Haematology Flashcards
MoA of venetoclax
Bcl2 inhibitor (which is anti-apoptotic –> restores apoptosis)
A/E of Venetoclax
TLS
MoA of ibrutinib
Blocks Brutons TKI
A/E of ibrutinib
AF
Indication for venetoclax
CLL refractor to FCR chemotherapy
Treatment of MDS with 5q deletion
Lenalidomide
High risk MDS treatment strategies
HSCT eligible? - transplant
Not transplant eligible - azacitidine
MoA of idelalisib and indication
Pl3 kinase inhibitor
Refractory CLL
anti CD33?
GEmtuzumab
Add to CD33 +ve AML
What to add for FLT3 positive AML to 7+3 induction
Add midostaurin
2 main A/E of CAR-T cell
CRS
ICANS
A/E of idelalisib
Increased risk opportunistic infections
Test for Fanconi’s anaemia
Chromosome fragility studies
CAL-R mutation associated with what FBE abnormality
Elevated Plt
- ET, prefibrotic PMF
Driver mutations for myeloproliferative disorders
JAK-2 - most common
CAL-R
MPL
Highest myeloproliferative at risk of transformation to AML
CML (if untreated)
Otherwise PMF
PRV High risk
How does this affect treatment?
High risk = age > 60, thrombosis, or high WCC/Plt
Add hydroxyurea to phlebotomy aiming < 0.45 and aspirin
High risk ET
Age > 60, thrombosis, Plt > 1500, symptomatic splenomegaly
Add hydroxyurea to aspirin
Management of PRV
Low risk - aspirin and venesection aiming HCT < 0.45
High risk - add hydroxyurea
Tear drop cells
Myelofibrosis
Dry tap
Myelofibrosis
Ruxolitinib MoA
JAk-2 inhibitor
Benefits of ruxolitinib
Improves splenomegaly
Improves constitutional symptoms
A/E of ruxolitinib
Cytopaenias
Increased ifnection risk
Pitted erythrocytes
Hyposplenism
Howell Jolly Bodies
Hyposplenism
Features of hyposplenisms, should be concerned for?
OPSI - overwhelming post splenectomy infection
Functions of spleen (3)
White pulp - 2nd lymphoid organ
Red pulp - filtration (RBC’s, deformed blood cells, bacteria)
Haematopoiesis - thalassaemia and PMF
Causes of hyposplenism
Anything that can acuse damage to spleen
- SCT, hSCT
- Autoimmune
- Hepatic - ALD, cirrhosis
- Splenic vasculature changes
Features of leukaemoid reaction
Toxic granulation
Toxic vacuolation
Dohle bodies - small blue inclusions
B cell markers
CD19
CD20
Kappy/lambda
T cell markers
CD3
CD4
CD5
CD8
Stem cell marker
CD34
Inheritance vWD
Autosomal dominant