Leukaemia Flashcards
what translocations are seen in Acute lymphocytic leukaemia?
10: 14
12: 21
4: 11
9: 22
what are the S&S of ALL?
childhood disease
Marrow failure symptoms
- Pallor, SOB, lethargy
- petechiae, purpuric rash
- fever
Infiltrative symptoms
- lymphadenopathy
- hepatosplenomegaly
- parotid enlargement
- bone pain
what investigations are done in ALL and what is seen?
FBC
- anaemia, neutropenia, thrombocytopenia
- leukocytosis
peripheral blood smear
- leukaemic lymphoblasts
BM aspiration and biopsy
- Hypercellularity
- > 20% lymphoblasts
U&E’s
- increased calcium due to bone infiltration
- Increased K+ due to leukaemic cell lysis
Cytogenetics
define AML
expression of myeloid blasts in the bone marrow, peripheral blood or extramedullary tissues. Bone marrow blasts >20% is diagnostic
what are the chromosomal abnormalities in AML?
15:17
8:21
deletions at 5 or 7
what are the clinical features of AML?
disease of older age (AMLderly)
Marrow failure
- anaemia symptoms
- thrombocytopenic symptoms
Infiltrative
- lymphadenopathy
- hepatosplenomegaly
- Gum swelling
- Bone pain
What investigations are done in AML and what do they show?
FBC
- anaemia, neutropenia, thrombocytopenia, large RBCs
- leukocytosis
Blood film
- bilobed nuclei, hypergranulated blasts and AUER rods
Bone marrow aspiration and biopsy
- blast >20%, auer rods
U&E’s
- increased calcium, potassium and urea
what distinctive feature is present in the myeloid blast cells of AML?
Auer rods (Dan auerbach has AML)
what is chronic lymphocytic leukaemia?
indolent lymphoproliferative disorder in which monoclonal B lymphocytes are predominantly found in peripheral blood
what are the S&S of CLL?
anaemia lymphadenopathy hepatosplenomegaly recurrent infection B-symptoms petechiae
what are B-symptoms?
fever, chills, night sweats, weight loss and fatigue
what investigations are done in CLL and what would they show?
WBC count with differential
- lymphocytosis
Blood film
- smudge cells, spherocytes and polychromasia
FBC
- reduced Hb and platelets is not overly common but is poor prognostic indicator
Flow cytometry for CD5, CD19, CD20
how is CLL staged?
0 = lymphocytosis alone 1 = lymphocytosis + lymphadenopathy 2 = lymphocytosis + hepato/splenomegaly 3 = lymphocytosis + anaemia 4= lymphocytosis + thrombocytopenia
(ALHAT)
what is CML?
malignant clonal disorder of the haematopoietic stem cell that results in marked myeloid hyperplasia of bone marrow
what is the cytogenetic change in CML?
phildelphia chromosome
9:22 leading to BCR/ABL gene on Ch22
