malignant haematology Flashcards
what is malignant haemopoiesis characterised by
increased numbers of abnormal and dysfunctional cells
loss of normal activity
what causes acute leukaemia
proliferation of abnormal progenitors with a block in differentiation/maturation
what causes chronic myeloproliferative disorders
proliferation of abnormal progenitors, but no differentiation/maturation block
what is a driver mutation
a mutations that confers a growth advantage on the cells
leads to cancer
what is a passenger mutation
a mutation that does not confer growth advantage
doesn’t cause cancer
what are clones
population of cells derived from a single parent cell
is malignant haemopoiesis polyclonal or monoclonal
malignant haemopoiesis is monoclonal as all cells derived from a single parent cell with malignant mutation
how can haematological malignancies be classified
lineage
developmental stage within lineage
anatomical site involved
how can haematological malignancy be classified by lineage
myeloid
lymphoid
how can haematological malignancy be classified based on developmental stage within lineage
- blastic (primitive precursor cell)
- cytic (mature precursor cell)
how can haematological malignancy be classified based on anatomical site involved
leukaemia (blood)
lymphoma (lymph nodes)
what is myeloma
plasma cell malignancy in the bone marrow
how do acute leukaemia present
histologically and clinically more aggressive than chronic leukaemia
signs of histological aggression in acute leukaemia
large cells with high N:C ratio
prominent nucleoli
open chromatin
rapid proliferation
signs of clinical aggression in acute leukaemia
rapid progression
short history of symptoms
how is acute leukaemia defined
excess of blasts (>20%) in either peripheral blood or bone marrow
what is the most common childhood cancer
acute lymphoblastic leukaemia
how does ALL present
marrow failure: anaemia, infections, bleeding
obstruction of circulation
involvement of areas outside the marrow and blood eg CNS, testis
bone pain due to rapid expansion of the marrow cavity
who gets acute myeloid leukaemia
elderly people
how is leukaemia investigated
blood count blood film coagulation screen bone marrow aspirate immunophenotyping genetics trephine
treatment for ALL
can last up to 2-3 years
different phases of varying intensity
targeted treatments in certain subsets
treatment for AML
intensive
2-4 cycles of chemotherapy (5-10 days followed by 2-4 weeks recovery)
how is chemo administered
via Hickman line
what are complications of chemo
nausea and vomiting hair loss renal and liver dysfunction tumour lysis syndrome infection loss of fertility cardiomyopathy
how should infection be managed in a patient on chemo
empirical treatment with broad spectrum antibiotics, particularly covering gram -ve, ASAP
