Leukaemia Flashcards
difference between normal haematopoiesis and malignant haemopoiesis?
normal is polyclonal whereas malignant is usually monoclonal
what does leukaemia involve?
the blood
what does lymphoma involve?
lymph nodes
which leukaemia involves both the blood and lymph nodes?
CLL
define acute leukaemia
proliferation of abnormal progenitors with block in differentiation/ maturation
which type of leukaemia is more aggressive?
acute is more aggressive and has rapid progression of symptoms
what is chronic leukaemia?
abnormal progenitors without any differentiation or maturation block
what do acute leukaemias have in the peripheral blood or bone marrow?
excess of blasts >20% with loss of normal haemopoietic reserve
types of acute leukaemia
- acute lymphoblastic leukaemia (ALL)
2. acute myeloid leukaemia (AML)
what is acute lymphoblastic leukaemia (ALL)?
malignant disease of the primitive lymphoid cells (lymphoblasts)
which is the most common childhood cancer?
acute lymphoblastic leukaemia (ALL)
presentation of ALL
- marrow failure
- extramedullary involvement= CNS, testis
- bone pain
signs of marrow failure
anaemia
infections (gram -ve sepsis, fungal infection)
bleeding
what is acute myeloid leukaemia (AML)?
malignant disease of the myeloid blood cells
who gets AML?
elderly >60
presentation of AML
- marrow failure
- coagulation defects (DIC)
- gum infiltration
diagnosis of acute leukaemia
- blood count and film
- coagulation screen
- bone marrow aspirate
- cytogenetics
- trephine
- auer rods in AML
what does the blood film show in acute leukaemia?
reduced normal with presence of abnormal blasts
tests done on the bone marrow aspirate?
morphology
immunophenotyping
what is the only test that can distinguish between AML and ALL?
immunophenotyping
role of cytogenetics
prognosis
what is a trephine?
piece of bone to assess cellularity
management of acute leukaemias
multi-agent chemotherapy given via Hickman line
where does the Hickman line sit?
junction between SVC and RA
management of ALL
2-3 years of multi-agent chemotherapy with different phases
management of AML
2-4 cycles with prolonged hospital stay of multi-agent chemotherapy
complications in chemotherapy
N&V alopecia liver and renal dysfunction tumour lysis syndrome (first course) infections fertility cardiomyopathy (anthracyclines)
when are smudge cells seen?
CLL
immature leukocytes
