Leukaemia Flashcards
What is leukaemia a cancer of?
A particular line of the stem cells in the bone marrow
What are the 4 main leukaemias?
- Acute myeloid leukaemia
- Acute lymphoblastic leukaemia
- Chronic myeloid leukaemia
- Chronic lymphocytic leukaemia
1) What leads to the excessive production of a single type of abnormal white blood cell in leukaemia?
2) The excessive production of a single type of cell can lead to what?
1) A genetic mutation in one of the precursor cells in the bone marrow
2) The suppression of the other cell lines causing underproduction of other cell types
What is the term for the suppression of all cell lines which can occur in leukaemia, and this is a combination of which 3 other terms?
Pancytopenia, which is a combination of low RBCs (anaemia), WBCs (leukopenia) and platelets (thrombocytopenia)
Of the 4 common leukaemias, what is the order of when they commonly occur in, and add the ages in (younger to older)
- u5 and over 45 – acute lymphoblastic leukaemia
- Over 55 – chronic lymphocytic leukaemia
- Over 65 – chronic myeloid leukaemia
- Over 75 – acute myeloid leukaemia
The presentation of leukaemia is non-specific, name 3 of these features
- Fatigue
- Fever
- Failure to thrive in children
- Pallor due to anaemia
- Petechiae and abnormal bruising due to thrombocytopenia (bleeding under the skin)
- Abnormal bleeding
- Lymphadenopathy
- Hepatosplenomegaly
1) What is the initial investigation?
2) What is the main investigation for establishing a definitive diagnosis of leukaemia?
1) FBC
2) Bone marrow biopsy
Acute lymphoblastic leukaemia
1) This is the commonest cancer in which group of people?
2) It causes acute proliferation of a single type of lymphocyte, usually what cell?
3) What genetic condition is it associated with?
4) What can be seen on a blood film on a patient with this?
5) What chromosome is it associated with?
1) Children
2) B cells
3) Down syndrome
4) Blast cells
5) Philadelphia chromosome
Chronic lymphocytic leukaemia
1) There is chronic proliferation of a single type of well differentiated lymphocyte, usually what cell?
2) Often it is asymptomatic but name 2 ways it can present
3) What type of anaemia can it cause?
4) CLL can transform into high-grade lymphoma - what is it called when this happens?
5) What does a blood film show?
1) B cells
2) Infections, anaemia, bleeding and weight loss
3) (warm) autoimmune haemolytic anaemia
4) Richter’s transformation
5) Smear or smudge cells
Chronic Myeloid Leukaemia
1) What are the 3 phases of this cancer?
2) In the 1st phase that lasts around 5 years, how are patients normally diagnosed?
3) What causes the 2nd phase occur?
4) Name a feature of the 2nd phase
5) Why is the last phase often fatal?
6) What is the characteristic cytogenetic change in CML?
1) Chronic, accelerated, blast
2) Incidentally by a raised WBC count
3) Abnormal blast cells take up a high proportion of the cells in the bone marrow and blood
4) Anaemia, thrombocytopenia, more immunocompromised
5) Even higher proportion of blast cells in blood
6) Philadelphia chromosome
Acute Myeloid Leukaemia
1) What does a blood film show?
2) These cells on the blood film have rods inside their cytoplasm - what are the rods called?
3) It can be the caused by a transformation from what kind of disorder?
1) Blast cells
2) Auer rods
3) Myeloproliferative
1) What are the 2 main aspects of the management of leukaemia?
2) Name another potential aspect of the management
1) Chemotherapy and steroids
2) Radiotherapy, bone marrow transplant, surgery
1) What causes tumour lysis syndrome?
2) How can it cause AKI?
3) How is it treated?
1) Release of uric acid from cells being destroyed by chemotherapy
2) Uric acid can form crystals in the interstitial tissue and tubules of the kidneys
3) Allopurinol or rasburicase
