Haematology 7 - CML Flashcards

1
Q

How does CML affect the liver and spleen?

A

Infarction of cords and red pulp (spleen) and hepatic sinusoids (liver) by granulocytes- causes hepatosplenomegaly, but no lymphadenopathy in CML

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2
Q

Recall 3 possible symptoms of CML

A

Lethargy
Bruising
Monocular blindness (due to CVA)

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3
Q

In what ways will a blood film be unusual in CML?

A
Myelocytes present (precursor neutrophils)
Raised basophils, eosinophiles
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4
Q

What investigation can be done to show BCR-ABL

A

FISH - a fluorescent DNA probe hybridises selectively to a particular chromosome segment

PCR (best to diagnose and determine response to therapy)

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5
Q

What are the phases of CML?

A

Chronic: 3-4 years (<5% blasts in BM)
Accelerated: 6-12 months (5-19% blasts)
Blast crisis: 3-6 months (>20% blasts)

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6
Q

What are the 1st, 2nd and 3rd line treatments for CML?

A

1st. Imatinib (1st gen Abl-TK inhibitor)
2nd. 2nd/3rd generation TK inhibitor
3rd. allogenic stem cell transplant

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