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Haematology HK > Leukaemia > Flashcards

Leukaemia Flashcards

1
Q

what antigen is expressed by mature red cells

A

glycophorin A

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2
Q

What enzyme is expressed by mature neutrophils

A

myeloperoxidase

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3
Q

what investigation do we use to look at antigens expressed on cells

A

immunophenotyping

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4
Q

what do neutrophils look like under a microscope

A

segmented nuclei, blue granules

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5
Q

what protein is expressed by all stem cells

A

CD34

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6
Q

what are the two types of leukaemia

A

lymphoid

myeloid

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7
Q

normal haemopoiesis is monoclonal/polyclonal

A

polyclonal

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8
Q

abnormal haemopoiesis is monoclonal/polyclonal

A

monoclonal

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9
Q

what causes haematological malignancies

A 
genetic mutations (inherited or acquired)
driver mutations/background passenger mutations
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10
Q

what developmental stage of haemopoiesis do acute leukaemia’s affect

A

precursors

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11
Q

what type of cells do chronic leukaemias affect

A

mature cells

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12
Q

what types of haematological malignancies are more aggressive

A

acute leukaemias

high grade lymphomas

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13
Q

presentation of acute leukaemias

A

marrow failure - anaemia, infections, bleeding

infiltration - hepatosplenomegaly, lymphadenopathy

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14
Q

features pointing towards acute lymphoblastic leukaemia

A

children

CNS involvement

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15
Q

features pointing towards acute myeloid leukaemia

A

> 60 years
gum infiltrates (monocytes)
less CNS involvement

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16
Q

common infections affecting those with acute leukaemias

A 
bacterial septicaemia 
zoster
CMV
measles 
candidiasis 
pneumocystis pneumonia 
fungal
17
Q

what does acute lymphoblastic leukaemia affect

A

B and T cell precursors - prevents maturation and differentiation producing immature blast cells

18
Q

what does acute myeloid leukaemia affect

A

myeloid cell precursors - they proliferate but do not mature

19
Q

what is a protein produced by immature lymphocytes and is a marker of ALL

A

TdT

20
Q

what are histological features of acute leukaemia

A

large cells
high nuclear-cytoplasmic ration
prominent nucleoli
rapid proliferation

21
Q

what are auer rods

A

pin shaped bodies seen in cytoplasm of myeloblasts in AML

22
Q

presentation of chronic myeloid leukaemia

A 
decreased weight 
tiredness
fever
sweats
gout - purine breakdown
bleeding 
abdominal discomfort (splenomegaly)
23
Q

presentation of chronic lymphocytic leukaemia

A

may be asymptomatic
weight loss and night sweats if severe
enlarged rubbery non-tender lymph nodes
hepatosplenomegaly

24
Q

first line test in leukaemia

A

blood count - high WCC
increased myeloid cells in CML (neutrophils, basophils, eosinophils etc)
high lymphocytes in CLL

blood film - look for blast cells, large cells, big nuclei, auer rod (AML)

25
Q

diagnostic test in acute leukaemia

A

bone marrow biopsy - immunophenotyping to differentiate between myeloid and lymphoid

26
Q

other investigations performed in ALL

A

CXR and CT Abdo - mediastinal and abdominal lymphadenopathy

lumbar puncture - CNS involvement

27
Q

treatment of ALL

A

2-3 years multi-agent chemotherapy

28
Q

treatment of AML

A

2-4 cycles of chemotherapy

5-10 days treatment followed by 2-4 weeks recovery

29
Q

what are the 4 phases of ALL chemotherapy

A

induction
consolidation
intensification
maintenance

30
Q

supportive treatment in ALL

A

blood/platelet transfusion
IV fluids
allopurinol (prevents tumour lysis syndrome)
Hickman line for IV access

31
Q

biggest risk/complication of leukaemia and its treatment

A

infection - especially susceptible to fungal infections (take antifungal medication - itraconazole)

32
Q

management of infection in leukaemia

A

immediately start IV broad spectrum antibiotics - do not wait for culture results

33
Q

side effects of chemotherapy

A 
nausea/vomiting 
hair loss
liver/renal dysfunction
tumour lysis syndrome (will occur during first course)
infection 
fertility loss
cardiomyopathy
34
Q

what genetic mutation is seen in >80% of those with CML

A

Philadelphia chromosome - translocation between chromosome 9 and 22 which affects tyrosine kinae activity (oncogene)

35
Q

treatment for CML

A

imatinib - tyrosine kinase inhibitor

36
Q

imatinib side effects

A 
nausea 
cramps
oedema
rash
headache 
arthralgia

Haematology HK (22 decks)

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