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clinical biomedicine > W3: Leukaemias, Lymphomas and Myelomas > Flashcards

W3: Leukaemias, Lymphomas and Myelomas Flashcards

1
Q

define leukaemia

A

cancer of wbcs

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2
Q

define lymphoma

A

cancer of lymphoid tissue

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3
Q

define myeloma

A

cancer of clonal plasma cells in BM (B cells)

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4
Q

4 main types of leukaemia

A

Acute myeloid leukaemia (AML)
Acute lymphoblastic leukaemia (ALL)
Chronic myeloid leukaemia (CML)
Chronic lymphoid leukaemia (CLL)

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5
Q

2 types of lymphoma

A

Hodgkin’s
Non-Hodgkin’s

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6
Q

2 cell cycle abnormalities that cause cancer + where do they occur

A

mutations in proto-oncogenes

mutations in tumour suppressor genes

occurs in BM or peripheral lymphoid tissue

*mutation in single gene

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7
Q

incidence vs prevalence

A

i = rate of new cases in given time period/ % of pop at risk of dev

p = no. of people already w condition

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8
Q

known causes of leukaemia

A
  • previous chemotherapy w alkylating agents
  • radiation exposure
  • benzene/ formaldehyde exposure
  • genetic conditions (down’s syndrome)
  • myelodysplasia (pre-leukaemia)
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9
Q

dysplasia vs myelodysplasia

A

d = abnormal dev
md = abnormal dev of myeloid cells (pre-leukaemia)

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10
Q

define acute myeloid leukaemia

A

> 20% myeloblast cells (immature wbcs) in blood/ BM

affects myeloid line (granulocytes + monocytes)

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11
Q

define acute lymphoid leukaemia

A

> 20% lymphoblast cells (immature wbcs) in blood/ BM

affects lymphoid line

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12
Q

define chronic myeloid leukaemia

A

chronic = incr no. of mature cells than blast cells

affects myeloids (granulocytes + monocytes)

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13
Q

define chronic lymphoid leukaemia

A

chronic = incr no. of mature cells than blast cells

affects lymphocytes

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14
Q

AML: median age

A

60yrs

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15
Q

AML: signs + symptoms + why

A
  • Acute, often critically ill
  • Malaise, fever, sweats (high E use of uncontrolled prolif - hot + sweaty)
  • Symptoms of anaemia (BM too crowded so no space + nutrients to make rbcs)
  • Neutropenia - infections
  • Thrombocytopenia - bleeding / DIC
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16
Q

what type of anaemia can be seen in AML + why

A

normocytic normochromic bc nothing wrong w prod of rbcs just not enough space to make them

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17
Q

testing to distinguish btwn myeloid leuk vs lymphoid leuk

A

m = myeloperoxidase (MPO) pos (enzyme found in granulocytes)

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18
Q

prognosis of AML

A

chemo leads to complete remission in 80-90% younger patients
cure rate lower ~45%

older patients - 5yr survival rate ~15%
cure rate rare

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19
Q

define “in remission”

A

cancer repressed to <5% blast cells

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20
Q

chemotherapy side effects

A

chemo = cytotoxic drugs = toxic to all rapidly dividing cells (healthy or not)

side effects:
- hair loss (bc hair follicles divide fast)
- nausea + vomiting (bc mucus mem gut lining cant divide)
- decr in sperm prod -> infertility

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21
Q

ALL: peak age, % of childhood leukaemias, ratio caused by B to T cells, categories

A

0-4 yrs
80%
85:15
L1-L3

22
Q

ALL signs + symptoms

A
  • Starts abruptly
  • Bone + joint pain
  • Symptoms of BM failure (anaemia, infection, haemorrhage)
  • Generalised lymphadenopathy (enlarged lymph nodes in multiple places)
    Hepatosplenomegaly (liver + spleen reactivated to prod wbcs)
  • Testicular involvement
  • CNS manifestations
23
Q

define sanctuary site

A

places in body where chemo struggles to reach

24
Q

ALL blood test

A

leukocytosis/ leukopenia/ normal wbc count

normo, normo anaemia

neutropenia
thrombocytopenia
wbcs MPO neg

25
Q

ALL prognosis

A

children curable w chemo + CNS prophylaxis

adult cured less freq - stem cell transpalnt
35% 5y survival adults

26
Q

CML common age range

A

65-85 yrs

27
Q

CML associated w presence of which chromosome

A

Philadelphia

28
Q

CML S+S

A

fatigue, weight loss, sweaty
splenomegaly
hepatomegaly (sensation of fullness)
gout, bruising
leukostasis (clumping of leukocytes)

29
Q

CML blood test

A

leukocytosis, neutrocytosis
incr basophils
normo normo anaemia
thrombocytosis most freq
incr lactate dehydrogenase (LDH)

30
Q

CML prognosis

A

50% 5y survival
indolent (slothful), followed by period of acceleration + final generally fatal leukemic phase
stem cell transplant - can cause mortality
tyrosine kinase inhibitor - imatinib as initial therapy

31
Q

CLL age

A

50+ , peak at 90+

32
Q

CLL S+S

A

asymptomatic
symmetrical + painless enlargement of lymph nodes
symptoms of anaemia
weight loss
indolent

33
Q

CLL blood test

A

lymphocytosis
wbcs appear as small + round lymphocytes
smear cells (fragile lymphocytes burst during processing)
immunotyping - shows as almost always B cells (bc CD19+ on surface)
normo normo anaemia
thrombocytopenia

34
Q

CLL prognosis

A

initially indolent
chemo not needed immediately
705 5y survival
often die of other causes
becomes more aggressive in advanced stages

35
Q

lymphoma is

A

cancer of lymphoid tissues
e.g
spleen, lymph nodes, tonsils, adenoids, thymus

36
Q

lymphoma effects

A

swollen lymphod tisses fileld w B or T cells

37
Q

% ratio of hodgkins vs non-hodgkins lymphoema + which cells + how distinguished

A

40% H (B lymphs)
60% non-H (T or B lymphs)
biopsy node + stain lymphs
CD15 marker of Reed-Sternburg cells (in hodgkins)

38
Q

hodgkins lymphoma

A

Malignant B-cells accumulate in lymph nodes
malignant cells = minority of tumour
inflammatory cells = majority

39
Q

2 peak ages of hodgkins

A

15-35
over 50

40
Q

hodgkins S+S

A

asymmetrical + painless lymphadenopathy (swollen lymph nodes)
splenomegaly
fever, night sweats, wt loss, pruritus (itching), fatigue in minority

41
Q

hodgkins blood test

A

normo normo anaemia
eosinophilia
neutrophilia
normal/ incr platelet count
advanced disease - lymphopenia, thrombocytopenia

42
Q

hodgkins prognosis

A

80% 10y survival
largely determined by stage of disease
chemo -> high cure rates
risk of 2ndary malignancy as late side effect of treatment

43
Q

non-hodgkins age

A

85-89

44
Q

non-hodgkins S+S

A

asymmetrical painless lymphadenopathy
Less fever, night sweats + wt loss than w Hodgkin’s
Sore throat
Symptoms of anaemia/ thrombocytopenia/ neutropenia w infections
Acute abdominal symptoms due to spleen/ liver enlargement + involvement of GI tract

45
Q

non-hodgkins blood tests

A

normo normo anaemia - maybe autoimmune haemolytic anaemia
in advanved diseas w marrow involvement - neutropenia, thrombocytopenia
lymph node biopsy
cytogenics (chromosome mapping)

46
Q

non-hodgkins prognosis

A

55% 10y survival
indolent
chemo effective
cure elusive
aggressive NHL cured w chemo + ruiximab
stem cell transplant

47
Q

multiple myeloma (MM)

A

cancer of clonal plasma cells in BM (B cells)

48
Q

MM detected by

A

Ab secreting B cells that secrete paraprotein (aka M protein) (detectable in serum/ urine)

49
Q

MM age + race most effected

A

85-89
african americans

50
Q

MM S+S

A

bone pain, fractures
anaemia symptoms
thrombocytopenia
leukopenia
renal failure, hypercalcaemia
amyloidosis (deposition of abnormally folded proteins)

51
Q

MM blood tests

A

incr plasma cells in BM
presence of paraprotein
normo normo OR macro anaemia
pancytopenia
hypercalcemia

52
Q

normo

A

clinical biomedicine (23 decks)

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