Leukaemia JH Flashcards
what is leukaemia?
cancer of WBCs
4 types of leukaemia
ALL acute lymphoblastic leukaemia
AML acute myeloid leukaemia
CLL chronic lymphocytic leukaemia
CML chronic myelid leukaemia
2 types of blood stem cells
- lymphoid stem cells (make lymphocytes)
- myeloid stem cells (make RBCs, platelets, other WBCs)
most common type of leukaemia
ALL acute lymphoblastic leukaemia (75% of laukaemias)
What causes ALL?
ALL develops when a lymphoid progenitor cell becomes genetically altered and undergoes uncontrolled proliferation
most common age to get ALL
children aged 1-4 years
presentation of leukaemia
enlarged lymph nodes
haematological abnormalities
pallor
ecchymoses - mottled skin
lymphadenopathy
hepatosplenomegaly
bone pain
testicular enlargment
cranial nerve palsies
What does diagnosis of ALL require?
bone marrow aspiration
biopsy
signs and Sx of ALL
- weakness/fatigue
- skin pallor
- fever/night sweats
- unexplained weight loss/anorexia
- easy bruising/bleeding gums/purple patches on skin/pinpoint spots under skin
- frequent chest/urinary infections
- unexplained swollen lymph nodes (neck, armpit, groin)
- diffuculty breathing
- pain in bones/joints
treatment for ALL
chemotherapy
phases of chemotherapy Tx for ALL
- induction - initial chemo to remove leukaemia cells
- intensification - repeat chemo at higher doses
- maintenance - keeps leukaemia away
intrathecal therapy for ALL
METHOTREXATE
leukaemia cells can travel into cerebrospinal fluid
vincrisine NEVER given intrathecally
targeted therapies in ALL
Philadelphia chromosome positive ALL
- TKIs
- BD with chemo
s/e of TKIs
blood dyscrasias
skin changes
diarrhoea
metabolism of TKIs
metabolised by CYP450
