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A Haematology and 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

What is the age distribution of new Hodgekin lymphoma cases?

A

Increase in incidence between 20-35 and 70+

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3
Q

What is the age distribution of Non-Hodgkin lymphoma?

A

Increases with age with peak between 70 and 85

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4
Q

What is the pathogenesis of haematological malignancy?

A
  • Multi step process
  • Result of acquired genetic alterations to long lived cells
  • Proliferative/survival advantage to that mutated cell
  • Production of malignant clone
  • Malignant clone grows to dominate the tissue
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5
Q

What are the properties of stem cells?

A
  • Able to self-renew
  • Able to differentiate
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6
Q

What is the origin of myeloid malignancies?

A
  • RBC
  • Platelets
  • Granulocytes
  • Monocytes
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7
Q

What is the origin of lymphoid malignancies?

A
  • B-cell
  • T-cell
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8
Q

What type of cancer arises from myeloid progenitor cells?

A

Acute myeloid leukaemia

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9
Q

What type of cancer arises from lymphoid progenitor cells?

A

Acute lymphoblastic leukaemia

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10
Q

What occurs in acute myeloid leukaemia?

A
  • Ongoing proliferation
  • Failure to differentiate
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11
Q

What occurs in myeloproliferative disorders?

A
  • Ongoing proliferation at a high rate
  • Ongoing differentiation
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12
Q

What occurs in acute lymphoblastic leukaemia?

A

Proliferation without differentiation

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13
Q

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

A

Myeloproliferative disorder

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14
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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15
Q

What are the major groups of haematological malignancies?

A
  • Acute leukaemias
  • Chronic leukaemias
  • Malignant lymphomas
  • Multiple myeloma
  • Myelodysplastic syndromes
  • Chronic myeloproliferative neoplasms
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16
Q

Name the 2 types of acute leukaemia

A
  • Acute lymphoblastic leukaemia
  • Acute myeloid leukaemia
17
Q

Name the 2 types of chronic leukaemia

A
  • Chronic myeloid leukaemia
  • -Chronic lymphocytic leukaemia
18
Q

Name the 2 types of malignant lymphomas

A
  • Non-Hodgekin lymphoma
  • Hodgekin Lymphoma
19
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)
20
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 presented with antigens as centroblasts and undergo somatic hypermutation to form centrocytes
  • They can mature into memory B cells or plasma cells
21
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
22
Q

What does localised and painful lymphadenopathy suggest?

A

Bacterial infection in draining site

23
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
24
Q

What does generalised and painful/tender lymphadenopathy suggest?

A

Viral infections like EBV, CMV, hepatitis and HIV

25
Q

What does generalised and painless lymphadenopathy suggest?

A
  • Lymphoma
  • Leukaemia
  • Connective tissue disease, sarcoidosis
  • Reactive, no cause identified
  • Drugs
26
Q

Acute leukaemia vs chronic leukaemia

Do leukaemic cells differentiate?

A

Acute leukaemia - Leukaemic cells do not differentiate

Chronic leukaemia - Leukaemic cells retain ability to differentiate

27
Q

Acute leukaemia vs chronic leukaemia

Bone marrow

A

Acute leukaemia - Bone marrow failure

Chronic leukaemia - Proliferation without bone marrow failure

28
Q

Acute leukaemia vs chronic leukaemia

Survival

A

Acute leukaemia - Rapidly fatal if untreated

Chronic leukaemia - Survival for a few years

29
Q

Acute leukaemia vs chronic leukaemia

Curable?

A

Acute leukaemia - Potentially curable

Chronic leukaemia - Potentially curable with modern therapy eg Tyrosine Kinase inhibitors in CML

A Haematology and Immunology (20 decks)

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