L25: Intro To Leukaemia Flashcards
Define leukaemia
→malignant disorders of haematopoietic stem cells characteristically associated with increase number of white cells in bone marrow or/and peripheral blood.
What are the two features of haematopoietic stem cells?
→Multipotent- can give rise to cells of every blood lineage
→Self maintaining- a stem cell can divide to produce more stem cells
What are the three features of progenitor cells?
→Can divide to produce many mature cells
→But cannot divide indefinitely
→Eventually differentiate and mature
What is the difference in morphology of undifferentiated and differentiated progenitor cells?
→cannot tell the difference between them morphologically because they do not show the characteristics of mature cells.
What is meant by leukaemia being clonal?
→all the malignant cells derive from a single mutant stem cell.
What are the first symptoms of all leukaemia?
→Abnormal bruising-commonest
→Repeating abnormal infection
→Sometimes anaemia
→Fever
What are the three ways of diagnosing leukaemia?
→Peripheral blood blasts test (PB)
→ Bone marrow test/biopsy (BM)
→Lumbar puncture
Why is peripheral blood test used in leukaemia diagnosis?
→looks for blasts and cytopenia.
→ if >30% blasts are suspected of acute leukaemia.
Where is bone marrow taken from?
→taken from pelvic bone and results compared with PB.
Why is lumbar puncture used in leukaemia diagnosis?
→to determine if the leukaemia has spread to the cerebral spinal fluid (CSF)
What techniques are involved in molecular and pathophysiological characterisation of leukaemia testing?
→Cytomorphology →Immunophenotyping →Next Generation Sequencing (NGS) →Flow cytometry →Fluorescence in situ Hybridation (FISH)
What type of leukaemia are sometimes hereditary?
→Chronic Lymphocytic Leukaemia (CLL)
What are some chromosome aberrations which may be genetic risk factors for leukaemia?
→Translocations (e.g. BCR-ABL in CML).
→Numerical disorders (e.g. trisomy 21-Down syndrome).
What are some inherited immune system problems that predisposes to leukaemia?
→Ataxia-telangiectasia,
→Wiskott-Aldrich syndrome
What are some genetic mutations that predisposes to leukaemia?
→TP53- Li-Fraumeni syndrome,
→NF1-Neurofibromatosis
What are some environmental risk factors that predisposes to leukaemia?
→Radiation exposure
→Exposure to chemicals and chemotherapy
→Immune system suppression
What are some risk factors linked to childhood leukaemia?
→Exposure to electromagnetic fields →Foetal exposure to hormones →Parent’s smoking history →Infections early in life →Mother’s age when child is born
What are the classifications of leukaemia?
→Acute Lymphoid Leukaemia (ALL) →Acute Myeloid Leukaemia (AML) →Chronic Lymphoid Leukaemia (CLL) →Chronic Myeloid Leukaemia (CML)
What is acute leukaemia?
→rapid onset and short but severe course
What are characteristics of acute leukaemia?
→Undifferentiated leukaemia
→uncontrolled clonal and accumulation of immature white blood cells (-blast)
→High number of blasts in blood
Which cells in the bone marrow are involved in acute leukaemia?
→myeloblast
→lymphoblast
What are the characteristics of chronic leukaemia?
→Differentiated leukaemia
→uncontrolled clonal and accumulation of mature white blood cells (-cyte)
Which cells in the bone marrow are involved in chronic leukaemia?
→-cytes
What is the age of onset for acute and chronic Leukaemia?
→ acute= children
→chronic= insidious
