Myeloid Malignancy Flashcards
What is the origin of bone marrow malignancies that are myeloid?
Red blood cells
Platelets
Granulocytes
Monocytes
What are the main groups of myeloid malignancies?
Acute Myeloid Leukaemia (AML)
Chronic Myeloid Leukaemia (CML)
Myelodysplastic Syndromes (MDS)
Myeloproliferative Diseases (MPD)
What are the sub groups of acute leukaemia?
Acute myeloblastic leukaemia
Acute lymphoblastic leukaemia
What are the clinical features of AML?
BONE MARROW FAILURE
Anaemia
Thrombocytopenic bleeding (Purpura and mucosal membrane bleeding)
Infection because of neutropenia (predominantly bacterial and fungal)
What essential investigations should be done in AML?
Blood count and blood film Bone marrow aspirate/ trephine Cytogenetics of leukaemic blasts Immunophenotyping of leukaemic blasts CSF examination if symptoms
What is the treatment for AML?
Supportive care
Anti-Leukaemia chemotherapy
Stem cell transplantation
All-Trans Retinoic Acid in APL
What are the clinical features of CML?
Anaemia Splenomegaly, often massive Weight loss Hyperleukostasis - Fundal haemorrhage and venous congestion, altered consciousness, respiratory failure Gout
What are the laboratory features of CML?
High WCC ( can be very high )
High platelet count
Anaemia
Blood film shows all stages of white cell differentiation with increased basophils
Bone marrow is hypercellular
Bone marrow and blood cells contain the Philadelphia chromosome - t(9;22)
What is the treatment for CML?
Tyrosine kinase inhibitors (Imatinib, Dasatinib, Nilotinib, Busitinib, Ponatinib)
Allogeneic Transplantation
What are myelodysplastic syndromes?
Acquired clonal disorders of the bone marrow
Commonly seen in old age
Pre-Leukaemic
How do myelodysplastic syndromes normally present?
Macrocytic anaemia
Pancytopenia
What is the treatment available for myelodysplastic syndrome?
Supportive
Stem cell transplantation in younger patients
What are the main myeloproliferative diseases?
Polycythaemia Vera
Essential Thrombocythaemia
Idiopathic Myelofibrosis
What are the clinical features of PRV?
Headaches Itch (particularly after hot bath/shower) Vascular occlusion Thrombosis TIA, stroke Splenomegaly
What are the laboratory features of PRV?
Raised haemoglobin conc and haematocrit
Raised WCC and platelet count
Raised uric acid
Increase in red cell mass
