MSRA Haematological Malignancy Flashcards
What are the salient features of Acute Lymphoblastic Leaukaemia (ALL)?
Most common childhood malignancy
Clonal expansion of lymphoid progenitor cells (T lymphocytes)
Blast cells (immature cells) seen on bone marrow aspirates
Presents with easy bruising, hepatosplenomegaly, lymphadenopathy and infection.
Very good prognosis >90% survival
What is the induction treatment regimen for ALL?
Daunorubicin, vincristine, prednisone, asparaginase and sometimes cyclophosphamide
What are the salient features of Acute Myeloblastic Leaukaemia (AML)?
Most commonly seen in adults
Highly aggressive form of leaukaemia
Classically Auer rods are seen on blood film (pink rods)
Present with signs of bone marrow failure, classically infection or bruising
What are the salient features of Chronic Lymphoblastic Leuakaemia (CLL)?
Disease of the elderly
Malignancy of B cell origin
Smudge cells are often seen on blood film
Can transform into an aggressive diffuse large B cell Lymphoma (known as Richter’s transformation)
What are the salient features of Chronic Myeloid Leaukaemia, including treatment?
Commonly seen in middle aged adults
Associated with the Philadelphia chromosome (formed by translocation of part of chromosome 9 to chromosome 22)
Presenting symptoms are often constitutional (weight loss, tiredness, night sweats) but may be picked up incidentally on FBC, anaemia, leukocytosis, low platelets.
Treated with tyrosine kinase inhibitors (imatinib, gefitinib, erlotinib)
What are the salient features of Hodgkins Lymphoma?
Develops from B lymphocytes
Characterised by the presence of multi nucleated giant cells (Reed-Sternberg cells).
Associated with EBV + HIV.
Presents with lymphadenopathy and B symptoms (night sweats and weight loss). May have hepatomegaly/splenomegaly on examination.
Staging with CT scan and PET scan
What is the broad treatment for Hodgkins Lymphoma, early/late/recurrent?
Early disease is often treated with: chemo and radiotherapy
Later disease is often treated with extended chemo
Recurrent disease is treated with high dose chemo followed by stem cell transplant
What are the different chemo treatment regimens used in Hodgkins Lymphoma?
ABVD: doxorubicin (used to be called Adriamycin®), bleomycin, vinblastine and dacarbazine. Used in early disease.
BEACOPP: consists of bleomycin, etoposide, doxorubicin (Adriamycin®), cyclophosphamide, vincristine (Oncovin®), procarbazine and prednisolone. Used in late disease.
What are the salient features of Non-Hodgkins Lymphoma?
Any lymphoma in which Reed-Sternberg cells are not present.
More common than Hodgkins Lymphoma
High grade diffuse large B cell lymphoma and follicular lymphoma most common
Ann Arbor staging is used
What is the most common chemotherapy regimen?
RCHOP
Rituximab, cyclophasphamide, doxorubicin (hydroxydaunorubicin), vincristine (Oncovin®), and prednisolone
Methotrexate is used in CNS lymphoma
