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Year 3 > Haematological Malignancy > Flashcards

Haematological Malignancy Flashcards

1
Q

haematological malignancies account for what percent of all human cancers?

A

10%

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2
Q

do blood cancers occur more often in men or women?

A

adult males

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3
Q

what is the most common cancer among children aged 0-14?

A

leukaemia

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4
Q

leukaemia makes up what percent of all childhood cancers?

A

30%

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5
Q

what is the most common form of leukaemia in children?

A

acute lymphocytic leukaemia

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6
Q

myeloid malignancies arise from what cells?

A 
RBC
Platelets
Neutrophils
Eosinophils
Basophils
Monocytes
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7
Q

lymphoid malignancies arise from what cells?

A

B-cell

T-cell

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8
Q

using a diagram describe leukaemia vs lymphoma

A

see notes

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9
Q

name the major groups of haematological malignancies

A 
acute leukaemia's
chronic leukaemia's
malignancy lymphomas
multiple myeloma
myelodysplastic syndromes (MDS)
chronic myeloproliferative disease (biologically malignant)
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10
Q

name acute leukaemia’s

A

acute lymphoblastic leukaemia (ALL)

acute myeloid leukaemia (AML)

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11
Q

name chronic leukaemia’s

A 
chronic myeloid leukaemia (CML)
chronic lymphocytic (CLL)
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12
Q

name the malignancy lymphomas

A 
Non-Hodgkin lymphomas (NHL)
Hodgkin lymphoma (HL)
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13
Q

describe the features of acute leukaemia

A

leukaemic cells do not differentiation
bone marrow failure
rapidly fatal if untreated
potentially curable

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14
Q

describe the features of chronic leukaemia

A

leukaemic cells retain the ability to differentiate
proliferation without bone marrow failure
survival for a few years
not presently curable without BMT

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15
Q

clinical features of acute leukaemia

A

bone marrow failure
anaemia
thrombocytopenic bleeding
infection because of neutropenia

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16
Q

what is the most likely cause of infection acute leukaemia?

A

bacterial and fungal

17
Q

essential investigations in acute leukaemia

A
  • Blood count and blood film
  • Bone marrow aspirate/trephine
  • Cytogenetics of leukemic blasts
  • Immunophenotyping of leukemic blasts
  • CSF examination if symptoms
18
Q

treatment of AML

A
  • Supportive care
  • Anti-leukemic chemotherapy
  • Stem cell transplantation – allogenic
  • All trans retinoic acid in APL
19
Q

clinical features of chronic myeloid leukaemia

A 
•	Anaemia
•	Splenomegaly, often massive
•	Weight loss
•	Hyperleukocytosis – fundal haemorrhage and venous congestion, altered consciousness, respiratory failure
Gout
20
Q

laboratory features of CML

A
  • High WCC (can be very high)
  • High platelet count
  • Anaemia
  • Blood film shows all stages of white cell differentiation with increased basophils
  • Bone marrow is hypercellular
  • Bone marrow and blood cells contain the Philadelphia chromosome t(9,22)
21
Q

treatment of CML

A

• Tyrosine Kinase Inhibitors
o Imatinib (Gilvec), Dasatinib (Sprycel), Nilotinib (Tasigna), Busitinib, Ponatinib
• Direct inhibitors of BCR-ABL is first line
• Allogenic transplantation – only in TKI failures

22
Q

what are myelodysplastic syndromes?

A

acquired clonal disorders of the bone marrow

23
Q

who gets myelodysplastic syndromes?

A

often old age

24
Q

what do myelodysplastic syndromes present as?

A

macrocytic anaemia

pancytopenia

25
Q

wht are myelodysplastic syndromes fatal?

A

result of progression to bone marrow failure of AML

26
Q

treatment of myelodysplastic syndromes

A

supportive or stem cell transplantation for the few young patients

27
Q

give 3 examples of myeloproliferative diseases

A
  • Polycythaemia vera
  • Essential thrombocythemia
  • Idiopathic myelofibrosis
28
Q

where are B cells found in lymph nodes?

A

follicles

29
Q

where are T cells found in lymph nodes?

A

paracortex

30
Q

where are plasma cells found in lymph nodes?

A

medulla

31
Q

where in the lymph node do cells undergo expansion and selection?

A

germinal centre

32
Q

where in the lymph node are naive cells found?

A

mantle zone

33
Q

presentation of the lymphomas

A

• Nodal disease – lymphadenopathy
o >90% HL
o ~60% present purely with nodal disease
• Extranodal disease
o ~40% NHL present with an extranodal component
• Systemic symptoms
o Fever, drenching sweats, loss of weight, pruritis, fatigue

34
Q

causes of lymphadenopathy: localised and painful

A

bacterial infection in drainng site

35
Q

causes of lymphadenopathy: localised and painless

A

rare infections, catch scratch fever, TB
metastatic carcinoma from draining site - hard
lymphoma - rubbery
reactive, no cause identified

36
Q

causes of lymphadenopathy: generalised and painful/tender

A

viral infections: EBV, CMV, hepatitis, HIV

37
Q

causes of lymphadenopathy: generalised and painless

A 
lymphoma
leukaemia
connective tissue diseases, sarcoidosis
reactive, no cause identified
drugs

Year 3 (164 decks)

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