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Haematology > Leukaemia > Flashcards

Leukaemia Flashcards

1
Q

What symptoms occur in acute myeloid leukaemia?

A 
Lethargy
Infection
Bleeding and bruising
Bone pain
Gum swelling
Lymphadenopathy
Skin rash
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2
Q

What syndromes are associated with acute myeloid leukaemia?

A

Down’s syndrome

Fanconi’s syndrome

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3
Q

What is the percentage of blast cells in leukaemia in the bone marrow?

A

> 20%

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4
Q

In the peripheral blood what abnormalities will be seen with leukaemia?

A

Anaemia
Thromvocytopaenia
neutropenia
Blasts

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5
Q

How is leukaemia diagnosed?

A

Via a bone marrow aspirate

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6
Q

How is acute myeloid leukaemia treated for patients <60 years?

A

Intensive chemotherapy

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7
Q

How is acute myeloid leukaemia treated for patients >60 years?

A

Low dose chemotherapy

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8
Q

How is acute myeloid leukaemia treated in elderly patients with co-morbidities?

A

Supportive care only

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9
Q

Most young patients with acute myeloid leukaemia are entered into trials. T/F?

A

True

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10
Q

What factors would worsen the prognosis of an acute myeloid leukaemia diagnosis?

A 
Secondary AML
Relapsed AML
AML derived form myelodysplasric syndrome
Biphenotypic disease
Elderly patients
Refractory to induction
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11
Q

The chemotherapy for acute myeloid leukaemia Is based on what drugs?

A

Anthracycline and cytarabine

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12
Q

What kind of rash is present in acute lymphoblastic leukaemia?

A

Purpuric rash

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13
Q

The Philadelphia chromosome can cause acute lymphoblastic leukaemia. T/F?

A

True

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14
Q

What drugs are used for chemotherapy to treat acute lymphoblastic leukaemia?

A 
Prednisolone
Cyclophosphamide
Anthracycline
Asparaginase
Vincristine
Etoposide
Cytarabine
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15
Q

It is essential in acute lymphoblastic leukaemia to direct treatment towards which body system?

A

CNS

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16
Q

What supportive treatments can be used in acute lymphoblastic leukaemia?

A

Blood transfusion
Fresh frozen plasma for coagulopathy
Platelet transfusion for purpora and bleeding
Antibiotics / growth factors / granulocytes during sepsis or fever

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17
Q

When would transplants be used in acute lymphoblastic leukaemia?

A 
Relapsed patients
Refactory patients
Poor risk disease in first CR
Age less than 60 years 
Good performance
18
Q

What is the most common type fo leukaemia?

A

Chronic lymphocytic leukaemia

19
Q

What are the symptoms of chronic lymphocytic leukaemia?

A 
Letahrgy
Night sweats
Weight loss
Symptoms of anaemia
Lymphadenopathy
Infection
20
Q

What antigens are expressed in chronic lymphocytic leukaemia?

A

CD5, CD19, CD20 and CD23

21
Q

What mutation in chronic lymphocytic leukaemia is particularly aggressive and refractory to chemotherapy?

A

17p deletions resulting in the loss of p53

22
Q

What are the possible immune complications of chronic lymphocytic leukaemia?

A

Autoimmune haemolytic anaemia

Autoimmune thrombocytopenia

23
Q

How are the immune complications of chronic lymphocytic leukaemia treated?

A

Steroids and treatment of underlying CLL

24
Q

What are the consequences of the immune complications of chronic lymphocytic leukaemia?

A 
Increased risk of infection due to:
Hypogammaglobulinaemia
Cell mediated immunity impairment
T lygmphopaenia
Neutropaeni and defects in complement activation
25
Q

What symptoms can occur as a result of the treatment of CLL?

A

Sweats
Weigth loss
Symptomatic nodes
Bone marrow failure causing anaemia and thrombocytopenia

26
Q

Asymptomatic patients are treated with chemotherapy in chronic lymphocytic leukaemia. T/F?

A

False

27
Q

What are the symptoms of chronic myeloid leukaemia?

A 
Fatigue
Weight loss
Night sweats
Abdominal discomfort
Splenomegaly
28
Q

Which abnormal protein is present in chronic myeloid leukaemia?

A

BRC-ABL

29
Q

How does the Philadelphia chromosome result in chronic myeloid leukaemia?

A

This codes for a abnormal protein BRC-ABL which is a tyrosine kinase which phosphorylates downstream molecules and results in increased cell proliferation

30
Q

How is chronic myeloid leukaemia treated?

A

TKI inhibitors such as imatinib

31
Q

What is the name of the acute stage which chronic myeloid leukaemia can progress to?

A

Blast crisis

32
Q

Which type of acute leukaemia is more common in children?

A

Acute lymphoblastic leukaemia

33
Q

CLL can develop into acute leukaemia. T/F?

A

False - it can progress but will not turn into acute leukaemia

34
Q

CML can develop into acute leukaemia. T/F?

A

True - it can develop into either ALL or AML

35
Q

What are the possible causes of pancytopenia?

A

Lack of production of blood cells due to severe vitamin B12/folate deficiency, aplastic anaemia, metastasis to the bone marrow, congenital causes and glucose/glycogen storage diseases
Due to destruction of blood. cells due to splenohepatomegaly (infections, cirrhosis), RA,

36
Q

Define hyposplenism

A

The combination of splenomegaly and pancytopenia

37
Q

What can cause a purpuric rash?

A

Platelet disorders (thrombocytopaenia), vascular disorders (hypotensive states, vasculitis), coagulation disorders (DIC, scurvy), meningococcaemia

38
Q

What is the name of the rash caused by pinpoint bleeding which results in sports smaller than in purpora?

A

Petechia

39
Q

Bleeding which causes sports larger than 1cm is called?

A

Ecchymosis

40
Q

Blast cells should never be seen in the peripheral blood. T/F?

A

True

41
Q

Hyperploidy is associated with better outcomes in patients with ALL. T/F?

A

True

42
Q

AML can spread to cause meningeal leukaemia. T/F?

A

False - ALL can do this

Haematology (6 decks)

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