Leukaemia

Question 1

Definition

Answer 1

Cancer that start sin blood-forming tissue
Bone marrow
Causes large numbers of abnormal blood cells

Question 2

Leukaemia - Haematopoiesis

Answer 2

Over production of immature / mature blood cells

Question 3

Leukaemia classification

Answer 3

Acute
Chronic
Myeloid origin
Lymphoid origin

Question 4

Symptoms

Answer 4

Fevers, frequent infections Night sweats
Fatigue (feeling tired or washed out), breathlessness Pallor, confusion, headaches, blurred vision
Weight loss
Easy bleeding or bruising, gum bleeding
Less common - swellings, bone pain, other pain.

Question 5

Diagnosis

Answer 5

• Full blood count and blood film
• Biochemistry (kidney/liver function tests, haemolysis)
• Bone marrow biopsy
• Immunophenotyping and genetic analysis • Chest x-ray
• Lumbar puncture

Question 6

FAB (french American British classification) 1976 of acute leukaemia

Answer 6

Acute myeloid (AML)
M0-M7 minimally differentiated - megakaryoblastic
Acute lymphoblastic (ALL)
L1-L3 small, monomorphic - Burkett-cell type

Question 7

Haematology malignancy classification

Question 8

Cytochemistry

Answer 8

Staining of enzymes

myeloperoxidase, Sudan Black, esterase, Periodic Acid Schiff

Question 9

Immunophenotyping

Answer 9

CD # = cluster designation number CD34

Question 10

Principles of flow cytometry

Question 11

Molecular tests for leukaemia and lymphoma:

Answer 11

• translocations,
• inversions,
• gene mutations,

Question 12

Cytogenetics-FISH

Answer 12

The basic principle of the method is that single-stranded DNA will bind or anneal to its complementary DNA sequence.

Question 13

Treatment

Answer 13

Transfusions – Red cells, Platelets, Fresh Frozen Plasma Chemotherapy – Induction, Consolidation, Maintenance Steroid therapy/Growth factors – GCSF, EPO Radiotherapy – Local therapy for CNS system
Bone marrow/stem cell transplant – Allogeneic or Autologous Transplantation

Question 14

Transplantation Outlook:

Answer 14

Tissue typing = matching the donor to the recipient
Transplantation may fail:- • Graft failure
• Graft versus host disease • Leukaemia relapse
• Infection

Question 15

Factors affecting outlook

Answer 15

• Age
• Level of leukaemia cells in the blood and bone marrow
• Extent to which different systems of the body are affected by leukaemia
• Chromosome abnormalities present in leukaemia cells

Question 16

5 year Survival

Answer 16

<20 = 37%
20-49 = 27%
50-64 = 45%
65-74 = 35%
75+ = 20%

Question 17

Summary

Answer 17

• Leukaemia definition and types
• Associated symptoms
• Diagnosis
• Treatment options