Leukaemia

Question 1

Acute vs Chronic

Answer 1

> 20% nucleated vs <20% nucleated
severe and sudden vs long standing and slow

Question 2

Acute Myeloblastic Leukaemia (AML)
Symptoms

Answer 2

2/3 adult cases are 60+ year old
Anaemia, Low WBC and Low PLT symptoms

Question 3

AML diagnosis

Answer 3

Low WBC, anaemia, thrombocytopenia
Lots of blasts
Auer rods

Question 4

AML treatment

Answer 4

Blood transfusions, antibiotics, hydration therapy
Chemo 4 cycles with 2-3 week break
Daunorubicin and Cytarabine

Question 5

Acute Lymphoblastic Leukaemia (ALL)

Answer 5

Common in children 2-10, another peak 15-24 and 80+
Cancer in the B or T lineage

Question 6

ALL symptoms

Answer 6

Anaemia, low WBC, low PLT, loss of appetite, bone and joint pain

Question 7

ALL diagnosis

Answer 7

Low WBC, low PLT, thrombocytopenia
Coagulation tests all deranged
Blasts

Question 8

ALL treatment

Answer 8

Chemo, transfusion, antibiotics, hydration
immunotherapy, stem cells

Question 9

Chronic Myelogenous Leukaemia (CML)

Answer 9

Usually 75-80 years
Chronic <10%
Accelerated 10-19%
Blast Crisis >20%

Question 10

CML symptoms

Answer 10

1/3 asymptomatic (detected through routine FBC)
fatigue, lethargy, weight loss, sweat, gout, bruising

Question 11

CML diagnosis

Answer 11

Raised WBC, neutrophilia, myelocytosis
Anaemia
Blasts, granulocytes - left shifted

Question 12

CML treatment

Answer 12

Imatinib
Hydroxycarbamide to normalise WBC (short term)
Stem cells (for kids)

Question 13

Chronic Lymphocytic Leukaemia (CLL)

Answer 13

> 70 years old, rare in children
Mature lymphocytes effected

Question 14

CLL symptoms

Answer 14

70-80% asymptomatic, night sweats, weight loss

Question 15

CLL diagnosis

Answer 15

Lymphocytes are massive >400
Anaemia, neutropenia, thrombocytopenia
Smear cells, spherocytes

Question 16

CLL treatment

Answer 16

Chemo, radiotherapy, immunotherapy, stem cells