leukaemia Flashcards
what is a haematological malignancy?
DNA mutation
stwitches off tumour suppressor gene or on an oncogene
clonal proliferation
what are the 3 characteristics of cancer cells
uncontrolled proliferation
loss of apoptosis
loss of normal functions/products
what are the 2 categories of leukemia?
acute and chronic
what describes the point in a cell line or the cell line at fault?
lymphocytic, lymphoblastic or myeloid
what is leukemia?
a group of cancers of the bone marrow which prevent normal manufacture of the blood
what does leukaemia result in?
anaemia
infection - neutropenia
bleeding - thrombocytopenia
what is the pathogenesis of leukaemia?
clonal proliferation
-plasma clones spread to bone and can replace proteins
replacement of marrow
increasing marginalisation of productive normal marrow
-marrow failure
-organ infiltration
what is the clinical presentation of leukaemia
anaemia neutropenia thrombocytopenia lymphadenopathy-neck lumps splenomegaly/hepatomegaly-swollen abdomen bone pain -esp. kids
what are the symptoms of anaemia?
breathlessness
tiredness
easily fatigued
chest pain/angina
what are the signs of anaemia?
pallor
signs of cardiac failure
nail changes
what is the clinical presentation of neutropenia?
infections associated with portals of entry
reactivation of latent infections
increased severity, frequency and can rapidly lead to systemic infection
what are the infections associated with portals of entry?
mouth throat- tonsillitis, pharyngitis chest-bronchitis, pneumonia skin- impetigo, cellulitis perianal- thrush, abscesses
what are the symptoms of neutropenia?
recurrent infection
unusual severity of infection
what are the signs of neutropenia?
unusual patterns of infection and rapid spread
will respond to tx but recur
signs of systemic involvement-fever, rigor, chills
what are the investigations of neutropenia?
unusual pathogens esp. bacterial
what are the symptoms of bleeding?
bruises easily or spontaneously
minor cuts fail to clot
gingival bleeding or nose bleeds
menorrhagia
what are the signs of bleeding?
bruising
petechiae
BOP
bleeding/bruising following procedures
describe acute lymphoblastic leukaemia
peak age 4 25 per 1,000,000 develops over days/weeks catabolic state-fever, sweats, malaise lymphadeopathy tissue infiltration >80% children cured
describe acute myeloid leukaemia?
25 cases per million
common in elderly
similar presentation to ALL
describe chronic lymphocytic leukaemia
B-cell clonal lymphoproliferative disease
older adults peak 70
70 per 1,000,000
2:1 M:F
mostly asymptomatic
slow progression may not require tx
occasional blast transformation-aggressive
describe chronic myeloid leukaemia
increase in neutrophils & their precursors 95% have Philadelphia chromosome 15 per 1,000,000 peak 50-7- y/o slight male prepondernce
what is the clinical presentation of chronic myeloid leukaemia?
fatigue, weightloss, sweating
anaemia, bleeding, splenomegaly
