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HTS > leukaemia > Flashcards

leukaemia Flashcards

1
Q

what are leukaemias?

A
  • heterogenous group of malignant blood disorders
  • type of cancers caused by unregulated proliferation of a clone of immature blood cells derived from mutant haemoatopoietic stem cells
  • arise as a result of multiple acquired genetic and epigentic events
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2
Q

percentage of leukaemias of total cancer cases is

A

3%

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3
Q

___ % of leukaemias in UK are male

A

60%

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4
Q

leukaemia locations

A
  1. bone marrow
  2. lymph system, including spleen
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5
Q

two types of bone marrow

A

red bone marrow
* red + white cells are made
* found in mature breast bone, skull, vertebrae, pelvis, ribs

yellow bone marrow
* made mostly of fat cells
* found in middle section of long bones

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6
Q

leukaemia aetiology ( causes )

A
  • chromosomal translocation
  • chromosomal deletion ( e.g. in AML a gene is lost )
  • chromosomal addition ( usually a duplication )
  • submicroscopic mutations ( change in base sequence of oncogenes )
  • epigenic changes where gene code is ok, but function affected ( by methylation )
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7
Q

examples of some epigenetic factors

A
  • environmental chemicals
  • drugs/pharmaceuticals
  • aging
  • diet
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8
Q

pathophysiology of leukaemia

A
  • normal bone marrow replaced by immature + undifferentiated leukocytes, stem cells and blast cells
  • abnormal immature leukocytes ciruclate in blood + infiltrate liver, spleen and lymph nodes
  • myeloid proliferation —-> no space for lymphoid cells to develop + WBC numbers fall
  • lymphoid prolifertaion —-> reduced red cells + platelets
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9
Q

predisposing factors of leukaemia

A
  • smoking
  • previous chemotherapy
  • occupational chemical exposure
  • down’s syndrome
  • myeloproliferative disorders
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10
Q

classifying leukaemias

A
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11
Q

acute myeloid leukaemia - list clinical mainfestations

A
  • marrow failure
  • tissue infiltration
  • leukostasis and DIC
  • sternal tenderness
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12
Q

acute myeloid leukaemia - what does marrow failure cause?

A

neutropenia
* more infections; sepsis

anaemia
* fatigue; pallor

thrombocytopenia
* bleeding; brusing

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13
Q

acute myeloid leukaemia - what does tissue infiltration cause?

A
  • organomegaly - liver, spleen, lymph nodes
  • gum hypertrophy
  • bone pain
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14
Q

acute myeloid leukaemia - what does leukostasis cause?

A

accumulation of cells in microcirculation impairs perfusion causing
* hypoxaemia
* stroke
* fever and sweats
* headacches

disseminated intravascular coagulation ( DIC )

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15
Q

acute myeloid leukaemia diagnosis

A
  • WCC ofetn high, could be normal/low
  • anaemia + thrombocytopenia common
  • blood film - many blast cells or dysplactic changes to cellls
  • diagnosis confirmed by bone marrow aspirate
  • difficult to distinguish from ALL so cell staining used
  • results with sudan black — > +ve AML, -ve ALL
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16
Q

acute lymphoblastic leukaemia incidence

A
  • 75% cases under 6yr
  • twice likely in white than black people
  • being pregnant increases risk
  • fatal within months if untreated ( 3 months )
17
Q

acute lymphoblastic leukaemia - symptoms

A
  • weakness
  • weight loss
  • bruising easily
  • bleeding from gums and nose
  • fever
  • swollen lymph glands
18
Q

acute lymphoblastic leukaemia - examination

A
  • Palpable liver (64%)
  • Palpable spleen (61%)
  • Pale appearance (54%)
  • Fever (52%)
  • Bruising (52%)
  • arm/leg pain
  • enlarged lymph node
  • testicular enlargement
19
Q

acute lymphoblastic leukaemia - diagnosis

A
  • WCC may be raised, normal, low
  • anaemia + thrombocytopenia common
  • bone marrow aspirate essential
  • stains positive for AML, negative for ALL
  • immunophenotyping essential for chromosomal abnormalities
20
Q

what is chronic myeloid leukaemia?

A

myeloproliferative disorder resulting from an acquired genetic change to a pluripotent stem cell

21
Q

chronic myeloid leukaemia phases

A
22
Q

chronic myeloid leukaemia - pathogenesis

A

more than 90% of cases result from the Philadelphia chromosome

23
Q

what is the only treatment for CML?

A

stem cell transplantation

24
Q

what is chronic lymphocytic leukaemia?

A
  • proliferation of B-lymphocytes
  • most common form of leukaemia
25
Q

chronic lymphocytic leukaemia - cause

A

thought to be caused by benzene exposure or high doses of ionising radiation

26
Q

chronic lymphocytic leukaemia - symptoms

A
  • often no symptoms
  • some have fatigue, weakness, fever, weight loss, joint pain
27
Q

chronic lymphocytic leukaemia - examination

A
  • enlarged spleen, liver or lymph nodes
  • pruritic vesicular lesions
28
Q

chronic lymphocytic leukaemia - examination

A
  • anaemia, thrombocytopenia
  • elevated WCC
  • increased blood viscosity and clotting
29
Q

chronic lymphocytic leukaemia prognosis

A

HTS (17 decks)

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