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House Hemat > Intro To Leukemia > Flashcards

Intro To Leukemia Flashcards

1
Q

What are Leukaemias?

A

Malignant neoplasm of the white blood cell, characterized by involvement of the bone marrow and blood

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2
Q

Leukaemias?

A group of disorders characterized by the _________ of __________ in the ________ and _______

A

accumulation

malignant white cells

bone marrow and blood.

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3
Q

Leukaemias?

(Localized or Generalized?) _______ proliferations or accumulation of leukopoietic cells with or without involvement of the ______

A

Generalized

neoplastic

peripheral blood

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4
Q

Recall normal haemopoiesis -

Abnormality can occur at _____ stage in the maturation sequence and lead to a variety of leukaemic illnesses which are classified according to the _____________

A

any

developmental stage affected

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5
Q

LEUKAEMIA AETIOLOGY PRINCIPLES

The neoplastic cell is a ___________ cell, or a ___________ cell - lymphoid or myeloid commitment.

A

hematopoietic pleuripotent stem

committed stem

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6
Q

LEUKAEMIA AETIOLOGY PRINCIPLES

Leukemogenesis is characterized by dysregulation of ______,_______, or _____, associated with _________ and then proliferation of the leukemic clone.

A

cell growth, differentiation or death

genetic mutations

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7
Q

LEUKAEMIA AETIOLOGY PRINCIPLES

When _______ is blocked at an early stage, leads to accumulation of _____ and the clinical consequences.

And with Cell _____ blocked – accumulation of _____ cells

A

differentiation

blasts

death

matured

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8
Q

LEUKAEMIA AETIOLOGY PRINCIPLES
The TWO-HIT MODEL OF LEUKEMOGENESIS

posits that acute leukemias arise from _______ derangements of _____ that regulate hematopoietic _______ and _____

A

two (or more)

genes

differentiation and proliferation.

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9
Q

One mutation alone is sufficient to generate the acute leukaemia phenotype.

T/F

A

F

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10
Q

Two-hit model of leukemogenesis

_____ of function of transcription factors needed for ________

____ of function mutations of tyrosine kinases

A

Loss ; differentiation

Gain

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11
Q

Two-hit model of leukemogenesis

_________ + __________ = Acute Leukemia

A

Differentiation block

Enhanced proliferation

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12
Q

LEUKAEMIA AETIOLOGY
No known causes of leukaemia but certain factors are associated with the aetiology.
A combination of

_______ background (______ alterations)

_____ factors

________ influence

A

Genetic; Chromosomal

Host

Environmental

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13
Q

Causes of LEUKAEMIA AETIOLOGY

List 4

A

No known causes of leukaemia

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14
Q

LEUKAEMIA AETIOLOGY: Chromosomal alterations

• growth promoting ______

•growth inhibiting _______

genes that regulate __________

A

oncogenes

tumour suppressor genes

programmed cell death or apoptosis -

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15
Q

LEUKAEMIA AETIOLOGY : Chromosomal alterations:

growth promoting oncogenes - mutation leads to abnormal ________

growth inhibiting tumour suppressor genes - mutation removes the molecular ____ leading to uncontrolled ______

genes that regulate programmed cell death or apoptosis - mutation causes excessive _________

A

cell proliferation

Brake; proliferation

cell proliferation.

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16
Q

LEUKAEMIA AETIOLOGY

The genetic damage that activates oncogenes or inactivates tumour suppressor genes may be _____ (e.g point mutation) or _______ to be detected in a ______.

A

subtle

large enough

karyotype

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17
Q

LEUKAEMIA AETIOLOGY

The common types of structural abnormalities in tumour cells are:

_______
_______
__________
___________

A

Translocation
Point mutation
Deletion
Gene amplification

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18
Q

LEUKAEMIA AETIOLOGY

Whole chromosomes may be gained or lost

T/F

A

T

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19
Q

Translocations are rare in haemopoietic neoplasms.

T/F

A

F

extremely common

20
Q

LEUKAEMIA AETIOLOGY
Most notable Translocations is ________ in _______ .

A

Philadephia (Ph1) in CML

21
Q

LEUKAEMIA AETIOLOGY

In Philadelphia chromosome, part of chromosome _____ is transferred to chromosome _____ and vice versa hence there is ________ between both chromosomes which results in leukaemia. This cytogenetic change is seen in ____% of cases of ____.

A

9

22

reciprocal translocation

90

CML

22
Q

LEUKAEMIA AETIOLOGY

Point Mutation: eg Mutation within the ____ oncogene

A

RAS

23
Q

LEUKAEMIA AETIOLOGY

________ of are the second most prevalent abnormality in tumour cells.

A

Deletions

24
Q

LEUKAEMIA AETIOLOGY

Deletion of chromosome ____ is the most common chromosomal abnormality in polycythaemia _____.

A

20q

rubra vera

25
Q

LEUKAEMIA AETIOLOGY

Gene Amplification is the process by which the ________ of a chromosome segment is increased in a somatic cell.

A

number of copies

26
Q

LEUKAEMIA AETIOLOGY

__________ is very rare in haematologic malignancy.

A

Gene Amplification

27
Q

Haemopoietic Stem Cell Mutations increase with age

T/F

A

T

28
Q

LEUKAEMIA AETIOLOGY : Host Factors

i. Heredity: Heredity plays an important role in leukaemias. Identical twins (have ____% chance), Fraternal twins have (more or less?) chance

A

25

Less

29
Q

LEUKAEMIA AETIOLOGY : Host Factors

i. _______
ii. _________ abnormalities
iii.__________
iv. Chronic ________

A

Heredity

Congenital chromosomal

Immunodeficiency

Marrow dysfunction

30
Q

LEUKAEMIA AETIOLOGY : Host Factors

Congenital chromosomal abnormalities: Patients with these illnesses have (higher or lower?) chance of having acute leukaemias.

Down’s Syndrome –___% chance of AML, ___eased incidence of ALL

______ syndrome
______ Syndrome
______ anaemia
______ Syndrome

A

Higher

40; incr

Klinefelter; turner; fanconi; bloom

31
Q

LEUKAEMIA AETIOLOGY : Host Factors

Immunodeficiency: Anything that disturbs the _______ may lead to development of leukaemias because the protection has been removed.

A

immune surveillance

32
Q

LEUKAEMIA AETIOLOGY : Host Factors

Chronic Marrow dysfunction e.g. __________, clonal blood disorder such as ________ and _____

A

Myelodysplastic syndrome (MDS)

aplastic anaemia & PNH.

33
Q

LEUKAEMIA AETIOLOGY
Hematologic disorders predisposing to acute leukemia

_____ and other myeloproliferative disorders (PRV, ET, MF)

_______ syndromes

______ anaemia

A

CML

Myelodysplastic

Aplastic

34
Q

LEUKAEMIA AETIOLOGY
Hematologic disorders predisposing to acute leukemia

Multiple myeloma: ______________________

________________________(PNH)

A

Waldenström’s macroglobulinaemia

Paroxysmal Nocturnal Haemoglobinuria

35
Q

Acute leukaemia arising out of hematologic disorders is more frequently _______ than ______

A

AML than ALL

36
Q

LEUKAEMIA AETIOLOGY :Environmental Factors

________
_________
_________

A

Ionizing radiations
Chemicals & drugs
Viruses

37
Q

LEUKAEMIA AETIOLOGY 3Environmental Factors

Ionizing radiations – Malignancy may develop following repeated exposure to heavy ionising radiations

e.g. _____,_____

e.g. in a pregnant woman – leukaemia may develop in the ____.

So also are victims of ______ who later developed leukaemia.

A

Radiotherapy, X-ray

foetus

Atomic bombs

38
Q

LEUKAEMIA AETIOLOGY :Environmental Factors

Chemicals & drugs – Certain drugs are known to predispose to secondary malignancies like leukaemias.

Some of these drugs are used to treat malignancy e.g. ______,______which are alkylating agents.

Certain chemicals e.g. ____ containing chemicals like _____ products have also been implicated.

A

Busulphan, chlorambucil

Benzene; petroleum

39
Q

LEUKAEMIA AETIOLOGY: Environmental factors

Viruses: – Can directly cause leukaemias. It is now known that the _____viruses especially the ___-type RNA viruses can cause leukaemias. These viruses possess the ________ enzyme.

A

retro; C

Reverse transcriptase

40
Q

HTLV-1 - Human T cell Leukemia/Lymphoma Virus can cause _______ but not _______

A

T-cell ALL but not AML

41
Q

LEUKAEMIA CLASSIFICATION
Main classification is into 2 groups based on the stage of cell maturation at which the abnormalities occur: _______ and ________

Each group is subdivided into 2 based on the lineage of cells affected: ______ and _____

A

Acute and Chronic leukaemia

Myeloid and Lymphoid

42
Q

Differentiate between avute and chronic leukemia under the following

Onset
Cell type
Survival
Treatment

A

Rapid ; Gradual

Blast cells; mature

Commonly fatal ; Long survival

Ammenable to chemotherapy ; may be resistant

43
Q

In ACUTE LEUKAEMIAS

There is usually:
increased __________
reduced ________
block in ____________

A

rate of proliferation

apoptosis

cellular differentiation.

44
Q

CHRONIC LEUKAEMIAS

Excessive build up of relatively _____, but still _______ white blood cells.

Typically take _____ or______ to progress

A

mature

abnormal

months or years

45
Q

CHRONIC LEUKAEMIAS

Chronic leukaemias are sometimes _______ before treatment to ensure _____________.

A

monitored for some time

maximum effectiveness of therapy

46
Q

Chronic leukemia mostly occurs in (younger or older?) people.

A

Older

House Hemat (29 decks)

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