Leukemia Flashcards
What’s the difference in presentation between cml and cll?
Cll - lymphadenopathy
CML - hepatosplenomegaly
Which cytogenetics in acute leukemia give a good prognosis? And which give a bad prognosis?
Good - T15:17
Bad - monosomy 3, 5, 7,
What’s the presentation of acute leukaemia?
BM failure - anemia, infection, bleeding with infiltration - splenomegaly, lymphadenopathy, CNS involment,
Gum hypertrophy - AML
What’s seen on a blood film for AML?
Auer rods in the cytoplasm
What’s seen on a blood film for ALL?
Blast cells
Leucocytosis
What’s the most common leukaemia?
CLL
What’s the presentation for CLL?
Insidious onset (asymptomatic)
If severe - weight loss, anemia,
Enlarged LN non-tender and rubbery.
Ix: ⬆️⬆️ mature lymphocytes, autoimmune haemolysis, marrow infiltration (late)
Treatment for CLL
Chemo, rituximab (CD20), imrutinib, ildelalisib
What’s the genetics of CML?
T(9,22) Philadelphia chromosome (BCR:ABL)
Can also be present in ALL
Presentation of CML?
Chronic and insidious: weight loss, tiredness, fever, sweats, gout, bleeding,splenomegaly (massive), hepatomegaly.
What are the investigations for CML?
FBC - WCC >100, neutrophils, basophils and eosinophils.
Hb low or normal.
Test cytogenetics
Targeted treatment in CML?
Imatinib for the 9,22 +ve CML.
Can turn into AML (JAK2 increases the risk
The presence of Tdt receptor on the cells, is indicative of which disease?
ALL - immature lymphoblasts express protein Tdt. (T-cells)
Smudge cells are present on blood films in which disease?
CLL
Lymphocytes are mature but do not function properly, causing them to break/smudge on blood films
Why is all-trans retinoic acid used in treatment of promyelocytic leukaemia?
Forces maturation of promylecytes (to neutrophils that can then be broken down)
