Haematology 2: Acute Leukaemias Flashcards
<p>Which acute leukaemia is an emergency ?</p>
<p>APML (acute promyeloid)</p>
<p>What translocation causes Acute promyelocytic leukaemia (APML), which fusion gene?</p>
<p>T(15;17)
| <br></br><br></br>Fusion gene = (PML-RARA) (promyelocytic leukemia/retinoic acid receptor alpha)</p>
<p>Which leukaemia is more common in patients with Down’s syndrome ?</p>
<p>ALL+ AML </p>
- Thought to be dose effect (they have more of the protoncogene)
<p>What signs is characteristic in APML ?</p>
<p>Sudden onset Haemorrhage (bruising and bleeding)
<br></br>
<br></br>
<br></br>This is because APML is associated w/ DIC + Hyperactive fibrinolysis</p>
<p>Which feature is characteristic of APML on microscopy ?</p>
<p>Multiple auer rods in promyelocytes</p>
<p>What does the variant of APML without auer rods look like on microscopy ?</p>
<p>Promyelocytes with Bilobed nuclei</p>
<p>Which 2 stains are possitive in AML but not In ALL ?</p>
<p>Myeloperoxidase stain<br></br>Sudan black B stain</p>
<p>Which leukaemia causes Gum infiltration ?</p>
<p>Monocytic AML</p>
<p>List 5 signs of AML ?</p>
<p>Anaemia- SOB, Pallor<br></br>Neutropenia- infections <br></br>Thrombocytopenia- easy Bruising and bleeding, DIC<br></br>Hepatosplenomegally <br></br>Retinal haemorrhage/exudates</p>
<p>What is the most important diagnostic test for Leukaemias ?</p>
<p>Immunophenotyping</p>
<p>What is the most common leukaemia in childhood ?</p>
Who else can commonly have this?
Prognosis?
<p>ALL</p>
Bimodal distribution - another peak in old age (this has higher incidence of philadelphia +ve cases) - t(9;22)
85% of children are cured, old age = poor prognosis as less likely to cope w/ chemo + philadelphia +ve is more severe
<p>List 5 signs of ALL ?</p>
<p>BM failure:
<br></br>- Anaemia- SOB, pallor
<br></br>- Neutropenia- infections
<br></br>- Thrombocytopenia- Easy bruising, bleeding
<br></br>
<br></br>Lymphadenopathy
<br></br>Hepatosplenomegaly</p>
<p>Which drug is used to treat CML or ALL with the Philadelphia chromosome abnormality ?</p>
<p>Tyrosine kinase inhibitor- Imatinib</p>
<p>Which cell level does CML tend to occur in? and AML?</p>
<p>CML:
Pluripotent haematopoietic stem cell<br></br>
AML:
Pluripotent haematopoietic stem cell or multipotent myeloid stem cell or granulocyte-monocyte precursor</p>
<p>Chromosomal abnormalities associated with AML? (5)</p>
<p>Duplications
Loss
Translocation
Inversion
Deletion</p>