leukaemia

Question 1

what are the 3 types of leukaemia and which are the most common in paediatriics?

Answer 1

Acute lymphoblastic leukaemia (ALL) is the most common in children

Acute myeloid leukaemia (AML) is the next most common

Chronic myeloid leukaemia (CML) is rare

Question 2

what will the FBC show for leukaemia?

Answer 2

pancytopenia, which is a combination of low:

Red blood cells (anaemia),
White blood cells (leukopenia)
Platelets (thrombocytopenia)

Question 3

what are risk factors for leukaemia?

Answer 3

• radiation exposure

some conditions:

• downs syndrome
• kleinfelter syndrome
• noonan syndrome
• fanconi anaemia

Question 4

how is leukamia diagnosed?

Answer 4

• fbc - showing pancytopenia
• blood film showing blast cells
• bone marrow biopsy

further testing for staging

• cxr
• CT scan
• lumbar puncture
• genetic analysis and immunophenotyping

Question 5

hopw is leukaemia managed?

Answer 5

• chemotherapy
• radiotherapy
• bone marrow transplant
• surgery

Question 6

what are complications of chemotherapy?

Answer 6

Failure to treat the leukaemia
Stunted growth and development
Immunodeficiency and infections
Neurotoxicity
Infertility
Secondary malignancy
Cardiotoxicity

Question 7

what is the prognosis of ALL?

Answer 7

The overall cure rate for ALL is around 80%, but prognosis depends on individual factors. The outcomes are less positive for AML.

Question 8

which children should be immediately reffered for specialist assesment?

Answer 8

• unexplained patechiae or hepatospplenomegaly

Question 9

what are the different ways in which leukaemia can present?

Answer 9

general= malaise and anaemia

Bone marrow infltration- anaemia leading you to feel pale and lethargic, neutropenia- causing reccurrent infection, thrombocytopenia- leading to bruising, patechiae and nose bleeds

reticulendothelial infiltration- hepatosplenomegaly and lymphadenopathy

other organ infiltration: inflitrating the CNS can cause headache, vomiting and nerve paplsy
the testes can also become enlarged