leukemia

Question 1

DIAGRAM what is leukemia

Answer 1

series of mutations in myeloid or lymphoid stem cells

Question 2

difference of leukemia unlike other cancer-

Answer 2

often not any solid tumour- because normal stem cells circulate in blood, these cancer cells circulate in blood

Question 3

benign vs malignant difference in leukemia

Answer 3

INVASION and METASTASIS don’t apply, so other ways of distinguishing benign and malignant needed: benign= chronic ie goes on for long, and malignant= acute ie disease aggressive

Question 4

how leukemia classified

Answer 4

chronic vs acute, lymphoid vs myeloid, lymphoid B or T, myeloid megakaryocytic,erythroid,monocytic or granulocytic

Question 5

causes of leukemia

Answer 5

mutation in protooncogene/TMS, or creation of fusion gene

Question 6

causes of mutations in leukemia

Answer 6

radiation, anti-cancer drugs, cigarettes, chemicals eg benzene

Question 7

difference between AML and CML- genes

Answer 7

T.F are affected, so multiple genes affected: in CML, a gene producing protein of membrane receptor or cytoplasmic protein affected, which is not as serious

Question 8

difference between AML and CML: cells

Answer 8

failure of production of mature cells ie lots of immature cells ie myeloblasts vs too much production of mature cells eg too many granulocytes ie differentiation still occurs

Question 9

differnce between ACL and CLL- cell

Answer 9

failure of production of mature cells ie lots of immature cells ie lymphoblasts vs mature B/T cells, but still abnormal

Question 10

features of leukemia due to accumulation of abnormal cells: especially ALL

Answer 10

leucocytosis, bone pain (if acute), hepato/splenomegaly (abnormal cells enter these tissues), lymphadenopathy (ie enlargement of nodes if lymphoid), enlargement of thymus (if T lymphoid), testicular enlargement and skin infiltration

Question 11

metabolic effects of leukemia

Answer 11

too much uric acid ie renal failure (due to DNA breakdown), weight loss (energy to break down DNA), and fever/sweating (due to high metabolic rate)

Question 12

effects due to lack of normal cells- especially in ALL and why it occurs in ALL

Answer 12

anemia- leads to fatigue/breathlessness+ pale: thrombocytopenia- leeds to bleeding, bruises+ petechiae: neutropenia= fever: occurs because the amounts of lymphoblasts crowd the other cells

Question 13

effect of leukemia on immune system, and particularly which type

Answer 13

deficiency due to less B/T cells especially CLL

Question 14

who does ALL affect most and why

Answer 14

children, due to delayed exposure to common pathogen

Question 15

DIAGRAM blood film in ALL

Answer 15

very large lymphoblasts

Question 16

immunophenotyping

Answer 16

tells you were ALL is B or T cell, and whether there’s leukemia- if there is, they will expresss CD19 and TDT

Question 17

cytogenetic analysis and prognosis

Answer 17

analyses chromosomes, whether there are translocations/extra choromosomes- important of prognosis

Question 18

FISH in cytogenetic analysis ie fluorescence

Answer 18

if there is translocation, there is fusion of two colours

Question 19

treatment of ALL

Answer 19

supportive therapy ie gives RBC, platelets and antibiotics- also systemic (as leukemia not one tumour) and intrathecal (via CSF in spine) chemotherapy

Question 20

types of ALL and effect on treatment

Answer 20

many different types dependent on cytogenetics- effects optimal treatment