Haematological Malignancy Flashcards
What type of age distribution is observed in new cases of Hodgkin lymphoma?
Twin peaks:
1st peak - 15-35
2nd peak - 60+
What is the age distribution for Non-hodgkin lymphoma?
Peaks in middle to older age
What are the pathological steps involved in haematological malignancies?
1 - Multiple mutations occur
2 - The mutated cell has a proliferative/survival advantage
3 - The mutated cell produces a malignant clone
4 - The malignant cell begins to dominate the tissue (bone marrow or lymph nodes)
From what cell types can myeloid malignancies develop from?
RBC’s
Platelets
Granulocytes
Monocytes
From which cells do lymphoid malignancies develop?
B-cells
T-cells
What is Acute Myeloid Leukaemia?
1 - Myeloid cells progenerate but do not differentiate
What are the myeloproliferative disorders?
Myeloid cells do differentiate and produce too many myeloid differentiated cells e.g.
- Neutrophils
- Eosinophils
With which mutation are the myeloproliferative disorders associated?
Philadelphia mutation
What is ALL?
Acute Lymphoblastic Leukaemia
- Lymphoblasts proliferate but do not differentiate
In which age group are ALL’s most common?
Children
What is CLL?
Chronic Lymphocytic Leukaemia
- Too many B-cell lymphocytes are produced
What is mutiple myeloma?
A type of blood cancer in which plasma cells produce abnormal antibodies
What is the key difference between leukaemia and lymphoma?
Leukeamia = bone marrow
Lymphoma = Lymphoid tissue
What are the most common acute leukaemias?
Acute Lymphoblastic Leukaemia
Acute Myeloid Leukaemia
What are the most common chronic leukaemias?
Chronic Myeloid Leukaemia
Chronic Lymphocytic Leukaemia
What are the categories of malignant lymphomas?
Non-Hodgkin Lymphoma
Hodgkin Lymphoma
Apart from acute, chronic and malignant leukaemias/lymphomas what other types of haemtaological malignancies are there?
Multiple myeloma
Myelodysplastic syndromes
Chronic myeloproliferative diseases
What are the features that differentiate acute leukaemias from chronic leukaemias?
Acute:
- Leukaemic cells do not differentiate
- Bone marrow failure
- Fatal if left untreated
Chronic:
- Leukaemic cells differentiate
- Cells proliferate without bone marrow failure
What are the clinical features of acute leukaemia?
1) Bone Marrow Failure:
- Anaemia
- Thrombocytopenic bleeding (purpura + mucosal membrane bleeding)
- Infections caused by neutropenia (bacterial & fungal - aspergillosis common))
Where in lymph nodes do most lymphomas originate?
Germinal centre
Where do B cells mature?
Germinal centre of lymph nodes
What are the most common systemic symptoms of lymphomas?
1 - Fever
2 - Drenching night sweats
3 - Weight loss
4 - Itchy skin
5 - Fatigue
What is a key clinical feature of lymphomas?
Lymphadenopathy
Is lymphadenopathy more common in hodgkins or non hodgkins lymphoma?
Hodgkins lymphoma
What does this x-ray show?
Sternal lymphadenopathy on Hodgkins Lymphoma
What is the most likely cause of localised and painful lymphadenopathy?
Bacterial infection in draining site
What is the most likely cause of localised and painless lymphadenopathy?
Tuberculosis
What is the most likely cause of generalised and painful lymphadenopathy?
Epstein-Barr Virus
Hepatitis
HIV
What is the most likely cause of localised and painless lymphadenopathy?
Lymphoma
Leukaemia
