Haematological malignancies

Question 1

What are the classifications of haematological malignancies

Answer 1

1) Myeloid
- (including myeloproliferative disorders which means of the bone marrow and blood)
- Myelodysplasia

2) Lymphoid
- including: lymphomas and immunosecretory disorders

Question 2

What do myeloproliferative disorders present with

Answer 2

Excess of mature cells in the blood

Question 3

What is leukaemia and what does it present with

Answer 3

Malignancy of the bone marrow

-Presents with bone marrow failure ie

+anaemia: tiredness, fatigue
+thrombocytopenia: bleeding, bruising
+neutropenia: infections

Question 4

How would you treat acute leukaemia

Answer 4

Commence chemotherapy immediately on diagnosis

Give a mix of strong chemotherapy and persisting milder tablets to prevent relapse

Question 5

Difference between lymphoma and leukaemia

Answer 5

Lymphoma affects the lymph nodes whereas leukaemia affects the blood and bone marrow

Question 6

what are features of acute leukemias

Answer 6

Very rapid cell growth
May fill marrow before spilling out blood
High WBC not always present

Question 7

What do chronic myeloid leukaemias present with

Answer 7

• High white cells but not usually bone marrow failure
• Splenomegaly
• Priapism (persistent and painful erection of penis)

Question 8

What is chronic myeloid leukaemia due to

Answer 8

Philadelphia chromosome

Question 9

How do you treat chronic myeloid leukaemia

Answer 9

with the drug IMATINIB

Question 10

How is chronic lymphocytic leukaemia treated

Answer 10

Treatment only only required for troublesome symptoms , bulk disease or marrow failure

Question 11

How does chronic lymphocytic leukaemia presented

Answer 11

• High lymphocytic count
• Appropriate cell surface markers on lymphocytes
• low antibody levels
• may have lymphadenopathy (abnormally sized lymph nodes) or splenomegaly
• may have immune disturbances
• may have marrow suppression

Question 12

what are the usual clues to Non Hodgkins Lymphomas

Answer 12

B symptoms (weight loss, drenching night sweats and fevers above 38 degrees) or lympadenopathy (enlarged lymph nodes)

Question 13

What is Hodgkins Disease a subtype of

Answer 13

NOn Hodgkins Lymphomas

Question 14

What is Hodgkins disease related to

Answer 14

EBV infection

Question 15

What does Hodgkins disease present with

Answer 15

B symptoms and contiguous nodal spread

Question 16

How can you assess stage of a lymphoma

Answer 16

CT scan to locate lymphadenopathy and extra lymphatic spread and bone marrow to assess marrow involvement

Question 17

What is NOT a diagnostic test for lymphoma

Answer 17

Bone marrow biopsy

Question 18

What do low grade and high grade lymphomas mean

Answer 18

low- slow, grumbling

high- fast, aggressive

Question 19

How is a myeloma diagnosed

Answer 19

2 out o 3 conditions must be met:

• plasma cells in marrow 10%
• Detectable paraprotein in blood or urine
• Lytic lesions on skeletal survey

Question 20

When should you be suspicious of a myeloma

Answer 20

If you see an elderly patient with:

• anaemia
• high ESR (test which measures inflammation in body)
• Back pain
• Unexplained renal failure
• Unusual fractures

Question 21

What is myelodysplasia

Answer 21

disordered maturation of blood cells in bone marrow

Question 22

What can myelodysplasia progress into

Answer 22

acute leukaemia with time