leukaemia Flashcards
define leukaemia
Leukaemia is a cancer of either the myeloid or lymphoid line of stem cells within the bone marrow
pathophysiology of leukaemia
- occurs when one of the
precursor cells in the bone marrow
leads to excessive production of a
single type of abnormal white blood cell. - The excessive production of this cell line can suppress the other cell lines, causing pancytopenia
- This is a combination of anaemia,
leukopenia, and thrombocytopenia.
how to classify signs of bleeding under the skin
its classified using size
Petechiae - <3mm due to burst
capillaries
Purpura – 3-10mm
Ecchymosis - >1cm
what are the 4 types of leukaemia
- Acute Myeloid Leukaemia (rapid, myeloid line)
- Acute Lymphoid Leukaemia (rapid, lymphoid line)
- Chronic Myeloid Leukaemia (slow, myeloid line)
- Chronic Lymphoid Leukaemia (slow, lymphoid line)
signs and symptoms of general leukaemia
- Fatigue
- Fever
- Pallor
- Petechiae/bruising
- Abnormal bleeding
- Lymphadenopathy
- Hepatosplenomegaly
what investigations to do for leukaemia
- blood film
- lactate dehydrogenase
- bone marrow biopsy
- CT/PET scan
- lymph node biopsy
- genetic tests
what is the first line of investigation for leukaemia
blood film
what does the leukaemia blood film show
abnormal cells/inclusions
what is the definitive diagnostic investigation for leukaemia
bone marrow biopsy
why is lactate dehydrogenase measured in leukaemia?
it is a non-specific tissue damage marker (often raised in
leukaemia)
what is a CT/PET scan used for in leukaemia
staging
what is a lymph node biopsy used for in leukaemia
assesses abnormal nodes
how is leukaemia mainly treated
Mainly treated with chemotherapy and targetedtherapies.
what are the targeted therapies for leukaemia
Tyrosine kinase inhibitors (ibrutinib) and monoclonal
antibodies (rituximab)
other treatments for leukaemia
*Radiotherapy
* Bone marrow transplant
* Surgery
what ages does AML affect
It presents at any age, although normally from middle age onwards.
what causes AML
It can be the result of a transformation of
a myeloproliferative disorder, such as
polycythaemia ruby vera or
myelofibrosis.
what do blood film and bone marrow biopsy show for AML
will show a high proportion of blast cells, containing Auer rods.
pathophysiology of ALL
- Affects one of the lymphocyte precursor cells, causing acute
proliferation of a lymphocyte – usually B. - Excessive amounts of these cells replace the other cells in the bone
marrow - causing pancytopenia
what age does ALL affect
ALL often affects kids
under 5 and in people
living with Down’s Syndrome
what is ALL somewhat associated with
It is somewhat associated
with the Philadelphia
chromosome (more likely
in CML)
what are the 3 stages of CML
- Chronic phase
- Accelerated phase
- Blast phase
describe the chronic stage of CML
usually asymptomatic, and patients are diagnosed due to incidental
findings (raised WBCC).
describe the accelerated stage of CML
occurs when the abnormal blast cells take up a high proportion of the bone
marrow (10-20%) and patients
develop symptoms
describe the blast stage of CML
involves an even higher proportion of blast cells and more severe symptoms, often being fatal.
pathophysiology of CLL
A slow proliferation (CLL) of a type of
lymphocyte (usually B).
what age does CLL affect
Usually affects adults over 60.
how does CLL present
It is often asymptomatic,
although can present with
infections, anaemia, bleeding,
and weight loss.
It may cause warm autoimmune
haemolytic anaemia.
what is richters transformation
Ritcher’s transformation refers
to the rare transformation of CLL
into high-grade B-cell
lymphoma
what does blood film for CLL show
Blood films show smear/smudge cells, which are ruptured white cells due to age or fragility.
