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Haematological disease (Den 303) > Lymphoid and myeloid disorders > Flashcards

Lymphoid and myeloid disorders Flashcards

1
Q

Normal blood film

A 
Donuts
Biconcave disc
Lymphocytes
Neutrophils
Platelets
***
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2
Q

Acute leukaemia

A

Proliferation of primitive precursor cells usually only found in bone marrow
Proliferation without differentiation

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3
Q

What does acute leukaemia do and lead to

A

Replaces normal bone marrow cells, leads to:

  • anaemia: palor and lethargy
  • neutropenia: infections -thrombocytopenia: bleeding
  • bone pain due to marrow infiltration
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4
Q

Acute leukaemia types

A

ALL: acute lymphoblastic leukaemia
AML: acute myeloid leukaemia

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5
Q

Chronic leukaemia types

A

Chronic lymphatic leukaemia (CLL)

Chonic myeloid leukaemia (CML)

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6
Q

Blasts in acute leukamia

A

Proliferation of balst cells?

**

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7
Q

Acute lymphoblastic leukaemia

A

Malignant proliferation of lymphoblasts in bone marrow

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8
Q

Acute lymphoblastic leukaemia affects

A

Mainly children

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9
Q

Acute lymphoblastic leukaemia prognosis

A

Good: 85% cure rate
-esp girls, age 1-10, low WBC, certain morphology
Poor: adults

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10
Q

Acute lymphoblastic leukaemia treatment

A

Induction chemotherapy
Consolidation chemotherapy +/- craniospinal irradiation
Maintenance chemotherapy
Bone marrow transplantation only if relapse
goes on for 2 years

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11
Q

Acute myeloid leukaemia

A

Malignant proliferation of myeloblasts in bone marrow

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12
Q

Acute myeloid leukaemia affects

A

Mostly adults

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13
Q

Acute myeloid leukaemia prognosis

A

Poor: 15-50% 5 year survival (depends on subtype)

Most pts relapse

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14
Q

Acute myeloid leukaemia subtype for dentists

A

M5: gum infiltration in acute monocytic subtype

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15
Q

Acute myeloid leukaemia treatment

A

Cyclical high dose chemotherapy (induction and consolidation with no maintenance)
Sometimes bone marrow transplantation

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16
Q

Chronic lymphatic leukaemia

A

Proliferation of mature lymphocytes, usually B cells

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17
Q

Chronic lymphatic leukaemia affects

A

Commonest leukaemia

Affects elderly >65 years

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18
Q

Chronic lymphatic leukaemia presents with

A

Anaemia, infections, lymphadenopathy, splenomegaly
Lymphocytosis on blood film
-nucleus is much more packed than earlier one??

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19
Q

Chronic lymphatic leukaemia prognosis

A

Good

Survival >10 years is norm

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20
Q

Chronic lymphatic leukaemia treatment

A

Only advanced disease

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21
Q

Chronic myeloid leukaemia

A

Gradual onset
High white cell count & splenomegaly
Philadelphia chromosome (chromosome translocation of 22 and 15)
BCR-ABL tyrosine kinase
-BCR and ABL oncogenes next to each other

22
Q

Chronic myeloid leukaemia phases

A

3: chronic, accelerated, and blast crisis
- diagnosis in chronic form (usually about 3 years)
- acute harder to treat with chemotherapy

23
Q

Chronic myeloid leukaemia treatment

A

Imatinib (Glivec)
-blocks abnormal BCR-ABL tyrosine kinase activity
-can result in molecular remission
Allogeneic stem cell transplantation

24
Q

Myelodysplasia

A

“Premalignant” condition of haemopoietic precursors

25
Myelodysplasia affects
Disease of the elderly
26
Myelodysplasia symptoms
Can be asymptomatic | May present with anaemia, thrombocytopenia, panycytopenia
27
Myelodysplasia types
Several subtypes Variable course Can transform to acute myeloid leukaemia
28
Myelodysplasia treatment
Supportive care | Bone marrow transplantation in the young
29
Lymphoma
Hodgkin lymphoma | Non Hodgkin Lymphoma
30
Hodgkin lymphoma presentation
Painless lymphadenopathy | B symptoms: Sweats, Weight loss, Fever
31
Hodgkin lymphoma affects
2 peaks 15-35 years and >55
32
Hodgkin lymphoma prognois
10 year survival 90%
33
Hodgkin lymphoma types
4 subtypes | Reed-Sternberg cell diagnostic on biopsy
34
Hodgkin lymphoma treatment
Chemotherapy Radiotherapy Stem cell transplantation
35
Non Hodgkin lymphoma
Indolent or low grade eg follicular lymphoma | Aggressive or high grade eg Diffuse large B cell lymphoma
36
Aggressive or high grade eg Diffuse large B cell lymphoma
Rapidly progressive Usually symptomatic Potentially curable
37
Aggressive or high grade eg Diffuse large B cell lymphoma treatment
Chemotherapy Radiotherapy Transplantation
38
Indolent or low grade eg follicular lymphoma
Gradual onset, usually advanced at presentation May be asymptomatic Incurable, median survival 10years
39
Indolent or low grade eg follicular lymphoma treatment
Chemotherapy Radiotherapy Transplantation
40
Myeloproliferative disorders
``` Polycythaemia Rubra Vera (PRV) -red cell proliferation Chronic Myeloid Leukaemia (CML) -white cell proliferation Essential Thrombocythaemia (ET) -platelet proliferation Myelofibrosis -marrow stroma proliferation ```
41
Polycythaemia = erythrocytosis
> in circulating red cell concentration
42
Secondary Polycythaemia = erythrocytosis
Hypoxic: High altitude, lung or cyanotic heart disease | Inappropriate erythropoietin secretion: Renal tumour
43
Primary Polycythaemia = erythrocytosis
Polycythaemia rubra vera Pruritus, plethoric facies Thrombosis Splenomegaly, hepatomegaly
44
Treatment of primary polycythaemia = erythrocytosis
Venesction Aspirin Myelosuppression
45
Outcome of polycythaemia = erythrocytosis
Myelofibrosis (15-20%), AML (2-10%)
46
Secondary Thrombocytosis
Bleeding Infection Inflammation Malignancy
47
Primary: Essential Thrombocythaemia
Uncontrolled malignant proliferation of megakaryocytes Platelets >600 persistently Arterial and venous thrombosis Bleeding with very high counts eg >1500
48
Primary: Essential Thrombocythaemia treatment
With aspirin, hydroxycarbamide, anagrelide, interferon
49
Multiple myeloma
Malignant proliferation of plasma cells in the bone marrow Plasma cells are terminally differentiated B lymphocytes that produce immunoglobulin Myeloma has monoclonal immunoglobulin in blood and urine
50
Symptoms of myeloma
``` Lytic lesions in bones including skull -pain and pathological fractures Hypercalcaemia due to bone resorption -thirst, polyurea, confusion, constipation Hyperviscocity due to immunoglobulin Renal failure Anaemia Infections *Plasma cells in bone marrow* ```
51
Diagnosis of myeloma
Blood and urine tests X-rays and CT/MRI Bone marrow
52
Treatment of myeloma
Chemotherapy Thalidomide, Bortezomib Radiation Stem cell transplantation

Haematological disease (Den 303) (6 decks)

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