myeloproliferative disorders (lymphoid/myeloid) - haematological disease Flashcards
acute leukaemia in general terms is
proliferation of primitive precursor cells usually only found in bone marrow
replaces normal one marrow cells
what can acute leukaemia lead to
anaemia
palor and lethargy
neutropenia leading to infections
thrombocytopenia- bleeding
types of leukaemia
lympoid
- acute lymphoblastic leukaemia
Chronic lymphatic leukaemia
Myeloid
- acute myeloid leukamia
chronic myeloid leukaemia
acute lymphoblastic leukaemia
malignant proliferation of lymphoblasts in bone marrow
treatment of acute lymphoblastic leukaemia
- induction chemotherapy
- consolidation chemo +/- craniospinal irradiation
- maintenance chemotherapy
- bone marrow transplantation only if relapse
acute myeloid leukaemia
malignant proliferation of myeloblasts in bone marrow
treatment of acute myeloid leukaemia
- cyclical high dose chemotherapy (induction and consolidation with no maintenance)
- sometimes bone marrow transplantation
what to check for orally for acute myeloid leukaemia
gum infiltrate in acute moncytic subtype
- pts with gum hypertrophy do blood count to check for leukamia
chronic lympathic leukaemia and presentation
proliferation of mature lymphocytes
usually B cells
anaemia, infections, lymphadenopathy, splenomegaly
chronic myeloid leukaemia phases
high white cell count (i.e. too many) and splenomegaly 3 phases - chronic - accelerated - blast crisis
treatment of chronic myeloid leukaemia
1) imatinib
- blocks abnormal BCR-ABL tyrosine kinase activity
- can result in molecular remission
2) allogenic stem cell transplantation
myelodysplasia
premalignant condition of haemopoietic precursors
can move to acute myeloid leukaemia
types of lymphoma
Hodgkin lymphoma
non Hodgkin lymphoma
hodgekin lymphoma
painless lymphadenopathy
B symptoms - sweats, weight loss, fever
B lymphocytes multiply in abnormal way
treatment of hodgekin lymphona
chemotherapy
radiotherapy
stem cell transplantation
types of non Hodgkin lymphoma
indolent or low grade
aggressive or high grade
indolent/low grade non hodgekin + treatment
- gradual onset
- usually advanced at presentation
- incurable
- can be asymptomatic
Treatment - chemotherapy
- radiotherapy
- transplantation
aggressive or high grade non Hodgkin + treatment
- rapidly progressive
- usually symptomatic
- potentially curable
Treatment - chemo
- radio
- transplantation bone marrow
what is a myeloproliferative disorder
proliferation of cells in the marrow
myeloproliferative disorders
1) polycythaemia rubra vera
2) chronic myeloid leukamia
3) essential thrombocythaemia
4) myelofibrois
what is polycythaemia rubra vera
red cell proliferation
primary and secondary
what is chronic myeloid leukamia
white cell proliferation
essential thrombocythaemia
platelet proliferation
myelofibrosis
marrow stroma proliferation
what is secondary polycythaeia due to
- hypoxic: high altitude, lung or cyanotic heart disease
- inappropriate erythropoietin secretion: renal tumour can stimulate production
primary polycythaeia causes and treatment
- thrombosis
- pruritus, plethoric facies
- splenomegaly, hepatomegaly
Treatment
- venesection, aspirin, myelosuppression
primary thrombocytosis
uncontrolled malignant proliferation of megakaryocytes
platelets more than 600+
treatment of thrombocytosis
aspirin etc
secondary thrombocytosis
bleeding
infection
inflammation
malignacy
normal platelet count
150-400
multiple myeloma
malignant proliferation of plasma cells in the bone marrow
myeloma has monoclonal immunoglobulin in blood and urine
symptoms of mutliple myeloma
lytic lesons in bones hyper calcaemia due to bone resopriton renal failure anaemia infections
diagnosis and treatment of mutiple myeloma
blood/urine test
x ray/MRI
bone marrow
Tx - chemotherapy thalidomide bortezomib radiation stem cell transplantation
