malignant haematology and acute leukaemia Flashcards
what is acute myeloid leukaemia
more common form of acute leukaemia in adults
rapidly progressing cancer of myeloid cell line
what is acute lymphoblastic leukaemia
most commonly affects children under 5
rapidly progressing cancer of lymphoid cell line
associated with down syndrome
clinical presentation of non hodgkin’s lymphoma
painless lymphadenopathy
weight loss, night sweats, lethargy
extranodal disease- gastric (dyspepsia, dysphagia, abdo pain), bone marrow (pancytopenia, bone pain), lungs, skin, CNS
palpable abdo mass- organomegaly
pain in lymph node when drinking alcohol
hodgkin’s lymphoma
investigations in non-hodgkin’s lymphoma
excisional node biopsy
CT CAP for staging
HIV
FBC and blood film
ESR- prognostic indicator
staging in non-hodgkin’s lymphoma
lugano staging
management of non-hodgkin’s lymphoma
watchful wait, chemo and radio
rituximab in combination with chemo
stem cell transplant
what to screen for before starting patients on rituximab
hep B
what is tumour lysis syndrome
usually triggered by combination chemotherapy
occurs from the breakdown of the tumour cells and subsequent release of chemicals from the cells
abnormal blood results in tumour lysis syndrome
high potassium
high phosphate
low calcium (as result of high phosphate)
high uric acid
to diagnose tumour lysis syndrome require one of these
increased serum creatinine
cardiac arrhythmia
seizure
prevention of tumour lysis syndrome
IV fluids
patients are higher risk: allopurinol or rasburicase
what is chronic myeloid leukaemia
slowly progressing cancer of the myeloid cell line
what is chronic lymphocytic leukaemia
slowly progressing cancer of the lymphoid cell line
what is chronic lymphocytic leukaemia associated with
warm haemolytic anaemia
richter’s transformation
smudge cells
potential presenting features of leukaemia
fatigue
fever
pallor
petechiae or bruising
abnormal bleeding
lymphadenopathy
hepatosplenomegaly
failure to thrive
guidelines for children with petechiae or hepatosplenomegaly
immediate specialist assessment
where are bone marrow biopsies taken
iliac crest
philadelphia chromosome associations
chronic myeloid leukaemia
but also ALL
pathology of ALL
affects one of the lymphocyte precursor cells causing acute proliferation of single type of lymphocyte usually B
presentation of chronic lymphocytic leukaemia
adults over 60
asymptomatic
infections
anaemia
bleeding
weight loss
what is richter’s transformation
CLL into high grade B-cell lymphoma
blood film of chronic lymphocytic leukaemia
smear or smudge cells
three phases of chronic myeloid leukaemia
chronic phase
accelerated phase
blast phase
