Leukaemia

Question 1

What is Leukaemia?

Answer 1

Malignant neoplasia (new/uncontrolled growth) of WCs.

Question 2

Classification of Leukaemia?

Answer 2

Myeloid - Neutrophils

Lymphoid - Lymphocytes: 70% B-cells

Question 3

Pathology of Acute vs Chronic Leukaemia?

Answer 3

Acute: XS IMMATURE blast cells = crowding of bone marrow
Chronic: XS production of MATURE abnormal cells

Question 4

Investigating suspected Leukaemia?

Answer 4

1) FBC (Hb, WCC + platelets)
2) Blood film, clotting screen
3) Imaging (dependent on signs) e.g. CXR

Question 5

Extra test if Acute Myeloid Leukemia suspected?

Answer 5

Bone Aspiration: >20% blast cells seen

Question 6

Common signs of Lymphoid Leukaemia (acute vs chronic)?

Answer 6

Acute: Anaemia, Bleeding + Infection.
Chronic: Lymphadenopathy, Hepatosplenomegaly (severe).

Question 7

Common signs of Myeloid Leukaemia (acute vs chronic)?

Answer 7

Acute: Anaemia, Bleeding, Infection + Delayed Intravascular coagulation.
Chronic: Hepatosplenomegaly (Spleen +75% or more)

Question 8

Managing Myeloid Leukaemia (acute vs chronic)?

Answer 8

Acute

1) Chemotherapy (induce remission)
2) Bone Marrow Transplant

Chronic

1) Chemo w/imatinib (specifically made drug)
2) Stem cell transplant (risky but curative)

Question 9

Managing Lymphoid Leukaemia (acute + chronic)?

Answer 9

Same for both

1) Supportive e.g. blood transfusion, growth factors
2) Combination chemotherapy (pegaspargase (induction) + monoclonal antibody (maintenance))