Malignant Haematology And Acute Leukaemia

Question 1

How do you identify normal mature cells?

Answer 1

Morphology
Cell surface antigens
Enzyme expression

Question 2

How do you identify normal progenitors/ stem cells?

Answer 2

Immunophenotyping
Cell culture assays
Animal models

Question 3

What is malignant haemopoiesis normally due to?

Answer 3

Increased proliferation
Lack of differentiation
Lack of maturation
Lack of apoptosis

Question 4

What does normal bone marrow aspirate reflect?

Answer 4

Normal kinetics of haemopoiesis

Question 5

Causes of haematological malignancies?

Answer 5

Genetic, epigenetic, environmental
Somatic mutations
Recurrent cytogenic abnormalities

Question 6

What is cloning?

Answer 6

A population of cells derived from a single parent cell. Parent cell has genetic marker shared by daughter cells

Question 7

Normal haemopoiesis is monoclonal / polyclonal?

Answer 7

Polyclonal

Question 8

Malignant haemopoieses is monoclonal/polyclonal?

Answer 8

Monoclonal

Question 9

Leukaemia?

Answer 9

Malignancy of blood

Question 10

Lymphoma?

Answer 10

Malignancy involving lymph node

Question 11

Acute leukaemia and high grade lymphoma are histologically and clinically more or less aggressive than chromic leukaemia and low grade lymphoma?

Answer 11

More aggressive

Question 12

What does clinical aggression mean?

Answer 12

Rapid progression of symptoms

Question 13

What does histological aggression mean?

Answer 13

Large cells with high nuclear-cytoplasmic ratio
Prominent nuclei
Rapid proliferation

Question 14

What disease is rapid progressive clonal malignancy of marrow or blood with maturation defects ?

Answer 14

Acute leukaemia

Question 15

What is there excess of in acute leukaemia?

Answer 15

Blasts

Question 16

Types of acute leukaemia?

Answer 16

Acute myeloid leukaemia (AML)

Acute lymphoblastic leukaemia (ALL)

Question 17

ALL is malignant disease of what?

Answer 17

Primitive lymphoid cells - lymphoblasts

Question 18

What age group is ALL most common in ?

Answer 18

Children - most common childhood cancer

Question 19

Presentation of ALL?

Answer 19

Anaemia
Infection
Bleeding
Bone pain

Question 20

What age group is AML more common in?

Answer 20

Elderly >60 yrs old

Question 21

What does AML Stand for?

Answer 21

Acute myeloid leukaemia

Question 22

What does ALL stand for?

Answer 22

Acute lymphoblastic leukaemia

Question 23

Investigations of acute leukaemia?

Answer 23

Blood count and film - decreased normal cells and increased abnormal
Coagulation screen
Bone marrow aspirate

Question 24

What is analysed using bone marrow aspirate?

Answer 24

Morphology
Immunophenotype
Cytogenesis
Trephine

Question 25

What is the curative treatment of acute leukaemia?

Answer 25

Multi agent chemo

Question 26

What problems can arise from marrow suppression?

Answer 26

Anaemia Neutropenia Thrombocytopenia

Question 27

Complications of chemo treatment?

Answer 27

``` Nausea and vomiting Hair loss Liver and renal dysfunction Tumour lysis syndrome Infection Infertility, cardiomyopathy with anthracyclines ```

Question 28

Cure rate in childhood ALL?

Answer 28

>85-90%

Question 29

Cure rate in adult ALL?

Answer 29

30-40%

Question 30

Cure rate in adult AML <60yrs old ?

Answer 30

40-50%

Question 31

Cure rate in adult AML >60yrs old?

Answer 31

<10%

Question 32

Another treatment option for acute leukaemia?

Answer 32

Allogenic stem cell transplantation