Haematology 7 - Leukaemia Flashcards
age distribution of the leukaemias from young to old
ALL 5 yrs below
CLL 55+
CML 65+
AML 75 yrs
8 features of leukaemia
fatigue fever FTT pallor petechiae+bruising abnormal bleeds raised LNs hepatosplenomegaly
DDx of petechiae x 6
leukaemia meningococcal septic vasculitis HSP ITP non accidental injury
investigations for leukaemia
FBC blood film LDH CXR LP LN biopsy BM biopsy
CT/MRI/PET for staging
where do you take a bone marrow sample from?
iliac crest
a bone marrow trephine is a solid core sample
acute lymphoblastic leukaemia tell me all about it
blast cells
assoc with Down’s
most common child cancer
anaemia, low WBC, low platelets
t(15,17) translocation
chronic lymphocytic leukaemia tell me about it
often asympto
anaemia, infection , weight loss
warm AIHA
can Richter’s into high grade lymphoma
smear smudge cells
chronic myeloid leukaemia tell me about it
3 phases
chronic where fine for 5 years of raised WBC count
accelerated phase
blast phase >30% of blood cells, severe + fatal
Philadelphia characteristic t(9,22)
acute myeloid leukaemia tell me about it
most common adult one
can be a transformation from myeloprolif disorder
auer rods, high blast cells
buzzwords for each leukaemia
ALL - children, Down’s, blast cells
CLL - smudge cells, warm haemolytic anaemia, Richter’s
CML - 5 years asympto chronic, Philadelphia
AML - auer rods, transformation
managing leukaemia
MDT
chemotherapy
steroids
complications of chemotherpay
tumour lysis stunted growth infertile cardiotoxic neutropaenic sepsis
dealing with tumour lysis syndrome
allopurinol
rasburicase
monitor potassium + phosphate + calcium
