Leukaemia

Question 1

Malignancy of lymphoid cells,commonest childhood cancer

Answer 1

Acute lymphoblastic leukaemia (ALL)

Question 2

Presentation of ALL (2)

Answer 2

Marrow failure: anaemia, infection, bleeding

Infiltration e.g. liver, spleen, parotid glands, lymph nodes

Question 3

Blood film in ALL

Answer 3

Blast cells, fewer normal cells

Question 4

Commonest leukaemia of adults

Answer 4

Acute myeloid leukaemia (AML)

Question 5

Symptoms of AML

Answer 5

Marrow failure; infiltration (including gum hypertrophy)

Question 6

AML sometimes occurs secondary to…

Answer 6

chemotherapy

Question 7

What coagulation disorder may develop in patients with AML?

Answer 7

Disseminated intravascular coagulation

Question 8

Investigations for acute leukaemia (3)

Answer 8

Blood film and count
Coagulation screen
Bone marrow aspirate

Question 9

Investigations which may be carried out to distinguish different leukaemias (2)

Answer 9

Immunophenotyping

Cytogenetics

Question 10

Problems associated with marrow suppression (3)

Answer 10

Anaemia
Neutropenia (infections)
Thrombocytopenia (bleeding risk)

Question 11

Complications of chemotherapy treatment (5)

Answer 11

infection (mainly bacterial, sometimes fungal)
tumour lysis syndrome
hair loss
loss of  fertility
Nausea and vomiting

Question 12

Which chromosomal abnormality is present in 80% patients with chronic myeloid leukaemia?

Answer 12

Philadelphia chromosome t(9;22), forming a fusion BCR-ABL