Haematological Malignancies

Question 1

What leukaemia investigations can be carried out

Answer 1

Blood tests (FBC)
Blood film
Bone marrow examination:
- Aspirate
- Trephine 
- Immunophenotyping
- Cytogenetics

Question 2

What are some symptoms that acute leukaemia presents with

Answer 2

Anaemia
Easy Bruising
Infection

Question 3

What is acute leukaemia treated with

Answer 3

Intensive chemotherapy

Question 4

What are some of the risk factors of acute myeloid leukaemia

Answer 4

• Radiation
• Alkylating agents
• Pre-existing myeloproliferative disorders
• Genetic abnormalities

Question 5

What classifications of AML are there

Answer 5

M0 - undifferentiated 
M1 - Early myeloblastic 
M2 - late myeloblastic
M3 - promyelocytic
M4 - Myelomonocytic 
M5 - Monoblastic
M6 - Erythroleukaemic
M7 - Megakaryoblastic

Question 6

Who does acute lymphoblastic leukaemia mainly affect

Answer 6

Children

Question 7

What ways can acute leukaemia management

Answer 7

Supportive Care
- Neutropenic care
- Mouth care
- Reverse barrier nursing
- Anti-viral/fungal prophylaxis
- Prophylactic antibiotics
Blood product support 
Anti-emetics

Question 8

What are the symptoms of chronic myeloid leukaemia

Answer 8

• Fatigue, weight loss, sweating
• Splenomegaly
• Bruising
• Leukocytosis - mainly neutrophils, myelocytes
• Excess basophils, eosinophils
• Thrombocytosis

Question 9

What drug is lit for chronic myeloid leukaemia

Answer 9

Imatinib

Question 10

What is the most common form of leukaemia

Answer 10

Chronic lymphocytic leukaemia

Question 11

What are some symptoms of chronic lymphocytic leukaemia

Answer 11

• Lymphocytosis
• Weight loss, night sweats
• Lymphadenopathy
• Splenomegaly/hepatomegaly
• Recurrent infections

Question 12

What does lymphoma present with

Answer 12

• Peripheral lymphadenopathy
• Effects of visceral lymph node masses
• Bone marrow infiltration

Question 13

What is needed for a lymphoma diagnosis

Answer 13

• LDH and inflammatory markers
• Leukocytosis
• Cytopenia (bone marrow failure)
• Bone marrow Biopsy

Question 14

In what ways are Non-Hodgkin’s lymphomas (NHLs) classified

Answer 14

• Non-hodgkin vs hodgkin
• High grade vs low grade
• T cell derived vs B cell derived
• Curable vs Palliative

Question 15

Describe the features of high grade NHLs

Answer 15

• Diffuse large B cell lymphomas - most common NHL

- Burkitt’s, lymphoblastic

Question 16

Describe the clinical features of hodgkins lymphoma

Answer 16

• Painless lymphadenopathy
• Splenomegaly
• Extranodal spread to bone marrow/lungs/liver
• B symtoms - night sweats, fever, weight loss

Question 17

What is needed for the diagnosis of hodgkin’s disease

Answer 17

• Histological examination of lymph node
• CT staging scan (chest/abdomen/pelvis)
• +/-Bone marrow investigation (trephine)
• FBC (eosionphilia/reactive leukocytosis)
• LDH

Question 18

What treatments are there for lymphomas

Answer 18

• Chemotherapy
• Radiotherapy
• Combination chemo-radiotherapy
• New treatments: targeted antibody therapy - Rituximab and Campath

Question 19

What does myeloma malignancy in plasma cells lead to (symptoms wise)

Answer 19

• Paraprotein in serum
• Bone pain
• Renal failure
• Anaemia

Question 20

What treatment is there for myelomas (of plasma cells i think)

Answer 20

• Chemotherapy

- New targeted therapies

Question 21

What pain control methods are there for myeloma (of plasma cells i think)

Answer 21

• Radiotherapy
• Kyphoplasty
• effective analgesia

Question 22

What is done to look after the bones of patients

Answer 22

Bisphosphonates