Leukaemia Flashcards
What ages do different leukaemias present?
ALL: <5, >45
CLL: >55
CML: >65
ALL: >75
ALL pathophysiology
Acute proliferation of a single type of lymphocyte (usually B)
CML pathophysiology
Chronic proliferation of a single type of lymphocyte, usually B
CML pathophysiology
Chronic phase: 5 years, asymptomatic, incidental diagnosis from raised WCC
Acute phase: abnormal blast cells take up 10-20% of BM and blood. Becomes symptomatic - anaemia, thrombocytopenia, immunosuppressant
Blast phase: >30% abnormal blast cells, severe symptoms and pancytopenia, often fatal
What is associated with ALL
T21
Philadelphia chromosome
What is associated with CLL
Associated with warm haemolytic anaemia
Richter’s transformation - into high-grade lymphoma
What is associated with CML
Philadelphia chromosome
What is associated with AML
Transformation from a myeloproliferative disorder
What would you find on a blood film in ALL?
Blast cells
What would CLL look like on a blood film
Smear / smudge cells
What would AML look like on blood film
Blast cells
What would CML look like on blood film
Blast cells with Auer rods
Presentation of leukaemia
Non-specific
Fatigue
Fever, failure to thrive, pallor due to anaemia, petechiae, abnormal bruising, bleeding, lymphadenopathy, hepatosplenomegaly
Ix leukaemia
FBC <48hrs LDH Blood film BM biopsy LN biopsy CXR LP CT / MRI / PET
Management of leukaemia
Chemotherapy and steroids
Radiotherapy, SC transplant, surgery
