Leukaemia

Question 1

AML is a neoplasm of infiltration of __, __, __ by ____ of haematopoietic system

Answer 1

Blood, bone marrow, other tissues
Prolfierative, clonal, poorly differentiated cells

Question 2

Risk factors for leukaemia

Answer 2

1. Idiopathic
2. Pre-malignant mutations
   - Translocation t(9:22) - CML (Philadelphia chromosome)
   - Translocation t(15:17) - AMPL
   - Point mutation FLT3 - AML
   - Deletion 13q14- CLL
3. Down syndrome
4. Fanconi anaemia, ataxia telangiectasis
5. Alkylating agents, topoisomerase II inhibitors, ionising radiation
6. Viruses - HTLV1 and 2

Question 3

General pathogenesis of Leukaemia
1. Monoclonal cells __ and __
2. Replacement of normal haematopoietic cells in bone marrow leading to __ (__)
3. Blast cells leukocytosis causes __
4. Infiltration and proliferation into other organs
(eg: __, __, __)
5. High cell turnover - __ manifesting as __, __

Answer 3

1. Proliferation and increasing abberation
2. Bone marrow failure (pancytopenia)
3. Hyperviscocity syndrome
4. Liver, spleen, CNS, skin
5. Hyperuricaemia - gout, renal failure

Question 4

Acute leukaemias: bone marrow contains ___ (% of what cells)
They are __ and presents __ (onset)
Affects __ and __

Chronic leukaemias: bone marrow contains ____ (% of what cells)
They are __ and presents __ (onset)
Affects __ (does not affect children except __)

Answer 4

Acute leukaemia
> 30% blast cells
Aggressive, weeks
Children and adults

Chronic leukaemias
> 30% matured cells
Slower, months
Adults (only juvenile CML in children)