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Rakeem's Haematology > leukaemia > Flashcards

leukaemia Flashcards

1
Q

define leukaemia

A

Leukaemia is a cancer of either the myeloid or lymphoid line of stem cells within the bone marrow

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2
Q

pathophysiology of leukaemia

A
  1. occurs when one of the
    precursor cells in the bone marrow
    leads to excessive production of a
    single type of abnormal white blood cell.
  2. The excessive production of this cell line can suppress the other cell lines, causing pancytopenia
  3. This is a combination of anaemia,
    leukopenia, and thrombocytopenia.
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3
Q

how to classify signs of bleeding under the skin

A

its classified using size

Petechiae - <3mm due to burst
capillaries
Purpura – 3-10mm
Ecchymosis - >1cm

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4
Q

what are the 4 types of leukaemia

A
  1. Acute Myeloid Leukaemia (rapid, myeloid line)
  2. Acute Lymphoid Leukaemia (rapid, lymphoid line)
  3. Chronic Myeloid Leukaemia (slow, myeloid line)
  4. Chronic Lymphoid Leukaemia (slow, lymphoid line)
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5
Q

signs and symptoms of general leukaemia

A
  • Fatigue
  • Fever
  • Pallor
  • Petechiae/bruising
  • Abnormal bleeding
  • Lymphadenopathy
  • Hepatosplenomegaly
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6
Q

what investigations to do for leukaemia

A
  1. blood film
  2. lactate dehydrogenase
  3. bone marrow biopsy
  4. CT/PET scan
  5. lymph node biopsy
  6. genetic tests
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7
Q

what is the first line of investigation for leukaemia

A

blood film

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8
Q

what does the leukaemia blood film show

A

abnormal cells/inclusions

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9
Q

what is the definitive diagnostic investigation for leukaemia

A

bone marrow biopsy

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10
Q

why is lactate dehydrogenase measured in leukaemia?

A

it is a non-specific tissue damage marker (often raised in
leukaemia)

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11
Q

what is a CT/PET scan used for in leukaemia

A

staging

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12
Q

what is a lymph node biopsy used for in leukaemia

A

assesses abnormal nodes

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13
Q

how is leukaemia mainly treated

A

Mainly treated with chemotherapy and targetedtherapies.

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14
Q

what are the targeted therapies for leukaemia

A

Tyrosine kinase inhibitors (ibrutinib) and monoclonal
antibodies (rituximab)

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15
Q

other treatments for leukaemia

A

*Radiotherapy
* Bone marrow transplant
* Surgery

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16
Q

what ages does AML affect

A

It presents at any age, although normally from middle age onwards.

17
Q

what causes AML

A

It can be the result of a transformation of
a myeloproliferative disorder, such as
polycythaemia ruby vera or
myelofibrosis.

18
Q

what do blood film and bone marrow biopsy show for AML

A

will show a high proportion of blast cells, containing Auer rods.

19
Q

pathophysiology of ALL

A
  1. Affects one of the lymphocyte precursor cells, causing acute
    proliferation of a lymphocyte – usually B.
  2. Excessive amounts of these cells replace the other cells in the bone
    marrow
  3. causing pancytopenia
20
Q

what age does ALL affect

A

ALL often affects kids
under 5 and in people
living with Down’s Syndrome

21
Q

what is ALL somewhat associated with

A

It is somewhat associated
with the Philadelphia
chromosome (more likely
in CML)

22
Q

what are the 3 stages of CML

A
  • Chronic phase
  • Accelerated phase
  • Blast phase
23
Q

describe the chronic stage of CML

A

usually asymptomatic, and patients are diagnosed due to incidental
findings (raised WBCC).

24
Q

describe the accelerated stage of CML

A

occurs when the abnormal blast cells take up a high proportion of the bone
marrow (10-20%) and patients
develop symptoms

25
Q

describe the blast stage of CML

A

involves an even higher proportion of blast cells and more severe symptoms, often being fatal.

26
Q

pathophysiology of CLL

A

A slow proliferation (CLL) of a type of
lymphocyte (usually B).

27
Q

what age does CLL affect

A

Usually affects adults over 60.

28
Q

how does CLL present

A

It is often asymptomatic,
although can present with
infections, anaemia, bleeding,
and weight loss.

It may cause warm autoimmune
haemolytic anaemia.

29
Q

what is richters transformation

A

Ritcher’s transformation refers
to the rare transformation of CLL
into high-grade B-cell
lymphoma

30
Q

what does blood film for CLL show

A

Blood films show smear/smudge cells, which are ruptured white cells due to age or fragility.

31
Q
A

Rakeem's Haematology (21 decks)

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