ls6003 haemotology lecture 1 Flashcards
what is conventional chemotherapy
cytotoxic to most cells, meaning it can damage normal, healthy cells in addition to damaging and killing cancer cells.
what is targeted therapy
Targeted drugs often work by blocking cancer cells from copying themselves. This means they can help stop a cancer cell from dividing and making new cancer cells.
whats palliative treatment
prolongs survival, improves QoL, unlikely to cure
In leukaemia what is the next option after a patient fails cycles of chemo in response to diagnosis with leukaemia
bone marrow transplant
what is salvage chemotherapy
potentially curative combination chemo, given to patients who hav efailed or recurred after curative
what is adjuvant chemo
Adjuvant therapies are delivered after the primary treatment, to destroy remaining cancer cells.
what is neo-adjuvant
Neoadjuvant therapies are delivered before the main treatment, to help reduce the size of a tumor or kill cancer cells that have spread.
what factors are considered when designin gcombination therapy
-drugs with known efficacy against a particular tumour type
-non-overlapping toxicity profile
-possible synergistic killing effects
-action at different phases in cell cycle
define leukaemia
malignant clonal disorder of immature cells in haemopoietic system derived from a single ancestral transformed cell with genetic alteration
what is AML
acute myeloid leukaemia
can you have genetic predispostion to AML
chromosomal instability syndromes e.g. bloom syndrome (quite rare)
symptoms of AML
anaemia
neutropenia
thrombocytopenia (petechiae)
organomeglay
gum hypertrophy
whats the pathogenesis of AML
escape from apoptosis, loss of cell cycle control, genomic instability
activation of RTK->PI3K signalling ->AKT and mTOR
BCL2 over-expression = anti-apoptosis protein
TP53 mutations (stops cell cycle)
what is induction
high-dose combination therpay with intent to inudce complete remission (50->5% bone marrow leukaemia cell))
whats consolidation
aims to remove any residual leukaemia cells after induction
intensification
chemo after complete remission, often higher dose or altenate combination
intends to increase sure or remission duration
whats the standard remission induction combination therapy
cytosine arabinoside (Ara-C) (purine antagonist), and anthracycline. 10 day cycle
whats the standard consolidation therapy
high dose Ara-C, muliple cycles
what are the 2 types of stem cell transplant
-allogeneic haematopoietic stem cell transplantation (Allo-HSCT) = uses donor cells, can result in GVHD, higher survival
-autologous HSCT (Auto-HSCT) = uses own cells, lower survival rate
what is APL and what is its hallmark
acute promyelocytic leukaemia (APL)
hallmark= genetic alterations involving retinoic acid receptor alpha (RARA) gene
what is ALL
acute lymphoblastic leukaemia
type of blood cancer that starts with lymphocytes in bone marrow. most common in children
increase in WBC
symptoms: reduced platelets
what are the 2 types of ALL
B-ALL - effects ages 1-10, less severe
T-ALL - effects 10<, more severe, effects CNS
induction of remission in ALL via what regimen
VDLP
what is CML
chronic myeloid leukaumia
