Leukaemia in Adults

Question 1

Which lymphocytes (T or B cells) proliferate in CLL?

Answer 1

B-cells (99% of the time)

Question 2

What are some features of CLL?

Answer 2

• Most often none
• Constitutional: anorexia, weight loss
• Bleeding, infections
• Lymphadenopathy more marked than CML

Question 3

What are some complications of CLL?

Answer 3

• Hypogammaglobulinaemia leading to recurrent infections
• Warm autoimmune haemolytic anaemia in 10-15% of patients
• Transformation to high-grade lymphoma (Richter’s transformation)

Question 4

What are some investigations for CLL?

Answer 4

• Blood film - smear (a.k.a. smudge cells)
• Immunophenotyping

Question 5

Leukaemia is a cancer where there are too many ? in the blood.

Answer 5

White blood cells

Question 6

What are the 3 main types of leukaemia in adults?

Answer 6

• Chronic
  
  • CML (Chronic myeloid leukaemia)
  • CLL (Chronic lymphoblastic leukaemia)
• Acute
  
  • AML (Acute myeloid leukaemia)

NOTE: ALL is only in children.

Question 7

What is the most common leukaemia in adults?

Answer 7

CLL

Question 8

CML vs CLL both present in roughly what age group and gender?

Answer 8

Older males. (>50 years)

CML is a bit older - mean age in CML is 65 years.

Question 9

How does CML present?

Answer 9

Usually asymptomatic at the chronic stage

until WCC is hugely raised.

Then there may be symptoms of anaemia, splenomegaly

Question 10

What is the most common form of acute leukaemia in adults?

Answer 10

AML

Question 11

What are some poor prognostic features of AML?

Answer 11

• ​> 60 years
• > 20% blasts after first course of chemo
• Deletion of chromosome 5 or 7

Question 12

Tell me about acute promyelocytic leukaemia M3?

Answer 12

• Presents younger than AML (~25 years old)
• Auer rods
• DIC or thrombocytopenia often at presentation.
• Good prognosis

Question 13

How does AML usually present?

Answer 13

• Anaemia
• Bleeding
• Petechiae
• Bruising