Leukaemia Flashcards
Leukemia
Malignancy of blood cells
Types
AML
CML
ALL
CLL
Acute vs chronic leukemia
Acute - impaired […], resulting in large numbers of […] in the bone marrow;
Chronic - excessive proliferation of […]. Cell differentiation is […].
Acute - cell differentiation, malignant precursor cells
Chronic - mature malignant cells, unaffected.
Myeloid vs lymphocytic
myeloid leukaemia commonly arises from a myeloid precursor cell, such as […]. Lymphocytic leukaemia arises from a lymphoid precursor, such as […].
neutrophils
B-cells
AML - most common acute leukemia in […]
Features
- Bone marrow failure (anaemia, bleeding, infections)
- Signs of […] - hepatomegaly, […], and […] hypertrophy
adults
infiltration
splenomegaly, gum hypertrophy
Diagnosis of AML
- Leucocytosis may be present, but WBCs can also be normal
- […] is required, may show […] rods (cytoplasmic inclusion bodies)
Bone marrow biopsy, Auer
AML mx
chemotherapy regimens or bone marrow transplant
AML Prognosis
- […] months without treatment
- […] survival rate in 3 years
2
20%
ALL - most common cancer in […]
childhood
ALL - Features
- symptoms caused by marrow failure (anaemia, bleeding, infection)
- bone pain (infiltration)
Signs include
- painless […]
- hepatosplenomegaly,
- CNS involvement (e.g. […] palsy)
- […] infiltration (resulting in painless […] […] enlargement).
lymphadenopathy
cranial nerve VII, meningism
testicular infiltration unilateral testicular
ALL diagnosis
- […] and […] cells on blood film and bone marrow analysis
leucocytosis and blast cells
Mx - ALL
chemo
Prognosis ALL - in children […] to […] cure rate
70-90%
CML - most common is […] patients, with […] slightly more affected.
It is classically associated with the […] chromosome.
middle-aged, males
Philadelphia - part of chromosome 9 moves to chromosome 22 - BcrAbl
CML features
- weight […], tiredness, fever, and […].
Common signs include massive […] (>75%), bleeding (due to thrombocytopenia), and […].
loss, sweating (night sweats?)
splenomegaly, gout
Diagnosis CML
- Blood tests: […], in particular raised […] cells which include: neutrophils, monocytes, basophils, and eosinophils.
Bone marrow analysis shows similar findings.
leucocytosis, myeloid
Mx - CML
Chemo
Prognosis - CML
5-6 years survival
CLL is most common in […] patients over the age of […]. It is caused by the proliferation of functionally incompetent malignant […] cells.
male, 60, B
CLL features
Typically presents […]. However, patients may present with non-tender […], hepatosplenomegaly, or […] (weight loss, night sweats, and fever).
Features of marrow failure (infection, anaemia, and bleeding) are […] common than in the acute leukaemias.
asymptomatically, lymphadenopathy
B symptoms
less
CLL diagnosis
The most common initial blood result is an incidental […].
Subsequent blood film shows […] cells, which are cells damaged as they lack a cytoskeletal protein.
[…] is then used to measure particular markers expressed by the malignant cells.
Other tests include bone marrow biopsy.
lymphocytosis
smudge
Flow cytometry
CLL mx
chemo
CLL prognosis
1/3 of cases don’t progress, 1/3 of cases progress slowly, and 1/3 of cases progress actively.
