Haematological Malignancies Flashcards
Which haemotological malignancies involve lymphoid cells?
Lymphoblastic leukaemia.
Lymphomas
Which haemotological malignancies involve myeloid cells?
Myeloid leukaemia
Myeloproliferative disorders
Who is most likely to get ALL?
Children
What is the peak age of onset of CML?
25-45 years
Which gene is normally present in CML?
BCR-ABL fusion gene
What does the BCR-ABL fusion gene do?
Causes abnormal expression of myeloid cells in the bone marrow and peripheral blood.
Which chromosomes are translocated in the Philadelphia chromosome?
22 and 9
What is the treatment for CML?
Imatinib or bone marrow transplant
What is CLL?
B-cell lymphoproliferative disease
What is the peak age of onset of CLL?
72 years
What would be found on blood in CLL?
High lymphocyte count
What is the management of CLL?
Chemotherapy
Tyrosine kinase inhibitors
Monoclonal antibodies
Bone marrow transplant in young patient
What are smudge cells?
Remnants of cells that lack any identifiable cytoplasmic membrane or nuclear structure. Also called basket cells.
What are smudge cells associated with?
Abnormally fragile lymphocytes in chronic lymphocytic leukaemia.
What is myeloma?
A malignant disorder of plasma cells producing the same abnormal immunoglobulin.
Who is myeloma most prevalent in?
Median age 72 years
More prevalent in Afro-Carribean descent.
What are the signs and symptoms of myeloma?
Bone pain Anaemia Infection Bone marrow failure Renal failure Amyloidosis Hypercalcaemia
Which investigations would be done to test for myeloma?
Blood film (rouleaux formation) Bone marrow aspirate (<10% plasma cells) Serum protein electropheresis Bence Jones protein in urine Bone profile - hypercalcaemia Imaging - skeletal survey
What is the treatment for myeloma?
Monitoring
Chemo - thalidamide and steroids (or doxorubicin and vincristine)
Bone marrow transplant after induction therapy
Radiotherapy for bone pain
Treatment for hypercalcaemia (fluids and bisphosphonates)
Aspirin for DVT prophylaxis.
What is lymphoma?
Cloncal prolfieration of lymphoid cells arising in the lymph nodes.
What are the symptoms of lymphoma?
Local or generalised lymphadenopathy
Night sweats
Weight loss
Fevers
Which cells are present in Hodgkin lymphoma?
Reed-Sternberg cells
What is the epedemiology of lymphoma?
M>F
Age 15-40 years
What is the treatment of lymphoma?
Local disease - radiotherapy
Wide spread disease - chemotherapy
+/- bone marrow transplant
What is the prognosis for lymphoma?
> 90% stage I-II cured
50-70% stage IV cured.
What are myelodysplasias?
Clonal haemopoetic stem cell disorder causing various cytopenias.
Bone marrow is hypercellular due to ineffective haemopoiesis.
What can myelodysplasia transform into?
AML
What is the treatment for myelodysplasias?
Blood transfusion +/- iron chelation
Chemo/bone marrow transplant in young patients
What is myelofibrosis?
Proliferation of an abnormal cell line results in fibrosis in the bone marrow.
What are the symptoms of myelofibrosis?
Bone pain
Marrow failure symptoms
Hepatosplenomegaly
Pancytopenia
