Haematological Malignancies Flashcards
What leukaemia investigations can be carried out
Blood tests (FBC) Blood film Bone marrow examination: - Aspirate - Trephine - Immunophenotyping - Cytogenetics
What are some symptoms that acute leukaemia presents with
Anaemia
Easy Bruising
Infection
What is acute leukaemia treated with
Intensive chemotherapy
What are some of the risk factors of acute myeloid leukaemia
- Radiation
- Alkylating agents
- Pre-existing myeloproliferative disorders
- Genetic abnormalities
What classifications of AML are there
M0 - undifferentiated M1 - Early myeloblastic M2 - late myeloblastic M3 - promyelocytic M4 - Myelomonocytic M5 - Monoblastic M6 - Erythroleukaemic M7 - Megakaryoblastic
Who does acute lymphoblastic leukaemia mainly affect
Children
What ways can acute leukaemia management
Supportive Care - Neutropenic care - Mouth care - Reverse barrier nursing - Anti-viral/fungal prophylaxis - Prophylactic antibiotics Blood product support Anti-emetics
What are the symptoms of chronic myeloid leukaemia
- Fatigue, weight loss, sweating
- Splenomegaly
- Bruising
- Leukocytosis - mainly neutrophils, myelocytes
- Excess basophils, eosinophils
- Thrombocytosis
What drug is lit for chronic myeloid leukaemia
Imatinib
What is the most common form of leukaemia
Chronic lymphocytic leukaemia
What are some symptoms of chronic lymphocytic leukaemia
- Lymphocytosis
- Weight loss, night sweats
- Lymphadenopathy
- Splenomegaly/hepatomegaly
- Recurrent infections
What does lymphoma present with
- Peripheral lymphadenopathy
- Effects of visceral lymph node masses
- Bone marrow infiltration
What is needed for a lymphoma diagnosis
- LDH and inflammatory markers
- Leukocytosis
- Cytopenia (bone marrow failure)
- Bone marrow Biopsy
In what ways are Non-Hodgkin’s lymphomas (NHLs) classified
- Non-hodgkin vs hodgkin
- High grade vs low grade
- T cell derived vs B cell derived
- Curable vs Palliative
Describe the features of high grade NHLs
- Diffuse large B cell lymphomas - most common NHL
- Burkitt’s, lymphoblastic
Describe the clinical features of hodgkins lymphoma
- Painless lymphadenopathy
- Splenomegaly
- Extranodal spread to bone marrow/lungs/liver
- B symtoms - night sweats, fever, weight loss
What is needed for the diagnosis of hodgkin’s disease
- Histological examination of lymph node
- CT staging scan (chest/abdomen/pelvis)
- +/-Bone marrow investigation (trephine)
- FBC (eosionphilia/reactive leukocytosis)
- LDH
What treatments are there for lymphomas
- Chemotherapy
- Radiotherapy
- Combination chemo-radiotherapy
- New treatments: targeted antibody therapy - Rituximab and Campath
What does myeloma malignancy in plasma cells lead to (symptoms wise)
- Paraprotein in serum
- Bone pain
- Renal failure
- Anaemia
What treatment is there for myelomas (of plasma cells i think)
- Chemotherapy
- New targeted therapies
What pain control methods are there for myeloma (of plasma cells i think)
- Radiotherapy
- Kyphoplasty
- effective analgesia
What is done to look after the bones of patients
Bisphosphonates
