leukaemia symposium Flashcards
what does G-csf do?
stimulates the production of neutrophils
what are the 3 myeloproliferative states?
- polycythemia- too many red cells
- thrombocytopenia= too many platelets
- myelofibrosis= massive spleen- occurs in later stages of both above- can progress to AML
which mechanism is affected in myeloproliferatiev disorders?
- JSK2 V617F mutation
- affects JAKSTAT signalling
- phosphorylation of proteins results in constitutive activation and a proliferative state
how does BCRABL appear on FISH ?
- yellow signal because of overlapping red and green
what is the targeted therapy for CML?
- Imatinib binding to the kinase domain of bcrabl
what is AML?
Uncontrolled proliferation of primitive cells in the bone marrow causing bone marrow failure
what 3 things occur in bone marrow failure?
– Anaemia
– Infections
– Bleeding
how can AML be diagnosed?
- blast cells observed on a blood film
- immunophenotyping
- cytogenetics
what are clinical features of AML?
- anaemia
- infections
- DIC
- Ulcers
- infiltration
- bruising
what are the 3 ways that AML is treated?
- Chemotherapy – kills rapidly dividing cells: – Combinationregimes
– Myelo-ablative cycles of treatment - Supportive therapy:
– Antibiotics, antifungals
– Transfusions of blood and platelets - Stem cell transplantation: – Autograft
– Allograft (full or reduced intensity) • Sibling
• Matched donor
what is the risk of stem cell transplant for AML patients?
graft vs host disease
what is a medical emergency for AML patients?
neutropenic sepsis
- Resuscitate patient with i.v. fluids if hypotensive
- May require inotropic support on ITU
what types of infection are AML patients at risk of?
- fungal infections
- pneumocytstis pneumonia