Leukaemia Flashcards

1
Q

What is leukaemia?

A

Cancer of stem cells in bone marrow

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2
Q

Types of leukaemia

A

Acute lymphoblastuc leukaemia
Acute myeloid leukaemia
Chronic myeloid leukaemia

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3
Q

When does ALL peak?

A

Most common leukaemia
Peaks in childre 2-3 years

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4
Q

When does AML peak?

A

Under 2 years
Second most common leukaemia

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5
Q

What happens in leukaemia?

A

Genetic mutation in precursor cell-> excessive production of one type abnormal white blood cell -> supression of other cell lines -> pancytopenia

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6
Q

What is pancytopenia?

A

Low:
RBC - anaemia
WBC - leukopenia
Platelets - thrombocytopenia
One proliferative line

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7
Q

What conidtions increase risk of developing leukaemia?

A

Radiation exposure during pregnancy
Downs syndrome
Kleinfelter syndrome
Noonan syndrome
Fanconis anaemia

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8
Q

What is kleinfelter syndrome

A
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9
Q

What is noonan syndrome

A
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10
Q

What is fanconis anaemia

A
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11
Q

Presentation of leukaemia

A

Typically non speicifc
Persistent fatigue
unexplained fever
FTT
Weight loss
Nigth sweats
Pallor (anaemia)
Petechiae + abnormal bruising
Abdo pain
Genrealised lymphadenopathy
Unexplained or persistent bone or joint pain
Hepatosplenomagealy

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12
Q

What children do NICE recommend referring for leukaemia assessmetn?

A

Unexplained peteciae or hepatomegaly

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13
Q

What need to do NICE if leukaemia suspected?

A

FBC in 48 hours

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14
Q

Investigations to establish leukaemia diagnosis

A

FBC - anaemia, leukopenia, thrombocytopenia, high WCC abnormal count
Blood ilm - blast cells
Bone marrow biopsy
Lymph node biopsy

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15
Q

What further investigtaions done to stage leukaemia?

A

CXR
CT scan
Lumbar puncture
Genetic analysis and immunophenotyping of abnoraml cells

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16
Q

Treatment for leukaemia?

A

Paediatrci oncology MDT
Chemotherapy primary treatment
Radiotherapy
Bone marrow transpplant
Surgery

17
Q

Complucations of chemotherapy

A

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

18
Q

Prognosis leukaemia

A

ALL - 80%, individual
AMl

19
Q

On exam leukaemia

A

Weigth loss
Pallor
Petechial rash , bruise
Tachy
Flow murmur
Hepatosplenomaegaly
Lymphadenopathy

20
Q

Red flags leukaemia

A

Unexplained petechiae/hepatosplenomegaly
Pallor
Geeky medics

21
Q

What is the result of a blood film in leukaemia

A

Immature blast cells on blood film - abnormal

22
Q

Why do CXR in leukaemia

A

Check for mediastinal mass

23
Q

What is tumour lysis syndrome?

A

Oncological emergency from lysis of tumour cells
-> hyperphosphatemia/kalemia/calcemia/uricaemia

24
Q

Presentation tumour lysis syndrome

A

AKI, cardiac, arrhythmias, seizures, N+V

25
Q

Treat tumour lysis syndomre

A

Allopurinol/Rasburicase - break down uric acid

26
Q

Chemotherapy in children

A

Stunted growth
Infertility
Cardiac/other orgna damage
Side effects
Children often recover well