Leukaemia Flashcards
What is leukaemia?
cancer of the blood and or bone marrow
What is the difference between leukaemia and lymphoma?
leukaemia is predominantly in the blood and bone marrow where as lymphoma is predominantly in the lymph tissue - there is some overlap and the cell types can be identical
What are the predisposing factors for leukaemia?
for most patients it is unknown but there is a contribution from environmental factors such as radiation, other myeloid diseases and haemopoeitic disorders and there is a genetic component with a higher incidence in Down’s syndrome patients and patients with a sibling with acute leukaemia
What is the pathogenesis of leukaemia?
There is a somatic mutation in a multipotential primitive cell or sometimes a more differentiated progenitor cell - the mutation is often a chromosomal translocation- fusion encodes for a fusion protein which disrupts the normal cell pathway and predisposes to malignancy
What is the origin of all blood cells?
the haemopoetic stem cell
What does a myeloblast differentiate into?
neutrophils, eosinophils, basophils, macrophage
What does a lymphoblast differentiate into?
B and T lymphocytes and NK cells
What does the haemopoeitic stem cell differentiate into?
the common myeloid progenitor and the common lymphoid progenitor
What does the common myeloid progenitor differentiate into?
megakaryoblast, erythroblast, myeloblast
What is acute leukaemia?
where the mutation is in an early progenitor cell (a blast) which results in a proliferation of immature cells and compromises marrow function - rapid clinical course and fatal if untreated
What is chronic leukaemia?
accumulation of maturer blood cells - gradually compromises marrow function
What are the classifications of leukaemia?
lymphoblastic, myeloblastic or other
What are the common symptoms of leukaemia?
weight loss, fever, frequent infections, shortness of breath, muscular weakness, pain or tenderness in bones or joints, fatigue, loss of appetite, enlarged lymph nodes, enlarged spleen and or liver, night sweats, easy bruising, purpuric spots
What is the mechanism of action of imatinib?
•Inhibits BCR-ABL autophosphorylation & phosphorylation•Induces apoptosis•Inhibits proliferation
What is the treatment for leukaemia?
chemotherapy, transplantion, targeted chemotherapy, supportive treatment
What is ALL?
acute lymphoblastic leukaemia - cancer of the precursor for either B or T lymphocytes in the bone marrrow and blood - differentiate between B and T with CD markers
What is the most common cancer of children?
ALL
What CD markers are usually expressed in B-ALL?
CD19 and CD10
What is AML?
acute myeloid leukaemia
What is CLL?
chronic lymphocytic leukaemia
What is CML?
chronic myelomonocytic leukaemia
What is the presentation for ALL?
pancytopaenia and bone pain
What is the cure rate for ALL in children?
80%
What is the average age of diagnosis for CLL?
60
Is CLL curable?
usually no - but its not aggressive so can be treated
What are the histological features of CLL?
• Many cells identifiable as lymphocytes, but small and ofatypical appearance• ‘Smudge’ cells – fragile cells collapsing during film preparation
