Haematological malignancies

Question 1

What is the pathogenesis of haem malignancies?

Answer 1

Acquired genetic alterations to one lived cell
Proliferative/survival advantage to mutated cell, producing malignant clone
This grows to dominate the tissue

Question 2

What are the major types of haem malignancy?

Answer 2

Acute leukaemias- acute lymphoblastic, acute myeloid
Chronic leukaemias- chronic myeloid, chronic lymphocytic
Malignant lymphomas- Non Hodgkin, Hodgkin
Multiple myeloma
Myelodysplastic syndromes
Chronic myeloproliferative neoplasms

Question 3

What is the difference between leukaemia and lymphoma?

Answer 3

Leukaemia= mostly in blood/bone marrow

Lymohoma- most in lymphoid tissue

Question 4

What is th difference between myeloid and lymphoid?

Answer 4

Myeloid= red cells, platelets, granulocytes, monocytes
Lymphoid= B and T cells

Question 5

What is the pathogenesis of acute leukaemia?

Answer 5

Leukaemia cells do not differentiate
Bone marrow failure
Rapidly fatal if untreated

Question 6

What are the clinical features of acute leukaemia?

Answer 6

Bone marrow failure
Anaemia
Thrombocytopenic bleeding
Infection- bacterial and fungal

Question 7

What is the pathogenesis of chronic leukaemia?

Answer 7

Leukaemia cells retain ability to differentiate
Proliferation without bone marrow failure
Can survive a few years without treatment

Question 8

What is the presentation of lymphoma?

Answer 8

Generalised and painless lymphadenopathy
Extranodal disease
Fever, drenching sweats, weight loss, pruritus, fatigue

Question 9

What % of lymphoma patients have node disease?

Answer 9

> 90% HL

~60% NHL only nodal

Question 10

What is the presentation of myeloma?

Answer 10

Calcium elevated
Renal complications
Anaemia
Bone disease
Other- hyperviscoty, hypogammaglobulinaemia, infections, amyloidosis