Leukaemia Symposium Flashcards

1
Q

What is cancer?

A

Transformed cell phenotype: uncontrolled proliferation; failure to undergo apoptosis
Genetic: oncogenes, tumour suppressor genes
Epigenetic: dysregulated gene expression; aberrant DNA methylation

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2
Q

Acute Myeloid Leukaemia

A

Uncontrolled proliferation of primitive cells in the bone marrow
Causes of bone marrow failure: anaemia, infections, bleeding
Blasts identified on blood film

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3
Q

How is it treated?

A

Chemotherapy - combination regimes; myelo-ablative cycles of treatment
Supportive therapy: antibiotics/antifungals; transfusions of blood and platelets
Allogenic stem cell transplantation: allograft from sibling/matched unrelated donor (Anthony Nolan)

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4
Q

Risk of neutropenic sepsis

A

Medical emergency
Gram negative bacteria are most dangerous
Blood cultures and blind antibiotic therapy if fever >38 degrees
- 1st line: Tazocin (piperacillin/tazobactam) +/- Gentamicin
- 2nd line – switch to meropenem +/- Teicoplanin (for Gram +ve)
- 3rd line – add anti-fungal e.g. ambisome (amphotericin)
Resuscitate patient with IV fluids if hypotensive
May require inotropic support on ITU

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5
Q

Graft vs Host disease

A

Caused by donor/host mismatches in major and minor HLA loci
Prevented by using: T cell depletion of infused donor cells, and immunosuppression of recipient
Clinical manifestations: skin rash, diarrhoea, deranged liver function
Graft vs leukaemia is how the stem cell transplant cures leukaemia
Donor lymphocyte infusions post treatment can treat relapse by augmenting GVL effect

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