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Molecular Basis Of Disease/ Microbiology And Immunology > Introduction To Leukaemia > Flashcards

Introduction To Leukaemia Flashcards

1
Q

What is leukaemia?

A

Malignant disorders of haematopoetic stem cells characteristically associated with an increase number of white cells in bone marrow or land peripheral blood

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2
Q

What are haematopoeitic stem cells?

A

Multipotent and self-maintaining

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3
Q

What can progenitor cells divide to produce?

A

Many mature cells

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4
Q

What are examples of progenitor cells?

A

Lymphoid/myeloid

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5
Q

What are the two types of progenitor cells?

A

Undifferentiated and committed

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6
Q

What is a clonal disease?

A

When all malignant cells derive from a single mutant cell

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7
Q

What can you use to diagnose leukaemia?

A

Peripheral blood blast test
Bone marrow biopsy
Lumbar puncture

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8
Q

What does a peripheral blood blast test in the diagnosis of leukaemia?

A

To check the presence of blasts and cytopenia

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9
Q

Where is the bone marrow biopsy taken from?

A

Pelvic bone and results compared with peripheral blood

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10
Q

Why is a lumbar puncture done?

A

To determine if leukaemia has spread to the CSF

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11
Q

What are the possible predisposing factors for leukaemia?

A

Genetic risk factors
Environmental risk factors
Lifestyle-related risk factors

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12
Q

What syndromes increase the likelihood of leukaemia?

A

Downs and fanconi’s anaemia

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13
Q

What are the genetic risk factors for leukaemia?

A

Gene mutations involving oncogenes and/or tumour suppressors
Chromosome aberrations
Inherited immune system problems

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14
Q

What types of chromosomal abberations increase the risk for leukaemia?

A

Translocations

Numerical disorders

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15
Q

What are the environmental risk factors for leukaemia?

A

Radiation exposure
Exposure to chemicals and chemo
Immune system suppression

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16
Q

What type of radiation exposure is a risk factor for leukaemia?

A

Acute radiation accidents

Atomic bomb survivors

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17
Q

What type of exposure to chemicals and chemo is a risk factor for leukaemia?

A

Cancer chemo with alkylating agents

Industrial exposure to benzene

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18
Q

What lifestyle risk factors are there for leukaemia?

A

Smoking
Drinking
Excessive sun exposure
Overweight

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19
Q

What are the risk factors for childhood leukaemia?

A 
Exposure to EM fields
Infections early in life
Mothers age when the child is born
Nuclear power stations
Parents smoking history
Foetal exposure to hormone
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20
Q

What are the four main types of leukaemia?

A

Acute lymphoblastic leukaemia (ALL)
Acute myeloblastic leukaemia (AML)
Chronic lymphocytic leukaemia (CLL)
Chronic granulocytic leukaemia (CML)

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21
Q

What are the features of acute disease (in general)?

A

Rapid onset and short but severe course

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22
Q

What are the features of chronic disease (in general)?

A

Persisting over a long time

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23
Q

What are the features of acute leukaemia?

A

Undifferentiated cells decharacterised by uncontrolled cloning and accumulation of blast cells

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24
Q

What are the characteristics of chronic leukaemia?

A

Differentiated leukaemia

Uncontrolled cloning and accumulation of mature white blood cells (-cyte cells)

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25
Q

What is the normal age of onset of acute leukaemia?

A

Childhood

26
Q

What is the normal style of onset of acute leukaemia?

A

Sudden

27
Q

What is the normal duration of acute leukaemia?

A

Weeks to months

28
Q

What is the normal white blood cell count in acute leukaemia?

A

Variable

29
Q

What is the normal age of onset of chronic leukaemia?

A

Middle age and elderly

30
Q

What is the normal style of onset of chronic leukaemia?

A

Insidious

31
Q

What is the normal duration of chronic leukaemia?

A

Years

32
Q

What is the normal white blood cell count in chronic leukaemia?

A

High

33
Q

What is ALL characterised by?

A

Large number of lymphoblasts

34
Q

What is AML characterised by?

A

Large number of myeloblasts

35
Q

What is the overarching issue in acute leukaemia?

A

Arrest of maturation that breaks the balance of proliferation and death

36
Q

What are the typical lab symptoms of ALL/AML?

A

Thrombocytopenia
Neutropenia
Anaemia

37
Q

What are the clinical symptoms of thrombocytopenia?

A

Purpura (bruising)
Epistaxis (nosebleed)
Bleeding from gums

38
Q

What are the clinical features of neutropenia?

A

Recurrent infections and fever

39
Q

What are the clinical symptoms of anaemia?

A

Weakness
Tiredness
Shortness of breath

40
Q

What are the skin symptoms of leukaemia?

A

Night sweats
Easy bleeding and bruising
Purplish patches or spots

41
Q

What are the bone symptoms of leukaemia?

A

Pain or tenderness

42
Q

What are the resp symptoms of leukaemia?

A

Easy shortness of breath

43
Q

What are the systemic symptoms of leukaemia?

A

Weight loss
Fever
Frequent infections

44
Q

What is the most common childhood cancer?

A

ALL

45
Q

How do you treat ALL?

A

Chemo

46
Q

How is AML classified?

A

M0-M7

47
Q

How do you treat AML?

A

Chemo, immunotherapy

With/without allogenic bone marrow transplant

48
Q

What is chronic leukaemia characterised by?

A

Increased number of differentiated cells

49
Q

What is the average age of CLL onset?

A

70

50
Q

What is CLL characterised by?

A

Large number of mature lymphocytes in bone marrow and peripheral blood

51
Q

What are the symptoms of CLL?

A 
Recurrent infections
Anaemia
Thrombocytopenia
Lymph node enlargement
Hepatosplenomegaly
52
Q

What is the treatment of CLL?

A

Regular chemo to reduce cell numbers

53
Q

What is the average age of CML onset?

A

85-89

54
Q

How is CML usually discovered?

A

Routine blood tests

55
Q

What are the hallmarks of CML in the blood?

A

Neutrophilia in blood and bone marrow and the presence of the philadelphia chromosome

56
Q

What is CML treated by?

A

Imatinib

57
Q

What does the BCR gene encode?

A

A protein that needs to be continually active

58
Q

What does the ABL gene encode?

A

tyrosine kinase

59
Q

What does unregulated BCR-ABL cause?

A

Proliferation of progenitor cells in the absence of growth factors
Decreased apoptosis
Decreased adhesion to bone marrow

60
Q

What is imatinib?

A

A small molecular inhibitor that targets specifically ABL-CML treatment

Molecular Basis Of Disease/ Microbiology And Immunology (57 decks)

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