3 - myeloid & lymphoid leukaemia Flashcards
(20 cards)
what cell types are associated with leukaemias?
group of blood cancers associated with increase in white blood cells
what are the 2 types of acute leukaemias?
- acute myeloid leukaemia (AML)
- acute lymphoblastic leukaemia (ALL)
what are the 2 types of chronic leukaemias?
- chronic myeloid leukaemia (CML)
- chronic lymphocytic leukaemia (CLL)
what is acute leukaemia? what is buzzwordy thing
= proliferation of primitive progenitors, blocked maturation.
excess of blasts = buzzword for acute leukaemia
what is acute lymphoblastic leukaemia?
= accumulation of lymphoblasts (lymphoid progenitors) - maturation problem so no T & B lymphocytes
= it’s the most common childhood cancer
what is acute myeloid leukaemia?
= accumulation of myeloblasts. get no RBCs, no WBC, no platelets - since no maturation
- more in older people, can happen randomly (de novo)
what is clinical presentation of acute leukaemias?
both have marrow failure so anaemia (consequence no RBCs), infections (consequence no WBC), bruising (consequence no platelets)
ALL = also has CNS & testes involvement
what are investigations for acute leukaemia?
- blood count & blood film
- coagulation screen for DIC (can be in acute myeloid leukaemia
- bone marrow biopsy
what is auer rod on blood film?
suggests acute myeloid leukaemia
what is definitive diagnosis for leukaemias?
immunophenotyping
what is treatment for acute leukaemias?
- supportive blood products
- different chemo - ALL and AML both have different types and lengths treatment
- can get allogeneic (bone marrow) stem cell transplant
what is Hickman line?
central line going into subclavian vein sitting between SVC & RA = good as stays in for months
what are 3 big problems of bone marrow suppression? (like symptoms)
- anaemia
- neutropenia - severe infections. especially sepsis from gram -ve (need urgent antibiotics)
- thrombocytopenia - bleeding showing as purpura or petechiae
what infections are people with acute leukaemia especially susceptible to?
all infections but particularly gram -ve as can cause life threatening sepsis, if infective then give immediate antibiotics. if don’t make effect then think about fungal infection like aspergillus
what are complications of chemo treatment for acute leukaemia?
- nausea & vomiting
- hair loss
- liver & renal dysfunction
- tumour lysis syndrome (tumour cells die releasing toxic chemicals)
- infection, sepsis since make immunocompromised
- pneumocystitis pneumonia is risk
*long term can get loss fertility & cardiomyopathy if use anthracyclines (chemo drug)
what is chronic myeloid leukaemia? what causes? what is unusual about first few years?
= clonal stem disorder of primitive compartment
- caused by philadelphia chromosome translocation from 9 to 22 (BCR-ABL1 re-arrangement)
- first 3-5yrs there is preserved maturation so lots made but all normal functioning, then will just randomly change and maturation stops meaning build up of blasts
what is chronic lymphocytic leukaemia?
= clonal lymphoproliferative disorder of mature B lymphoid
- infiltrates blood & bone marrow
- it’s most common type adult leukaemia, slower pace of diagnosis
what is presentation of chronic lymphocytic leukaemia?
= often no symptoms since slow working
- can have symptoms of areas affected e.g. lymph node, spleen enlargement, bone marrow infiltration
what is buzzword for chronic lymphocytic leukaemia? (histology)
smear cell = fragile cells that splatter membrane so look like smudges
what is treatment for chronic lymphocytic leukaemia?
- can be no treatment
- can just be supportive blood products
- would treat more aggressively like cancer if night sweats, fever, weight loss, spleen or lymph node problems etc
*it’s incurable disease but can have long life, also targeted treatments that help symptoms
