Paediatric oncology

Question 1

What are the most common types of cancers in chidlren?

Answer 1

Leukaemias and brain tumours.

Question 2

What is leukaemia?

Answer 2

cancer of white blood cells.

Question 3

What is the most common type of leukaemia in children?

Answer 3

Acute lymphoblastic leukaemia

Question 4

What is the peak age of ALL?

Answer 4

2-5y

Question 5

What is the pathophysiology of ALL?

Answer 5

Rapidly proliferating lymphocytes resulting in accumulation of abnormal, immature blast cells (B or T lymphocytes)

Question 6

What are the symptoms of ALL?

Answer 6

Onset over several weeks:
General: malaise, anorexia, lymphadenopathy, hepatosplenomegaly
Anaemia: Lethargy, pallor, SOB
Neutropenia: infections= risk of neutropenic sepsis
Thrombocytopenia: bruising, petechiae, nose bleeds
Bone marrow infiltration: bone pain
CNS infiltration: headaches, vomiting

Question 7

What are the investigations and results for ALL?

Answer 7

FBC: decreased Hb, platelets, neutrophils and increased or decreased WCC
Peripheral blood film: blast cells
Clotting screen: 10% have DIC
Bone marrow biopsy: diagnostic and prognostic
CXR: mediastinal mass (characteristic of T cell disease)