic syndromes.
refractory anaemia (RA)
refractory anaemia with ringed sideroblasts (RARS)
refractory anaemia with excess blasts (RAEB)
refractory cytopenia with multilineage dysplasia (RCMD)
refractory cytopenia with multilineage dysplasia and ringed sideroblasts (RCMD-RS)
What is the incidence of myelodysplastic syndromes in the UK?
estimated 4/100,000 each year
increases to 30/100,000 each year for people >70 years
What is myeloproliferative neoplasm?
a group of rare blood cancers in which excess erythrocytes, leucocytes, or platelets are produced in the bone marrow
Name the six types of myeloproliferative neoplasm.
chronic myelogenous leukaemia polycythemia vera primary myelofibrosis (also called chronic idiopathic myelofibrosis) essential thrombocythemia chronic neutrophilic leukaemia chronic eosinophilic leukaemia
What is the incidence of myeloproliferative neoplasm in the UK?
estimated 1/100,000
most people affected >60 years
What are six common signs and symptoms of non-Hodgkin’s lymphoma?
swelling of the face
enlargement of lymph nodes (especially in neck, axilla, and groin)
abdominal pain, distention, bloating, and constipation
loss of appetite, diarrhoea, and potential weight loss
shortness of breath, chest pain, difficulty breathing and coughs due to enlargement and swelling of the lymph nodes in the chest
pain and swelling surrounding lymph nodes and vital organs (including liver, stomach, kidneys, spleen)
What is an excision biopsy?
the first diagnostic procedure for people with suspected non‑Hodgkin’s lymphoma at first presentation
the whole lesion or mass is removed and tested
What is a needle core biopsy?
undertaken if the risk of a surgical procedure outweighs the potential benefits of an excision biopsy
if diagnosis is not possible after a needle core biopsy, an excision biopsy is offered (if surgically feasible) in preference to a second needle core biopsy
What are gene testing strategies?
utlising FISH (fluorescence in situ hybridisation) to identify an MYC rearrangement in all people newly presenting with histologically high‑grade B‑cell lymphoma
Name one of the recommended methods of staging B-cell lymphoma?
FDG‑PET‑CT (fluorodeoxyglucose‑positron emission tomography‑CT)
How can FDG-PET0CT be used to stage B-cell lymphoma?
stage 1 - diffuse large B‑cell lymphoma by clinical and CT criteria
stage 1 or localised stage II follicular lymphoma if disease is thought to be encompassable within a radiotherapy field
stage 1 or 2 Burkitt lymphoma with other low‑risk features
What is the suggested treatment for follicular lymphoma?
first line - local radiotherapy, or ‘watch and wait’
advanced stage may start with rituximab or combination with other medications to target cancers
autologous stem cell transplantation for people with follicular lymphoma in second or subsequent remission
What is the suggested treatment for MALT lymphoma?
first-line - ‘watch and wait’ alongside H. pylori eradication therapy
chemotherapy with rituximab or gastric radiotherapy if first-line treatment is ineffective
What is the suggested treatment for large B-cell lymphoma?
first-line - radiotherapy at 30 Gy to the specific sites
offered pre- or post-immunotherapy treatment
What is the suggested treatment for mantle cell lymphoma?
first-line - chemotherapy with rituximab
advanced stages involve the use of immunochemotherapy
‘watch and wait’ approach can be undertaken if no progression
