Brainscape's Knowledge GenomeTM


Top Flashcards (Certified)
All Flashcards

RADT317 - Brain > Leukaemia > Flashcards

Leukaemia Flashcards

1
Q

What does leukaemia affect?

A

The ability to produce normal blood cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What does leukaemia cause?

A

The overproduction of abnormal, immature WBC in the bone marrow

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What 2 categories do leukaemia’s fall into?

A

Chronic or acute

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What 2 cell type categories do leukaemia’s fall into?

A

Lymphoblastic or myeloid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What 4 categories can stem cells develop into?

A

Lymphoid stem cells, myeloid stem cells, erythroblasts and megakaryoblasts

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Lymphoid cells become?

A

WBC Lymphocytes (T and B)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Myeloid cells become?

A

WBC Monocytes and neutrophils

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Erythroblasts become?

A

RBC

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Megakaryoblasts become?

A

Platelets

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are the 2 acute classifications?

A

Acute lymphoblastic leukaemia
Acute myeloid leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the 2 chronic classifications?

A

Chronic lymphoblastic leukaemia
Chronic myeloid leukaemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is ALL characterised by?

A

Overproduction of cancerous, immature lymphocytes (lymphoblasts)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What is AML characterised by?

A

Rapid growth of WBC that accumulate in the bone marrow and affect WBC production

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Function of monocytes (myeloid)?

A

WBC - responds to bacteria, viruses and fungi, produced in the bone marrow and released when infection occurs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Function of lymphocytes (lymphoblastic)?

A

Many functions.
B - mature in bone marrow
T - mature in thymus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is chronic leukaemia characterise by?

A

Build up of abnormal WBC over months or years

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is the peak incidence age of ALL?

A

0-4

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What is the management of ALL?

A

1 - Induction - 4 week chemo
2 - Consolidation - 4 week chemo
3 - Maintenance - weekly 3 weeks chemo (methotrexate)
4 - 4 cycles chemo + maintenance or stem cell transplant

vincristine, dexamethasone
Pegaspargase - combination therapy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What is the management of AML?

A

1 - Induction - 4 week chemo
2 - Consolidation - 4 week chemo
*3 - Maintenance - weekly 3 weeks chemo (methotrexate)
*4 - 4 cycles chemo + maintenance or stem cell transplant

cytarabine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is the management of CLL?

A

1 - Watch and wait
*2 - Chemo (fast developing disease)
*3 - RT (lymphadenopathy 4gy)
*4 - Surgery or RT (splenomegaly 6-10gy)
*5 - Bone marrow transplant (rare)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the management of CML?

A

1 - Biological therapy (imatinib)
2 - Chemo
*3 - Bone marrow or stem cell transplant
*4 - RT (rarely used - symptom palliation)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Induction chemotherapy purpose?

A

Clear the blood of leukaemia cells
Reduce the number of blasts in the bone marrow to normal

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Consolidation chemotherapy purpose?

A

Given after induction recovery
Kills remaining (undetectable) leukaemia cells

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Maintenance chemotherapy purpose?

A

Long term low dose
Not used for all leukaemia types - most common for ALL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Name a AML chemo drug
Cytarabine
26
Name a ALL chemo drug
Vincristine, dexamethasone
27
What drug is used for maintenance?
Methotrexate
28
General chemotherapy side effects
Nausea Alopecia Cardiotoxicity Neuropathy Skin changes Mouth sores Taste changes Infertility/sexual dysfunction
29
What is Pegaspargase (oncaspar)?
Used as combination therapy for ALL management Recommended for use in children, young people and adults, diagnosed with untreated, new disease
30
Pegaspargase (oncaspar) side effects
Nausea/vomiting Stomach pain Weakness Allergic reaction Mouth pain Acute pancreatitis (rare)
31
What are the 2 types of stem cell transplant?
Autologous and allogeneic
32
What happens in a autologous stem cell transplant?
Stem cells harvested from the patient are given back after conditioning regimen of high dose chemo and/or RT
33
What happens in a allogenic stem cell transplant?
Same procedure as autologous, however, uses relative, unrelated individual or saved umbilical cord blood Needs a successful human leukocyte antigens (HLA) test Preferable as donor cells are non-malignant but hard to match donors
34
When would you use TBI?
Before stem cell transplant to help reduce chance of transplant rejection or if stem cell transplant has failed
35
Side effects of TBI?
Nausea, diarrhoea, fatigue, mouth sores, skin changes, immunosuppression
36
What is often shielded for TBI and why?
Reduce long term issues and even out dose
37
Infection control
Protective isolation Room sterilisation Clean air Clean food Purified water Removal of plants Hand washing Sealed room 1 visitor per day Can lead to psychological issues
38
What percentage of new cancer diagnoses does CLL account for (2016-2018)?
1%
39
What is CLL incidence rates strongly related to?
Age
40
What staging system does CLL use?
The Binet Staging system
41
How many stages does the CLL Binet staging system have?
3 (Stage A, B and C)
42
What does CLL Binet staging system Stage A mean?
Fewer than 3 groups of enlarged lymph nodes (lymphadenopathy) and a high white blood cell count
43
What does CLL Binet staging system Stage B mean?
More than 3 groups of enlarged lymph nodes (lymphadenopathy) and a high white blood count
44
What does CLL Binet staging system Stage C mean?
Enlarged lymph nodes or spleen, a. high white blood cell count and low red blood and platelet counts
45
What percentage of new cancer diagnoses does CML account for (2016-2018)?
Less than 1%
46
What gender are incidence rates lower in CML?
Females
47
What are the 3 phases of CML?
Chronic, accelerated, blast crisis
48
How many patients present in the chronic phase?
85%
49
What is shown in the accelerated phase?
Some signs in blood/bone marrow that patient is moving towards blast crisis
50
What happens to cells in the blast crisis phase?
Behaves like AML Rapid progression Short survival
51
What does the Philadelphia chromosome cause?
Causes the production of an enzyme called tyrosine kinase (TK) which stimulates the production of leukaemic cells
52
What is the Philadelphia chromosome treated with?
Treated with TK inhibitors (TKI therapy) such as Glivec
53
Arsenic Trioxide (Trisenox or ATO)
Long history of use in Chinese medicine Current use in subtype of AML (acute promylocytic leukaemia) ‘chemo free’ treatment Minimal side effects Given over 6 month period Causes death of leukaemia cells via morphological changes and DNA fragmentation. Arsenic Trioxide also damages or degrades the fusion protein promyelocytic leukemia (PML) - retinoic acid receptor (RAR) alpha
54
Monoclonal antibodies
Monoclonal antibodies recognise and find specific abnormal proteins on cancer cells Each monoclonal antibody recognises 1 particular protein Different cancers have different abnormal proteins, CD20 in CLL CD20 antigen is a protein found on surface of B-lymphocytes Drugs include; Rituximab, Obinutuzumab and Ofatumumab CD52 antigen found on surface of CLL cells and many T-lymphocytes Alemtuzumab (Campath) targets CD52, used if CLL no longer responding to standard chemo
55
What is CAR T cell treatment?
Blood taken from patients and separated to get T-cells The T-cells are then genetically engineered, using a disarmed virus (not going to harm the cell anymore), to produce cell surface receptors, called Chimeric Antigen Receptors (CARs) These receptors then allow the T cells to recognise and attach to a specific protein or antigen on tumour cells An antigen found on B-cells is CD19 The CAR s “program” the T-cells to find and destroy cancer cells CAR T cell therapy used for B-cell ALL patients recurrence or relapse (Kymriah)
56
How common is leukaemia in the UK overall?
12th most common
57
How common is leukaemia in UK males?
10th most common
58
What is the cause of leukaemia?
Unsure of cause! Certain link to DNA mutations disrupting cell death, differentiation or division process Many different mutations have been identified Mutations may be due to carcinogens, radiation or exposure to certain viruses Downs syndrome. 10-20% increased risk of developing acute leukaemia's Krummel cluster, Germany Seascale cluster, 1955-1983. proven higher incidence of leukaemia near to Sellafield Chernobyl East v’s West Germany
59
Leukaemia symptoms
Fever, chills Fatigue, weakness Loss of appetite, weight loss Night sweats Bone/joint pain Abdominal discomfort Headaches Shortness of breath Frequent infections Easy bruising or bleeding Petechiae (small red spots under the skin)
60
Leukaemia signs
Anaemia Leukopaenia (low white blood cell count) Thrombocytopenia (low blood platelet count) - bruising or bleeding Lymphadenopathy (with lymphatic spread) Hepatomegaly / splenomegaly - abnormal cells in liver or spleen
61
AML prognostic factors
Age Treatment induced Myeloproliferative disorders CNS involvement Cytogenics White blood cell count (>100 unfavourable)
62
What are cytogenetics?
Investigation of chromosome abnormalities is increasingly valuable for leukaemia diagnosis Chromosome abnormalities are strongly associated with both AML and ALL Molecular studies of these abnormalities identified specific genes implicated in leukaemia development
63
What is complete remission?
No evidence of disease after treatment Bone marrow contains fewer than 5% blast cells Blood cell counts within normal limits No signs or symptoms “Molecular” complete remission if no leukaemia cells in marrow
64
What is minimal residual disease?
Sensitive tests (flow cytometry or PCR) find leukaemia in marrow
65
What is active disease?
Evidence of leukaemia during treatment Reappearance of disease after treatment (relapse) More than 5% blast cells in bone marrow
66
What percentage of deaths does AML account for?
2%
67
ALL prognostic factors
Gender (males worse) Age WBC Cytogenetics CNS disease Response to treatment
68
What is the Philadelphia chromosome (PH+)?
Translocation of chromosomes 22 and 9 Creates a new “BCR-ABL” gene which produces a new protein Protein creates an enzyme called tyrosine kinase which stimulates the production of leukaemic cells Tyrosine Kinase Inhibitors can be used as a treatment
69
Ph-positive ALL
Approximately 25% of adults with ALL and a small number of children have Philadelphia positive ALL (Ph+) More strongly associated with CML Associated with poor prognosis - More intensive treatment - Addition of Tyrosine kinase inhibitors (TKIs) - Addition of Glivec (imatinib) to chemotherapy - Continuation of Glivec after consolidation

RADT317 - Brain (10 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2025 Bold Learning Solutions. Terms and Conditions