Myeloid malignancy Flashcards
What are myeloid malignancies?
Bone marrow cancers of red cell, platelet, monocyte and granulocyte origin
What are lymphoid malignancies?
B and T cell origin bone marrow cancer
Acute Myeloid Leukaemia originates in which cells?
Myeloid Progenitor cells
What are the main groups of myeloid malignancies?
Acute Myeloid Leukaemia
Chronic Myeloid Leukaemia
Myelodysplastic Syndromes
Myeloproliferative Neoplasms
How does Acute vs Chronic myeloid leukaemia differ?
Acute - do not differentiate, bone marrow fails rapidly, curable
Chronic - differentiate, no marrow failure, few years survival
What are the Sub groups of Acute Leukaemia?
Acute Myeloblastic Leukaemia
Acute Lymphoblastic Leukaemia
What are the typical features of Acute Myeloblastic Leukaemia?
Anaemia
Mucosal bleeding with purpura
Infection (neutropenia)
What infections are common in Acute Myeloblastic Leukaemia?
Bacterial and fungal
Aspergillosis
What investigations are used in suspected leukaemia?
Blood count Blood film Bone marrow Aspirate Cytogenics and Immunophenotyping CSF examination Targetted molecular genetics
What treatment is used in Acute Myeloblastic Leukaemia?
Anti-lukaemic Chemotherapy Allogeneic stem cell transplant All-trans retinoic acid Arsenic trioxide Targeted antibodies
What are the symptoms of Chronic Myeloblastic leukaemia?
Anaemia Splenomegaly Weight loss Gout Hyperleukostasis
What are the symptoms of hyperleukostasis?
Fundal haemorrhage
Venous congestion
LoC
Respiratory failure
What is typical of a FBC in Chronic Myeloblastic leukaemia?
Anaemia Elevated WCC (very high) High platelets White cell differentiation on blood film (Basophils++) Hypercellular bone marrow Philadelphia chromosome
What are the treatment for Chronic Myeloblastic leukaemia?
Tyrosine Kinase Inhibitors
BRC-ABL direct inhibitors
Allogeneic Transplantation
What are the Myeloproliferative Neoplasms?
Polycythaemia Vera
Essential Thrombocythaemia
Idiopathic Myelofibrosis
What mutation is associated with Myeloproliferative Neoplasms?
JAK2 V617F
CALR (in some ET)
What are the symptoms of Polycythaemia Vera?
Headaches Itch Vascular occlusion Thrombosis - TIA/Stroke Splenomegaly
What are the lab features of Polycythaemia Vera?
Raised Hg and Hematocrit
Raised WCC
Raised platelets
Raised Uric acid
How is Polycythaemia Vera treated?
Venesections
Aspirin
Hydroxycarbamide/a-interferon
JAK2 inhibitor
Polycythaemia Vera can progress to what?
Stroke if uncontrolled
Bone marrow failure
Acute Myeloblastic Leukaemia
How does Essential thrombocythaemia present?
Arterial thromboses Digital ischaemia Gout Headache Splenomegaly
How is Essential thrombocythaemia managed?
Aspirin
Hydroxycarbamide
