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APO509 - CELLULAR AND TRANSFUSION SCIENCE > Leukemia > Flashcards

Leukemia Flashcards

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1
Q

leukemia definition

A

cancer of the body’s blood forming tissues

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2
Q

neoplasm

A

abnormal new growth

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3
Q

benign tumour

A

remain localised and do not metastasize

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4
Q

malignant tumour

A

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

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5
Q

carcinoma

A

90% of cancers - cancer of epithelial cells

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6
Q

sarcoma

A

rare - cancer of connective tissues

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7
Q

leukemias

A

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

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8
Q

lymphomas

A

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

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9
Q

2 types of cancer genes

A

proto-oncogenes and tumour surpressor genes

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10
Q

proto-oncogenes

A

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

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11
Q

tumour suppressor genes

A

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

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12
Q

what tumour suppressor gene plays a role in myeloid leukemia?

A

neurofibromatosis type 1

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13
Q

symptoms of leukaemia

A

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

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14
Q

what cells arise from lymphoid linage?

A

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

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15
Q

how does leukaemia occur?

A

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

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16
Q

general mechanisms of leukaemia transformed cell. (4)

A

impaired differentiation
increased cell survival
increased proliferation
increased self renewal

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17
Q

what is metastasis

A

spread of cancer

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18
Q

cause of leukaemia

A

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

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19
Q

cause of mutations

A

hereditary
chromosomal abnormalities
chemical agents
viruses

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20
Q

3 chromosomal abnormalities in leukaemia

A

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

21
Q

how many chromosomes are involved in a chromosomal inversion?

A

2

22
Q

how many chromosomes are involved in a chromosomal translocation?

A

2

23
Q

when in the linage do acute and chronic leukaemia form?

A

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

24
Q

what type of leukaemia forms blasts?

A

acute only

25
Q

what leukaemia is most common in children?

A

acute lymphoid leukaemia

26
Q

why do infections and aneamias increase with leukaemia ?

A

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

27
Q

acute leukaemia characteristic

A

uncontrolled proliferation of poorly differentiated blast cells

28
Q

what are auer rods?

A

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

29
Q

how is acute leukaemia diagnosed?

A

bone marrow aspirate (sample)

30
Q

what leukaemia is most commonly seen in adults?

A

acute myeloid leukaemia

31
Q

what is the FAB?

A

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

32
Q

M0-M5 FAB

A

immature forms of wbcs

33
Q

M6 FAB

A

immature forms of erythrocytes

34
Q

M7 FAB

A

immature platelets

35
Q

define malignant haematopoiesis

A

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

36
Q

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

A

genetics

37
Q

clinical features of acute leukaemia

A

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

38
Q

what is the wbc count in acute leukaemias?

A

increased to greater than 100,000/ micro L

39
Q

how is leukaemia subtype determined?

A

immunological markers

40
Q

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

A

cluster of differentiation markers (CD)

41
Q

info on acute lymphoblastic leukaemia

A

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

42
Q

info on chronic leukaemias

A

malignant cells are well differentiated
identifiable by Romanowski staining procedure

43
Q

info on chronic myeloid leukaemia

A

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

44
Q

what chromosome is present in CML?

A

Philadelphia chromosome

45
Q

chronic myeloid leukaemia features

A

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

46
Q

what is a diagnostic indicator of CML

A

abnormally small chromosome - translocation of chromosome 22 to chromosome 9

47
Q

chronic lymphocytic leukaemia info

A

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

48
Q

chronic lymphocytic leukaemia features

A

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

49
Q

what is hairy cell leukaemia?

A

subtype of CLL - abnormal B-lymphocytes in bone marrow

APO509 - CELLULAR AND TRANSFUSION SCIENCE (18 decks)

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