Leukaemia Haematology Flashcards
When does acute lymphoid leukaemia commonly present?
In childhood
What is the primary presenting problem of acute leukaemia?
- sore legs
- not wanting to walk/play
What are the clinical signs of acute leukaemia?
- anaemia
- bruising
- lymphadenopathy
- organomegaly
What is used to investigate a possible case of leukaemia?
- FBC
- Differential count
- Blood film
What are the two main branches of haematopoietic progenitor cells?
Lymphoid and Myeloid
What do lymphoid progenitor cells give rise to?
- T and B lymphocytes
- NK cells
What do myeloid progenitor cells give rise to?
- RBCs
- Megakaryotes
- Eosinophils
- Basophils
- Monocytes
- Neutrophils
What mediates haematopoiesis?
Cytokines: small proteins that are important for cell signalling
Name four types of cytokines.
- Interferon
- Tumour necrosis factors
- Growth factors
- Interleukin
Describe haematopoietic malignancies.
- clonal diseases
- single cell in bone marrow or lymphoid tissue undergoes a genetic alteration
Define acute leukaemia.
- uncontrolled proliferation of leukaemic cells (at least 20% blasts)
- at early stage of haematopoietic differentiation
- with arrest of differentiation/maturation
What is chronic leukaemia?
- proliferation of mature/differentiated haematopoietic cells
- proliferation at slow rate
What signs can leukaemia cause?
- hepatosplenomegaly
- lymphadenopathy
- gym hypertrophy
What is hyperleukocytosis?
- increased viscosity of the blood due to an increase in WBCs
- medical emergency
Briefly discuss two complications of hyperleukocytosis.
- pulmonary leukostasis: present with dyspnoea and cough
- cerebral leukostasis: loss of consciousness, confusion, cerebral nerve palsies, vision loss, cerebral infarcts, bleeding
What can cause hyperviscosity? (5)
- decreased volume: dehydration
- increased protein: paraprotein
- increased RBCs: polycythaemia
- increased WBCs: leukaemia
- increased platelets: thrombocythaemia
How can leukaemia be diagnostically classified?
- morphology and staining
- immunophenotyping: looking for antigens and specific cell contents
- cytogenetics: looking for translocations, etc.
- molecular genetics: looking for fusion proteins, etc.
What is the aim of treatment in leukaemia?
- destroy clonal cells
- protect residual stem cell compartment for normal haematopoiesis
How is leukaemia managed?
Supportive care
- Transfusions
- Treat infections
- Prevent and manage metabolic complications (liver, kidney, electrolytes)
- Psychological care
How is neutropenic fever identified?
- potentially life-threatening complication of chemotherapy
- temp > 38
- WBC < 0.5
- no pus formation
How is neutropenic fever managed?
- take cultures
- broad-spectrum antibiotics within an hour
- no rectal examinations or suppositories to avoid infection
