Leukemia

Question 1

leukemia definition

Answer 1

cancer of the body’s blood forming tissues

Question 2

neoplasm

Answer 2

abnormal new growth

Question 3

benign tumour

Answer 3

remain localised and do not metastasize

Question 4

malignant tumour

Answer 4

metastasize through lymphatic channels or blood vessels to other lymph nodes and tissues on the body

Question 5

carcinoma

Answer 5

90% of cancers - cancer of epithelial cells

Question 6

sarcoma

Answer 6

rare - cancer of connective tissues

Question 7

leukemias

Answer 7

8% of tumours - liquid tumours.
Originates from hematopoietic stem cells in bone marrow.
Originates from myeloid and lymphoid lineages

Question 8

lymphomas

Answer 8

8% of tumours with leukaemias - liquid tumours.
lymphomas arise from cells of the immune system

Question 9

2 types of cancer genes

Answer 9

proto-oncogenes and tumour surpressor genes

Question 10

proto-oncogenes

Answer 10

over 100 known
proteins that promote cell cycle
mutations lead to oncogenes, promote cells growth regardless of circumstance

Question 11

tumour suppressor genes

Answer 11

proteins that inhibit cell cycle
12 known
mutations lead to cell cycle not stopping when it should

Question 12

what tumour suppressor gene plays a role in myeloid leukemia?

Answer 12

neurofibromatosis type 1

Question 13

symptoms of leukaemia

Answer 13

weight loss
fever
frequent infections
shortness of breath
weakness of muscles
swelling of lymph nodes
prone to infections and bruising

Question 14

what cells arise from lymphoid linage?

Answer 14

NK cells, B cells, T cells, lymphoid dendritic cell, plasma cell

Question 15

how does leukaemia occur?

Answer 15

several mutations of hematopoietic stem cell (or cell formed later in linage) - forms leukaemia stem cell - forms blasts
all descendant cells in linage contain this mutation

Question 16

general mechanisms of leukaemia transformed cell. (4)

Answer 16

impaired differentiation
increased cell survival
increased proliferation
increased self renewal

Question 17

what is metastasis

Answer 17

spread of cancer

Question 18

cause of leukaemia

Answer 18

genetic mutation/ oncogene activation
increased rate of proliferation
reduced apoptosis
accumulation of blasts in bone marrow

Question 19

cause of mutations

Answer 19

hereditary
chromosomal abnormalities
chemical agents
viruses

Question 20

3 chromosomal abnormalities in leukaemia

Answer 20

deletion of chromosome
inversion of chromosome (rearrangement or segment is reversed)
translocation (exchange of genetic material between chromosomes)

Question 21

how many chromosomes are involved in a chromosomal inversion?

Answer 21

2

Question 22

how many chromosomes are involved in a chromosomal translocation?

Answer 22

2

Question 23

when in the linage do acute and chronic leukaemia form?

Answer 23

early mutations in the linage forms an acute leukaemia.
mutations later in linage forms a chronic leukaemia.

Question 24

what type of leukaemia forms blasts?

Answer 24

acute only

Question 25

what leukaemia is most common in children?

Answer 25

acute lymphoid leukaemia

Question 26

why do infections and aneamias increase with leukaemia ?

Answer 26

leukaemia causes suppression of other marrow elements, therefore lack of normal rbcs, wbcs and platelets

Question 27

acute leukaemia characteristic

Answer 27

uncontrolled proliferation of poorly differentiated blast cells

Question 28

what are auer rods?

Answer 28

large, crystalline cytoplasmic inclusion bodies sometimes observed in myeloid blast cells during acute myeloid leukaemia

Question 29

how is acute leukaemia diagnosed?

Answer 29

bone marrow aspirate (sample)

Question 30

what leukaemia is most commonly seen in adults?

Answer 30

acute myeloid leukaemia

Question 31

what is the FAB?

Answer 31

french-american-british scheme of classification of leukaemia based on morphology

Question 32

M0-M5 FAB

Answer 32

immature forms of wbcs

Question 33

M6 FAB

Answer 33

immature forms of erythrocytes

Question 34

M7 FAB

Answer 34

immature platelets

Question 35

define malignant haematopoiesis

Answer 35

uncontrolled proliferation of blood cell precursors/progenitors that fail to mature or show improper maturation.

Question 36

what is the WHO scheme of classification of AML based on?

Answer 36

genetics

Question 37

clinical features of acute leukaemia

Answer 37

anaemia - reduction of erythropoiesis fever, malaise, infections - reduction of wbcs bone pain

Question 38

what is the wbc count in acute leukaemias?

Answer 38

increased to greater than 100,000/ micro L

Question 39

how is leukaemia subtype determined?

Answer 39

immunological markers

Question 40

what immunological markers allow identification of cells at varying stages of leukaemia?

Answer 40

cluster of differentiation markers (CD)

Question 41

info on acute lymphoblastic leukaemia

Answer 41

accumulation of lymphoblasts in bone marrow incidence off ALL highest at 3-7 years most common leukaemia in children acute leukaemia poorly differentiated cells

Question 42

info on chronic leukaemias

Answer 42

malignant cells are well differentiated identifiable by Romanowski staining procedure

Question 43

info on chronic myeloid leukaemia

Answer 43

20% of all leukaemias 20-60 yrs old malignant proliferation of granulocytes in bone marrow characterised by presence of ph chromosome

Question 44

what chromosome is present in CML?

Answer 44

Philadelphia chromosome

Question 45

chronic myeloid leukaemia features

Answer 45

larger than usual platelets PH chromosome large no of myeloid cells abnormally small chromosome - translocation of chromosome 22 to chromosome 9

Question 46

what is a diagnostic indicator of CML

Answer 46

abnormally small chromosome - translocation of chromosome 22 to chromosome 9

Question 47

chronic lymphocytic leukaemia info

Answer 47

male to female ratio 2:1 usually older than 40 splenomegaly and hepatomegaly bruising infections are common

Question 48

chronic lymphocytic leukaemia features

Answer 48

anaemia caused later in disease 70-99% of cells are small mature lymphocytes smear cells are common - fragile cells which are disrupted in blood film

Question 49

what is hairy cell leukaemia?

Answer 49

subtype of CLL - abnormal B-lymphocytes in bone marrow