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Haematology Year 3 > Leukaemia > Flashcards

Leukaemia Flashcards

1
Q

kinetics of normal haemopoiesis

A 
self renewal 
proliferation
differentiation 
maturation
apoptosis
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2
Q

what enzyme do mature neutrophils express

A

myeloperoxidase

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3
Q

what cell surface antigen to red blood cells express

A

glycophorin A

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4
Q

what is malignant haemopoiesis characterised by

A

increased numbers of often dysfunctional cells

loss of normal haemopoietic reserve

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5
Q

what is needed for haemopoeisis to be classified as malignant

A

one or more of:

  • increased proliferation
  • lack of differentiation
  • lack of maturation
  • lack of apoptosis
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6
Q

what is acute leukaemia

A

abnormal proliferation and maturation

  • bone marrow over run by mononuclear cells = loss of variation
  • cells unable to mature
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7
Q

what is a driver mutation

A

mutation that gives a selective advantage to a clone through either increasing its survival or reproduction
causes clonal expansions

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8
Q

what is a passenger mutation

A

mutation that has no consequence to the cell or growth advantage

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9
Q

most common childhood cancer

A

acute lymphoblastic leukaemia

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10
Q

what is a ‘clone’

A

population of cells derived from a single parent cell

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11
Q

clonal features of

  • normal haemopoeisis
  • malignant haemopoiesis
A 
normal = polyclonal
malignant = monoclonal
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12
Q

what are haematological malignancies based on

A
  1. speed of presentation
    - acute or chronic
  2. based on site
    - medullary (marrow) / extramedullary
    - blood (leukaemia) / lymph node (lymphoma)
  3. lineage:
    - myeloid
    - lymphoid
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13
Q

types of haematological malignancy

A

acute myeloid leukaemia
acute lymphoblastic leukaemia

chronic myeloid leukaemia
chronic lymphocytic leukaemia

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14
Q

what is a myeloma

A

plasma cell malignancy in marrow

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15
Q

which type of leukaemia can involve both blood/bone marrow and lymph nodes

A

chronic lymphocytic leukaemia

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16
Q

features of acute leukaemia

A

rapidly progressive clonal malignancy of marrow/blood with maturation defects

defined as excess of ‘blasts; in either the peripheral blood or bone marrow

decrease/loss of normal haemopoietic reserve

17
Q

types of acute leukaemia

A

acute myeloid leukaemia (AML)

acute lymphoblastic leukaemia (ALL)

18
Q

What is acute lymphoblastic leukaemia (ALL)

A

malignant disease of lymphocytes- arrest in maturation of lymphoblasts + proliferation
most common childhood cancer

19
Q

presentation of ALL

A

anaemia/infection/bleeding – due to marrow failure

High WCC and involvement of extra-medullary areas e.g.CNS

bone pain

20
Q

who is acute myeloid leukaemia more common in

A

elderly >60

neoplastic proliferation of myeloblasts

21
Q

presentation of acute myeloid leukaemia

A

anaemia/infections/bleeding – marrow failure

22
Q

investigation for acute leukaemia

A

blood count + blood film
coagulation screen
bone marrow aspirate

23
Q

blood results of an acute leukaemia

A

LOW Hb, platelets + neutrophils

24
Q

what is required to differentiate AML from ALL

A

immunophenotyping

25
Q

what feature on blood film would make you think of acute myeloid leukaemia

A

AEUR RODS

red staining needle like bodies

26
Q

immunomarker for stem cell precursors

A

CD34

27
Q

immunomarker for myeloid precursors

A

CD33

28
Q

treatment for ALL

A

lasts up to 2-3 years

-different phases of treatment

29
Q

treatment for AML

A

normally intensive

  • 2-4 cycles of chemotherapy
  • prolonged hospitalisation
30
Q

problems of marrow suppression

A

anaemia
neutropenia – infections
thrombocytopenia – bleeding

31
Q

side effects of chemo treatment

A 
N+V
hair loss 
tumour lysis syndrome 
liver/renal dysfunction 
infection 
infertility
32
Q

which chemotherapy drug has a risk of cardiomyopathy

A

anthracyclines

33
Q

what needs to be done as soon as a neutropenic fever develops

A

empirical treatment with broad spectrum antibiotics

34
Q

childhood cure rate of ALL

A

> 85-90%

35
Q

Potential curative treatment for leukaemia

A

allogenic stem cell transplantation (donor stem cells)

36
Q

what is Philadelphia chromosome

A

genetic abnormality in chromosome 22 of leukaemia cancer cells

37
Q

what leukaemia is Philadelphia chromosome particular seen in

A

chronic myeloid leukaemia

38
Q

aetiology of chronic lymphocytic leukaemia

A

clone of mature B cells (memory cells)

39
Q

aetiology of chronic myeloid leukaemia

A

clonal proliferation of myeloid cells

Haematology Year 3 (21 decks)

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