Myeloid malignancy Flashcards

1
Q

What are myeloid malignancies?

A

Bone marrow cancers of red cell, platelet, monocyte and granulocyte origin

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2
Q

What are lymphoid malignancies?

A

B and T cell origin bone marrow cancer

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3
Q

Acute Myeloid Leukaemia originates in which cells?

A

Myeloid Progenitor cells

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4
Q

What are the main groups of myeloid malignancies?

A

Acute Myeloid Leukaemia
Chronic Myeloid Leukaemia
Myelodysplastic Syndromes
Myeloproliferative Neoplasms

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5
Q

How does Acute vs Chronic myeloid leukaemia differ?

A

Acute - do not differentiate, bone marrow fails rapidly, curable
Chronic - differentiate, no marrow failure, few years survival

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6
Q

What are the Sub groups of Acute Leukaemia?

A

Acute Myeloblastic Leukaemia

Acute Lymphoblastic Leukaemia

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7
Q

What are the typical features of Acute Myeloblastic Leukaemia?

A

Anaemia
Mucosal bleeding with purpura
Infection (neutropenia)

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8
Q

What infections are common in Acute Myeloblastic Leukaemia?

A

Bacterial and fungal

Aspergillosis

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9
Q

What investigations are used in suspected leukaemia?

A
Blood count
Blood film
Bone marrow Aspirate 
Cytogenics and Immunophenotyping
CSF examination
Targetted molecular genetics
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10
Q

What treatment is used in Acute Myeloblastic Leukaemia?

A
Anti-lukaemic Chemotherapy 
Allogeneic stem cell transplant 
All-trans retinoic acid
Arsenic trioxide 
Targeted antibodies
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11
Q

What are the symptoms of Chronic Myeloblastic leukaemia?

A
Anaemia
Splenomegaly 
Weight loss
Gout 
Hyperleukostasis
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12
Q

What are the symptoms of hyperleukostasis?

A

Fundal haemorrhage
Venous congestion
LoC
Respiratory failure

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13
Q

What is typical of a FBC in Chronic Myeloblastic leukaemia?

A
Anaemia
Elevated WCC (very high)
High platelets 
White cell differentiation on blood film (Basophils++)
Hypercellular bone marrow
Philadelphia chromosome
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14
Q

What are the treatment for Chronic Myeloblastic leukaemia?

A

Tyrosine Kinase Inhibitors
BRC-ABL direct inhibitors
Allogeneic Transplantation

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15
Q

What are the Myeloproliferative Neoplasms?

A

Polycythaemia Vera
Essential Thrombocythaemia
Idiopathic Myelofibrosis

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16
Q

What mutation is associated with Myeloproliferative Neoplasms?

A

JAK2 V617F

CALR (in some ET)

17
Q

What are the symptoms of Polycythaemia Vera?

A
Headaches
Itch
Vascular occlusion
Thrombosis - TIA/Stroke
Splenomegaly
18
Q

What are the lab features of Polycythaemia Vera?

A

Raised Hg and Hematocrit
Raised WCC
Raised platelets
Raised Uric acid

19
Q

How is Polycythaemia Vera treated?

A

Venesections
Aspirin
Hydroxycarbamide/a-interferon
JAK2 inhibitor

20
Q

Polycythaemia Vera can progress to what?

A

Stroke if uncontrolled
Bone marrow failure
Acute Myeloblastic Leukaemia

21
Q

How does Essential thrombocythaemia present?

A
Arterial thromboses
Digital ischaemia 
Gout 
Headache
Splenomegaly
22
Q

How is Essential thrombocythaemia managed?

A

Aspirin

Hydroxycarbamide