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Haematology > Leukaemia > Flashcards

Leukaemia Flashcards

1
Q

What is leukaemia?

A

A type of cancer affecting white blood cells

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2
Q

What are the 4 main types of leukaemia?

A

Acute myeloid leukaemia (AML)

Acute lymphoblastic leukaemia (ALL)

Chronic myeloid leukaemia (CML)

Chronic lymphocytic leukaemia (CLL)

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3
Q

What is the difference between myeloid and lymphoblastic leukaemias?

A

Myeloid: cancer affects myeloid precursor cells

Lymphoblastic: cancer affects lymphoid precursor cells

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4
Q

What cells do myeloid precursor cells give rise to?

A

Neutrophils
Basophils
Eosinophils
Monocytes + macrophages

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5
Q

What cells do lymphoid precursor cells give rise to?

A

Natural killer cell

T and B lymphocytes

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6
Q

What is AML?

A

Acute myeloid leukaemia

Malignancy in the myeloid blasts in the bone marrow, blood or other tissues

Malignant proliferation of monocytes and granulocytes, there are too many, they are not fully developed and don’t work properly

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7
Q

What are granulocytes?

A

Neutrophils
Basophils
Eosinophils

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8
Q

What problems does leukaemia cause in the blood, and why?

A

Immunodeficiency: because the monocytes and granulocytes are abnormal, they are unable to fight infection properly

Anaemia: too many WBCs in the bone marrow means less room for RBC production

Thrombocytopenia: too many WBCs in bone marrow means less room for platelet production

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9
Q

Clinical presentation of AML?

A

Develops quickly over days or weeks

Anaemia
Leucopenia
Thrombocytopenia

Fatigue, headache, collapse, infections, bleeding

Pallor, tachycardia, fever, purpura

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10
Q

Who gets AML?

A

Any age or gender

But more common in adults over the age of 60

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11
Q

What is ALL?

A

Acute lymphoblastic leukaemia

Malignancy in the lymphoid blasts in the bone marrow, blood or other tissues

Malignant proliferation of B and T lymphocytes, there are too many, they are not fully developed and don’t work properly

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12
Q

Clinical features of ALL?

A

Develops quickly over days or weeks

Anaemia
Leucopenia
Thrombocytopenia

Fatigue, dizziness, infections, weight loss, bruising, bone pain

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13
Q

Who gets ALL?

A

Any age or gender

Mostly affects children

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14
Q

Investigation of leukaemias?

A

Blood film:

  • look for increased numbers of specific WBCs
  • look for WBC abnormalities

Bone marrow biopsy

Lymph node biopsy

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15
Q

Management of acute leukaemias?

A

Medical emergency

Supportive care

  • treat + prevent infections
  • give blood products (RBCs, platelets, WBCs)

Chemotherapy

Stem cell transplant
Bone marrow transplant

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16
Q

What is the significance of the Philadelphia chromosome in ALL?

A

If the patient has the Philadelphia chromosome the prognosis is poor

17
Q

What is CML?

A

Chronic myeloid leukaemia

Malignancy of granulocytes: neutrophils, basophils, eosinophils

Too many, abnormal and immature granulocytes are produced

Strong association with Philadelphia chromosome

18
Q

Clinical features of CML?

A

Develops slowly, months to years

Anaemia
Thrombocytopenia
Leucopenia

Weight loss
Fatigue
Fever
Gout
Splenomegaly
Bruising
19
Q

Who gets CML?

A

Adults usually age 40-60

20
Q

Management of CML?

A

Chemotherapy

Bone marrow transplant

21
Q

What complication can occur in CML?

A

A blast crisis, a sudden increase in speed of development of CML

Sudden increase of leukaemia cells, a lot of myeloid cells in the bone marrow and blood

22
Q

What is CLL?

A

Chronic lymphocytic leukaemia

Malignancy of B lymphocytes

Too many abnormal, immature B lymphocytes are produced

23
Q

Clinical features of CLL?

A

Develops over months and years

Anaemia
Thrombocytopenia
Leucopenia

Enlarged lymph nodes, rubbery, soft, tender

Splenomegaly
Infections
Weight loss
Fatigue

24
Q

Who gets CLL?

A

Generally the elderly, but not always

25
Q

Management of CLL?

A

Do nothing, the disease sometimes doesn’t progress in some people

Chemotherapy

Monoconal antibodies: anti-CD20 rituximab

Bone marrow transplant

26
Q

What’s the difference between leukaemia that affects the lymphocytes (ALL + CLL) and lymphoma?

A

ALL + CLL: the malignancy originates from the bone marrow

Lymphoma: the malignancy originates from the lymph nodes

27
Q

What is the difference between autologous and allogeneic transplant?

A

Autologous: own bone marrow is transplanted

Allogeneic: from someone else

28
Q

What are some things that are thought to cause leukaemia?

A

Genetics: e.g. Philadelphia chromosome

Environment:

  • benzene
  • alkylating agent drugs
  • radiation exposure
29
Q

What is the Philadelphia chromosome?

A

Reciprocal (switching) translocation of genetic material between chromosome 9 and chromosome 22

Haematology (9 decks)

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