Leukemia JH

Question 1

what are the two types of blood stem cell?

Answer 1

lymphoid cells- which make a type of white blood cells called lymphocytes
myeloid stem cells- which make all the other types of blood cells- red, platelets and other wbc

Question 2

what are the 4 main types of leukaemia?

Answer 2

Acutelymphoblasticleukaemia(ALL)
– Acutemyeloidleukaemia(AML)
– Chroniclymphocyticleukaemia(CLL)
– Chronicmyeloidleukaemia(CML)

Question 3

what does ALL develop from?

Answer 3

lymphoid blast

Question 4

define ALL

Answer 4

a malignant clonal disease that develops when a lymphoid progenitor cell becomes genetically altered and undergoes uncontrolled proliferation

Question 5

what do early lymphoid precursor cells do in ALL?

Answer 5

replace the normal haematopoietic cells of the bone marrow and further infiltrate various body organs

Question 6

who is childhood ALL more common in?

Answer 6

can affect any age
more common in 1-4yr

Question 7

how does ALL present?

Answer 7

• Enlarged lymph nodes are frequently the initial cause for seeking medical attention by the patient.
• Haematological abnormalities
• Pallor, ecchymoses, lymphadenopathy, or
  hepatosplenomegaly. There may also be
  evidence of tissue infiltration such as bone
  pain, testicular enlargement, and cranial nerve
  palsies

Question 8

what does ALL diagnosis require?

Answer 8

Definitive diagnosis requires a bone marrow
aspiration and biopsy.

Question 9

what are the signs and symptoms of ALL?

Answer 9

• Weakness or fatigue
• Skin pallor
• Fever and/or night sweats
• Unexpected weight loss or anorexia
• Easy bruising, including bleeding gums, purplish
  patches in the skin (purpura), or flat, pinpoint spots
  under the skin (petechiae)
• Frequent chest or urinary tract infections
• Unexplained usually painless swollen lymph nodes in
  the neck, armpit, or groin
• Swelling or discomfort in the abdomen due to
  enlarged spleen and/or liver
• Difficulty breathing
• Pain in the bones or joints

Question 10

what is the treatment for ALL?

Answer 10

• Three phases:
  – Induction
  – Initial chemotherapy to remove leukaemia cells
  – Intensification
  – Repeat chemotherapy at higher doses
  – Maintenance
  – Keeps leukaemia away

Question 11

what is intrathecal therapy?

Answer 11

leukaemia cells may travel into the cerebrospinal fluid
- still have it if leukaemia cells are not present

Question 12

what are the targeted therapies for ALL?

Answer 12

• PhiladelphiachromosomepositiveALL
• Tyrosinekinaseinhibitore.g.imatinib
• Takenasadailytabletthroughouttreatment
  (withchemotherapy)

Question 13

what can targeted therapies cause?

Answer 13

blood dyscrasias, skin changes, diarrhoea
metabolised by cyp450

Question 14

what are the treatment options for relapsed ALL?

Answer 14

induction phase may be repeated
newer targeted therapies
leukaemia resistance