Malignant Haematology

Question 1

What is malignancy haemopoeisis?

Answer 1

Increased numbers of abnormal and dysfunctional cells

Loss of normal activity

Question 2

What can malignant haemopoiesis affect?

Answer 2

Haemopoeisis

Immune function

Question 3

What can cause malignancy haemopoiesis?

Answer 3

Increased proliferation
Lack of differentiation
Lack of maturation
Lack of apoptosis

Question 4

What occurs in acute leukamia?

Answer 4

Proliferation of abnormal progenitors with block in differentiation/maturation

Question 5

What occurs in chronic myeloproliferative disorders?

Answer 5

Proliferation of abnormal progenitors but no differentiation block

Question 6

What causes haematological malignancies?

Answer 6

Genetic
Environmental
Mutations

Question 7

What are clones?

Answer 7

Population of cells derivedd from a single parent cell

Question 8

Is normal haemopoeisis polyclonal or monoclonal?

Answer 8

Polyclonal

Question 9

Is malignant haemopoiesis monoclonal or polyclonal?

Answer 9

Monoclonal

Question 10

What mutations confer growth advantage?

Answer 10

Driver mutations

Question 11

What are the 3 types of haematological malignancies?

Answer 11

Based on lineage
Based on developmental stage
Based on anatomical site

Question 12

What are the 2 different lineages of haem malignancies?

Answer 12

Myeloid

Lymphoid

Question 13

What are the types of haem malignanciesbased on developmental stage?

Answer 13

Lymphoblastic
Lymphocytic
Myeloma

Question 14

What is a Haem malignancy involving blood?

Answer 14

Leukaemia

Question 15

What is a haem malignancy that involved lymph nodes with lymphoid malignancy?

Answer 15

Lymphoma

Question 16

What is myeloma?

Answer 16

Plasma cell malignancy in marrow

Question 17

What haem malignancy can involve blood and lymph nodes?

Answer 17

Chronic lymphocytic leukaemia

Question 18

What is more aggressive: Chronic/Low grade or Acute/High grade?

Answer 18

Acute/High grade

Question 19

What are features of histological aggression?

Answer 19

Large cells with high N:C ratio
Prominent nucleoli
Rapid proliferation

Question 20

What are features of clinical aggression?

Answer 20

Rapid progression of symptoms

Question 21

What do acute leukaemias present with?

Answer 21

Failure of normal bone marrow function

Question 22

What is acute leukaemia?

Answer 22

Rapidly progressive clonal malignancy of the marrow/blood with maturtion defects
>20% of blasts in peripheral blood
Loss of normal haemopoietic reserve

Question 23

What are 2 types of acute leukaemia?

Answer 23

Acute myeloid leukaemia (AML)

Acute lymphoblastic leukaemia (ALL)

Question 24

What is Acute lymphoblastic leukaemia?

Answer 24

Malignant disease of primitive lymphoid cells

Question 25

what is the most common childhood cancer?

Answer 25

Acute lymphoblastic leukaemia

Question 26

What is the clinical presentation of ALL?

Answer 26

Anaemia Infections Bleeding Bone pain

Question 27

What age group is likely to get acute myeloid leukaemia?

Answer 27

>60Years

Question 28

What investigations for acute leukaemia?

Answer 28

``` Blood count and film Coagulation screen Bone marrow aspirate Morphology Immunophenotype ```

Question 29

What is seen on blood film in acute leukaemia?

Answer 29

Reduction in normal Presence of abnormal cells (Blasts) with high N:C ratio Auer rod

Question 30

What is required for a definitive diagnoses between AML and ALL?

Answer 30

Immunophenotyping

Question 31

How is acute leukaemia treated?

Answer 31

Multi-agent chemotherapy

Question 32

How is ALL treated?

Answer 32

Can last up to 3 years | Different phases

Question 33

How is AML treated?

Answer 33

2-4 cycles of chemotherapy | Prolonged hospitalisation

Question 34

What are problems of marrow suppression?

Answer 34

Anemia Neutropenia Infections Thrombocytopenia

Question 35

What bacteria affect marrow suppressed patients?

Answer 35

Gram -VE bacteria

Question 36

What are the complications of chemotherapy?

Answer 36

``` Nausea and Vomiting Hair Loss Liver Renal dysfunction Tumour lysis syndrome Infections ```

Question 37

What is the treatment for bacterial infectionas soon as neutropenic fever?

Answer 37

Broad spectrum antibiotics

Question 38

What is remission?

Answer 38

<5% marrow blasts with recovery of normal haemopoieses

Question 39

What will some patients die of?

Answer 39

Treatment-related toxicity