lymphoproliferative malignancies Flashcards
acute lymphoblastic leukaemia pathology
acute proliferation of a single type of lymphocyte (usually B)
due to a disorder of lymphoid progenitor cells
presentation of ALL
bone/joint pain - investigate a child with a limp anaemia neutropenia thrombocytopenia - petechiae weight loss infection splenomegaly hepatomegaly fever testicular swelling
investigations for ALL
blood film - blast cells
FBC - Hb and platelets low, WCC high
bone marrow biopsy - 90% of cells are B-cells
risk factors for ALL
children <5
downs syndrome
treatment of ALL
induction chemotherapy
immunotherapy - CAR
CNS directed treatment - LP
stem cell transplant
chronic lymphoblastic leukaemia pathology
mutations in T or B cells
chronic proliferation of a single type of well differentiated lymphocytes (usually B)
what is richters transformation
when CLL develops into high grade lymphoma
presentation of CLL
asymptomatic anaemia - haemolytic infection bleeding lymphadenopathy splenomegaly fever sweats weight loss
investigations for CLL
FBC - lymphocyte count >5, anaemia
blood film - smear/smudge cells
immunophenotyping
binet criteria to stage
risk factors for CLL
most common leukaemia in adults
males>females
what finding in lymphocyte count means you should treat for CLL
doubling time <6months
50% increase in 2 months
treatment for CLL
keep vaccines up to date
watchful waiting
cytotoxic chemotherapy - fludarabine, bendamustine
monoclonal antibodies - rituximab, obinatuzumab
