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Systems: Haematology + Immunology > Haematological Malignancies > Flashcards

Haematological Malignancies Flashcards

1
Q

What is the epidemiology of haematological malignancies?

A
  • Haematological Malignancies account for approximately 10% of all human cancers
  • They occur in all age groups, including children
  • Adult males are more commonly affected than females
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2
Q

How does the incidence of lymphomas compare to other cancers?

A

Significantly lower in comparison to lung, colorectal and breast

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3
Q

What is the age distribution of new Hodgekin lymphoma cases?

A

Increase in incidence between 20-35 and 70+

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4
Q

What is the age distribution of Non-Hodgkin lymphoma?

A

Increases with age with peak between 70 and 85

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5
Q

What is the pathogenesis of haematological malignancy?

A
  • Multi step process
  • Result of acquired genetic alterations to a long lived cells
  • Proliferative/survival advantage to that mutated cell
  • Production of malignant cone
  • Malignant clone grows to dominate the tissue
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6
Q

What are the properties of stem cells?

A
  • Able to re-new

- Able to differentiate

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7
Q

What is the origin of myeloid malignancies?

A
  • RBC
  • Platelets
  • Granulocytes
  • Monocytes
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8
Q

What is the origin of lymphoid malignancies?

A
  • B-cell

- T-cell

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9
Q

What type of cancer arises from myeloid progenitor cells?

A

Acute myeloid leukaemia

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10
Q

What type of cancer arises from lymphoid progenitor cells?

A

Acute lymphoblastic leukaemia

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11
Q

What occurs in acute myeloid leukaemia?

A
  • Ongoing proliferation

- Failure to differentiate

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12
Q

What occurs in myeloproliferative disorders?

A
  • Ongoing proliferation at a high rate

- Ongoing differentiation

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13
Q

What occurs in acute lymphoblastic leukaemia?

A

-Proliferation without differentiation

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14
Q

What type of cancer arises from WBC, platelets and RBCs?

A

Myeloproliferative disorder

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15
Q

Leukaemia vs Lymphoma

A

Descriptive terms related to distribution of disease

  • Leukaemia is in the blood and bone marrow
  • Lymphomas is in the lymph glands and other solid tissues
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16
Q

What are the major groups of haematological malignancies?

A
  • Acute leukaemias
  • Chronic leukaemias
  • Malignant lymphomas
  • Multiple myeloma
  • Myelodysplastic syndromes
  • Chronic myeloproliferative neoplasms
17
Q

Name 2 types of acute leukaemia.

A
  • Acute lymphoblastic leukaemia

- Acute myeloid leukaemia

18
Q

Name 2 types of chronic leukaemia.

A
  • Chronic myeloid leukaemia

- Chronic lymphocytic leukaemia

19
Q

Name 2 types of malignant lymphomas.

A
  • Non-Hodgekin lymphoma

- Hodgekin Lymphoma

20
Q

What are the features of acute leukaemia?

A
  • Leukaemic cells do not differentiate
  • Bone marrow failure
  • Rapidly fatal if untreated
  • Potentially curable
21
Q

What are the features of chronic leukaemia?

A
  • Leukaemic cells retain ability to differentiate
  • Proliferation without bone marrow failure
  • Survival for a few years
  • Potentially curable with modern therapy
22
Q

What are the clinical features of acute leukaemia?

A

Triad of bone marrow failure

  • Anaemia
  • Thrombocytopenic bleeding (purpura and mucosal membrane bleeding)
  • Infection because of neutropenia (predominantly bacterial and fugal)
23
Q

When do lymphomas commonly occur?

A

As lymphocytes pass through the germinal centres of lymph node follicles

24
Q

Briefly describe B cell maturation.

A
  • Progenitor B cell> Pre B cell>Immature B cell in the bone marrow
  • Naïve B cells migrate to the germinal centres of lymph node follicles where they are prented with antigens as centroblasts and undergo somatic hypermutation to form centrocytes
  • They can mature into memory B cells or plasma cells
25
Q

How do lymphomas present?

A

Lymphadenopathy

  • > 90% HL present with nodal disease
  • 60% NHL present with purely nodal disease

Extranodal disease
-40% of NHL present with an extranodal component

Systemic symptoms
-Fever, drenching sweats, loss of weight, pruritus, fatigue

26
Q

What does localised and painful lymphadenopathy suggest?

A

Bacterial infection in draining site

27
Q

What does localised and painless lymphadenopathy suggest?

A

Rare infections, catch scratch fever, TB

  • Metastatic carcinoma from draining site- hard
  • Lymphoma-rubbery
  • Reactive, no cause identified
28
Q

What does generalised and painful/tender lymphadenopathy suggest?

A

Viral infections like EBV, CMV, hepatitis and HIV

29
Q

What does generalised and painless lymphadenopathy suggest?

A
  • Lymphoma
  • Leukaemia
  • Connective tissue disease, sarcoidosis
  • Reactive, no cause identified
  • Drugs
30
Q

What are the clinical features of myeloma?

A
  • Bone pain and lytic lesions
  • Anaemia
  • Recurrent infection
  • Renal failure
  • Amyloidosis
  • Bleeding tendency
  • Hyperviscosity syndrome

Systems: Haematology + Immunology (19 decks)

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