Leukaemia Flashcards
Most common type in children ?
ALL
L=LITTLE
Most common acute type in older people?
AML
M= MATURE
why do you get bone pain?
bone marrow infiltration
They usually present with bone marrow failure. What 3 things do you get?
anaemia, neutropaenia, thrombocytopenia
basically a pancytopaenia
what clinical signs do they get?
pallor, fever, petechaie
anaemia, netropaenia, thrombocytopenia
what type of cells are normally always seen on blood film?
blasts (abnormal cells)
what is classically seen in AML?
auer rods
in which acute leukaemia are there more likely to be blasts?
ALL
how is the lineage of the tumour confirmed?
flow cytometry immunophenotyping
what are the two lineages
myeloid and lymphoid
what is the blood count like ?
pancytopaenia with variable white cell count
pancytopaenia?
reduction of cells of all lineages
symptoms of pancytopenia?
pANcyTopaenia
Anaemia (pallor, SOB)
Neutropaenia (fever)
Thrombocytopaenia (purpura, petechaie)
Bone and joint pain, hepatosplenomegaly and organ infiltration more common in ? less common in ?
more in ALL
less in AML
In terms of treatment, which one can take a few years and which one is more intense?
ALL a few years, AML more intense
what is the prognosis like in ALL for kids?
very good, complete remission in almost all patients
CML, what age group? (makelele)
adults
CML characterised by the presence of?
philidephia chromosome
what is the first line tx of CML?
imatinib
CLL - who get this?
old >60
in CLL, you get an accumulation of ?
incompetent B cells
how do we identify normal cells?
immunophenotyping
malignant haematopoesis is characterised by?
increased numbers of abnormal and dysfunctional cells
CLL, what happens to B cells?
proliferation
what is myeloma?
plasma cell malignancy in bone marrow
why do you get bone pain in myeloma?
bone marrow infiltration
acute leukaemia is defined as excess of ?
blasts (>20% )
presentation of ALL?
ANT
anaemia, infections, bleeding
which leukaemia do you get gum infiltration ?
AML
investigations for leukaemia?
blood count and film
coag screen
bone marrow aspirate
cells in AML and ALL are very similar, what is needed for definitive diagnosis?
immunophenotyping
why is the diagnosis of AML and ALL important?
they have different treatment
bone marrow suppression causes neutropenia. what sort of infections are patients prone to?
gram negative
what antibiotic is staph aureus treated with?
flucloxaclillin
which haemophilia is also known as chritmas tree disease? how is it treated?
haemophilia B
shortage of factor 9
treated with factor 9 precipitate
what is pancytopaenia?
all cells down. deficiency of cells from all lineages
platelets are produced from ?
megakaryocytes
which syndrome has propensity for evolution to AML?
myodysplastic syndrome
what is the white cell count like in acute leuk?
variable
why does acute leukaemia cause pancyto?
proliferation of abnormal cells prevents normal haematopoetic stem cell development
why does hypersplenism cause pan?
increased splenic pool
causes of hypersplenism?
portal hypertension (cirrhosis) rheumatoid arthritis (feltys) splenic lymphoma
bloods in pancytopaenia?
pANcyTopaenia
Anaemia
Neeutropaenia
Thrombocytopania
symptoms in pancytopaena?
SOB, pallor, infections, bruising and petechaie
treatment of idiopathic aplastic anaemia?
immunosuppressoin
which virus can cause bone marrow suppression?
HIV
antibodies are made of which kind of chains?
2 heavy chains and 2 light chains
myeloma is a malignancy of?
plasma cells in the marrow
where are B cells produced?
bone marrow
description of plasma cell nucleus?
clock face nucleus
where are plasma cells found?
lymph and plasma
what are plasma cells laden with? what do they pump out?
antibodies
which proteins are a marker of underlying monoclonal b cell disorder>
paraproteins
how do you detect immunoglobulins?
serum electrophoresis
which protein detected on urine electrophoresis?
bence jones protein
free light chain production by normal plasma cells is 0.5g/day
excess can leak into the urine as?
bence jones protein
direct tumour effects of myeloma?
bone lesions
increased calcium
bone pain
marrow failure
calcium in myeolma?
hypercalcamia
what lesions can you get in the spine?
oestolytic lesions
what do you use to monitor response to treatment
paraproteins
which type of cells are seen in CLL blood film?
smudge cells
why does hypercalcaemia in multiple myeloma result in pathological fractures and osteoporosis?
calcium out of bones
important differential for poorly patient with herediatary spherocytosis?
splenic rupture
in hereditary spherocytosis, what shape are the RBCs?
ball shaped
where are spherocytes destroyed?
spleen. red blood cell survival is reduced
which is more common, von willebrands or haemophilia?
von Willebrands
