SYMPOSIUM: Leukaemia Flashcards
Give examples of white blood cells
Neutrophil, eosinophil, basophil, monocyte, lymphocyte, and activated lymphocyte
What are growth factirs?
Chemical involved in maturation
What is G-CSF?
Granulocyte colony stimulating factor. It promotes maturation of neutrophils
What are some clinical features of Leukaemia?
Myelofibrosis causing splenomegaly, polycythaemia rubra vera (too many RBC’s), Essential thrombocythemia (too many platelets)
JAK-STAT is the signalling pathway for which factors?
Erythropoietin and G-CSF
What is chronic myeloid leukaemia characterised by?
Too many white cells
What is the ‘Philadelphia chromosome’?
The chromosome mutation common to those with chronic myeloid leukaemia
What is FISH used for?
It detects the BCR-ABL oncogene to diagnose chronic myeloid leukaemia
What is the mechanism of action for Imatinib?
It binds to ABL kinase and normalises blood counts. It’s the first targeted treatment for cancer
Is it true that CML can occasionally transform into AML?
Yes
What is acute myeloid leukaemia characterised by?
Uncontrolled proliferation of primitive cells in the bone marrow and causes bone marrow failure
What are leukaemia blasts?
Rapidly dividing cells that don’t function properly
What are some clinical features of AML?
Anaemia, infections, Disseminated intravascular coagulation (DIC), ulcers, infiltration, and bruising
How can AML be diagnosed?
Morphology, genetics, cytogenetics, FISH
How is AML treated?
Chemotherapy
What is supportive therapy and why is it needed with AML?
Antibiotics, antifungals and blood transfusions given because while the bone marrow is recovering from chemotherapy, the patient is at risk of opportunistic infections
What is an allograft?
A tissue graft from a donor of the same species as the recipient but not genetically identical
What are the lines of treatment for neutropenic sepsis?
1st line - Tazocin +/- Gentamcin
2nd line - Switch to Meropenem +/- Teicoplanin for Gram +ve bacteria
3rd line - Add antifungal like Ambisome
What is graft-vs-host disease?
Caused when there is a mismatch between major or minor HLA loci
How can graft-vs-host disease be prevented?
T-cell depletion of infused donor blood and immunosuppression of patient
What are -mab drugs?
Monoclonal antibodies
What are -nib drugs?
Small molecule inhibitors
What is the most common leukaemia in children?
ALA (Acute lymphoblastic anaemia)