Haematology - Acute Leukaemia Flashcards
What is the median age of presentation of AML?
65-70
Recall some chromosomal genetic associations of AML
t(8; 21) (translocation) Trisomy 21 (duplication) 5q deletion, 7q deletion (deletions)
Which type of leukaemia is most likely to cause haemorrhage?
Acute Promyelocytic leukaemia (APML)
aka AML - M3
Which type of leukaemia is most likely to cause DIC?
APML
What is the key triad of clinical features of acute leukaemias?
Anaemia
Thrombocytopaenia
Neutropaenia
acute = rapidly pressing and fatal, immature blasts over 20% of bone marrow cels
others - lymphadenoapthy, splenomegaly,
Recall 4 clinical signs that can be used to identify AML
Hepatosplenomegaly
Monocytic gum infiltration
Occasional lymphadenopathy
How can myeloid lineage be proved on blood film in AML?
Presence of auer rods
What is the most effective investigation for differentiating AML and ALL, and what results would it show for each?
Immunophenotyping:
AML: CD13, CD33, MPO
ALL: CD3, CD4, CD8
both have CD34 = stems ells
Recall 4 useful supportive therapies for AML
Blood products: red cells, platelets and FFP
Antibiotics
Long line
Allopurinol (as uric acid may be released from dying cells when treatment is started)
Which type of leukaemia is most likely to present with long bone pain?
ALL
Recall some sights of leukaemic involvement in ALL that you wouldnt see in AML
Thymus enlargement (mediastinum), testes, CNS
Which ALL patients are appropriate for imatinib treatment?
Philadelphia chromosome positive
When is the presentation of ALL
childhood
most common childhood malignancy by far
what gene is relevant in APML
t (15; 17) - PML-RARA fusion gene
what’s 3 features in AML M4+5
skin/gum infiltration
hypokalaemia
