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Haemotology > Leukaemia- Basics > Flashcards

Leukaemia- Basics Flashcards

1
Q

What is leukaemia?

A

Cancer of particular line of stem cells in the bone marrow

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2
Q

What are the 4 main types of leukaemia?

A

Acute myeloid leukaemia
Acute lymphoblastic leukaemia
Chronic myeloid leukaemia
Chronic lymphocytic leukaemia

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3
Q

How does the nomenclature work?

A

Onset- acute or chronic for rapid or slow progression

Affected cell type- myeloid or lymphoid

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4
Q

What are the most commonly affected ages?

A

All are likely to occur in patients age 60-70 EXCEPT acute lymphoblastic- this one common in kids under 5

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5
Q

Which one is most common in kids under age 5?

A

Acute lymphoblastic

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6
Q

Which one is associated with Down syndrome?

A

Acute lymphoblastic

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7
Q

warm haemolytic anaemia, Richters transformation, and smudge cells

A

Chronic lymphocytic

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8
Q

Which leukaemia has 3 stages?

A

chronic myeloid

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9
Q

Which are associated with the Philadelphia chromosome

A

Chronic myeloid and acute lymphoblastic

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10
Q

Which leukaemia may result in a transformation from a myeloproliferative disorder?

A

Acute myeloid

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11
Q

What is the pathophysiology of leukaemia

A

One of the precursor cells in bone marrow leads to excessive production of a single type of abnormal WBC

Excess prod can suppress other lines -> pancytopenia

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12
Q

How does leukaemia present?

A

Non specific features-

Fatigue (anaemia)
Fever
Pallor and petechiae
Lymphadenopathy and hepatosplenomegaly

Failure to thrive

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13
Q

How is leukaemia diagnosed?

A

Urgent FBC, children with hepatosplenomegaly or petechiae sent for urgent specialist assessment

Blood film
LDH but very non specific
Bone marrow biopsy for definitive diagnosis
CT and PET scans for stage
Lymph node biopsy

Genetic testing may help to guide treatment

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14
Q

General leukaemia management

A

Targeted therapies (mainly in CLL)-
tyrosine kinase inhibitors (eg ibrutinib)
Monoclonal antibodies (rituximab)

Radiotherapy
Bone marrow transplants

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15
Q

What are the complications of chemotherapy?

A

Failure to treat cancer
Stunted growth and development in children
Infections due to immunosuppression
Neurotoxicity
Infertility
Secondary malignancy
Cardiotoxicity (heart damage)
Tumour lysis syndrome

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16
Q

What is tumour lysis syndrome?

A

Chemicals released when cells are destroyed in chemotherapy-

High uric acid
High potassium (hyperkalaemia)
High phosphate
Low calcium (as a result of high phosphate)

17
Q

Specific presentation of acute leukaemias

A

Pancytopenia -> fatigue, inc infections, easy bleeding

Bone pain due to increased cell production

MORE SPECIFIC TO ALL-> lymph node pain, abdominal fullness (hepatosplenomegaly)

Haemotology (18 decks)

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