Lecture 11 - Malignant Blood Disorders

Question 1

Non-leukemia blood cancer?

Answer 1

Myeloproliferative neoplasms (polycythaemia), lymphomas (hodgkins lymphoma), myeloma

Question 2

Leukemia characteristics?

Answer 2

proliferation of immature bone cells, expand and replace other marrow cells, abnormal white blood cells leak into blood

Question 3

Chronic leukemia?

Answer 3

slower progression, characterised with enlarged lymph nodes and lymphocytosis

Question 4

Types of acute leukemia?

Answer 4

acute myeloid (AML) and acute lymphoblastic (ALL)

Question 5

Pathogenesis of leukemia?

Answer 5

congenital, viral infection, radiation, chemical/DNA damaging drugs

Question 6

Chromosomal abnormality found in chronic myeloid and some acute leukemias?

Answer 6

Philadelphia chromosome t(9;22)

Question 7

Inhibition of philadelphia chromosome to prevent leukemia?

Answer 7

Imatinib - tyrosine kinase inhibitor

Question 8

Acute Leukemia - Clinical?

Answer 8

ALL mainly childhood, AML mainly adults

Question 9

Signs and symptoms of acute leukemia - due to bone marrow failure?

Answer 9

anaemia (fatigue, dyspnoea), neutropenia (infection, slow healing), thrombocytopenia (bruising and bleeding)

Question 10

signs and symptoms of acute leukemia - organ infiltration?

Answer 10

enlarged liver, spleen and lymph nodes, gum abnormalities

Question 11

Leukemia - diagnosis?

Answer 11

pancytopenia w high circulating primitive leukocytes - bone marrow biopsy (aspirate, trephine)

Question 12

Leukemia diagnosis?

Answer 12

> 20% blasts, myeloid or lymphoid

Question 13

Specialised testing?

Answer 13

immunophenotype, chromosomes, molecular studies

Question 14

Acute leukemia therapy - general/supportive care?

Answer 14

intensive transfusion support (red cells, platelets), management of infection (antibiotics, lab support), vascular access (tunnel venous cathedars), patient and family support

Question 15

Chemotherapy for acute leukemia?

Answer 15

induction therapy (induce remission), consolidation (mop up residual leukemia cells), maintenance therapy (ALL only, maintains remission)

Question 16

Haematopoetic stem cell transplant?

Answer 16

sourced from the bone marrow, peripheral blood or cord blood of self (autologous) or matched donor (allogenic)