Malignant Haematology Flashcards
what cell type expresses the cell surface antigen glycophorin A?
red cells
what type of cell expresses the enzyme myeloperoxidase?
neutrophils
what is the underlying process behind acute myeloid leukaemia?
proliferation of abnormal progenitors with a block in differentiation/maturation
describe the appearance of the blood film in acute leukaemia
all the cells just look the same
what is the underlying process behind chronic myeloid leukaemia?
proliferation of abnormal progenitors but no block in differentiation or maturation
describe the appearance of the blood film in chronic myeloid leukaemia?
presence of lots of cells of different types
what is a clone cell?
a population of cells derived from a single parent cell
what are the two types of malignancy if classified by lineage?
myeloid
lymphoid
what cancer has a malignant change within primitive B cell precursors in the marrow?
acute lymphoblastic leukaemia
what cancer has a malignant change in a more mature B lymphocyte?
chronic lymphocytic leukaemia
what is myeloma?
a plasma cell malignancy
what type of cancer has blood involvement?
leukaemia
what is the cell of origin in chronic myeloid leukaemia?
LT and ST HSC’s
what is the cell of origin in AML?
MPP
what is the cell of origin in ALL?
CLP
what is the cell of origin in CLL?
B cells
what is the cell of origin in myeloma?
plasma cells
what is acute leukaemia?
a rapidly progressive clonal malignancy of the marrow/blood with maturation defects
how is acute leukaemia defined?
excess of blasts (>20%) in either blood or bone marrow
what are the two types of acute leukaemia?
acute myeloid leukaemia (AML)
acute lymphoblastic leukaemia (ALL)
what age groups is most commonly affected by AML?
elderly - >60
how can acute promyelocytic leukaemia present?
with a coagulation defect causing DIC
what is acute lymphoblastic leukaemia (ALL)?
a malignant disease of lymphoblasts
what are lymphoblasts?
primitive lymphoid cells
what is the most common childhood cancer?
ALL
how does ALL present?
anaemia, infections and bleeding due to marrow failure
bone pain
what three investigations are done for acute leukaemia?
blood count + film
coagulation screen
bone marrow aspirate
what changes are seen in the blood count in acute leukaemia?
low Hb
low neutrophils
low platelets
what can be seen in the blood film in acute leukaemia?
blasts
why is a coagulation screen done for investigation of acute leukaemia?
to identify any life threatening coagulation problems e.g. DIC
what test is needed for a definitive diagnosis of acute leukaemia?
immunophenotyping on. abone marrow aspirate
what is the main curative treatment for acute leukaemia?
multi-agent chemotherapy
what do patients with acute leukaemia often have to allow long term central venous access?
a hickman line
where does the tip of a hickman line sit?
junction between the SVC and the RA
what should be done if a neutropenic patient develops a fever?
immediate broad spectrum antibiotics + send blood cultures
when are prophylactic platelets transfusions given for patients undergoing chemo?
cut off is 10-20x10^9
what are some possible complications of intensive chemotherapy?
N+V
hair loss
liver and renal dysfunction
infections
when can tumour lysis syndrome occur?
during the first course of chemotherapy
when is an acute leukaemia patient considered to be in remission?
<5% marrow blasts with recovery of normal haemopoiesis
