Acute Leukaemia Flashcards Preview

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Flashcards in Acute Leukaemia Deck (29):
1

what is acute leukaemia

haematopoietic blast cells constitute >20% bone marrow cells

2

what is the most common type of malignancy in childhood

ALL

3

when does AML occur

at all ages

4

clinical features

short hx symptoms due to bone marrow failure- anaemia, abnormal bruising/bleeding, infection; weating, fever, weight loss, malaise

5

what signs are present

lymphadenopathy and hepatosplenomegaly freq especially in ALL

6

what is common in promyelocytic AML

DIC

7

lab features

anaemia, thrombocytopenia, neutropenia. leucocytosis. infiltration by blast cells.

8

good prognostic features in ALL

female, 2-9 years, low WCC, absent extramedullary disease, 4 weeks remission speed, 1 week clearance peripheral blood blasts, negative minimal residual disease in bone marrow at 1-3m

9

good prognostic indicators in AML

remission after one course chemo.

10

what can AML be a result of (iatrogenic)

chemo treatment eg for lymphoma

11

what is AML associated with

myelodysplastic states, radiation, syndromes. progresses rapidly

12

what rods are diagnostic of AML

auer rods

13

what is the first stage of treatment

remission induction- high dose intensive combination chemo - reduce or eradicate leukaemic cells from bone marrow, re establish normal haemopoiesis. post induction chemo- initially intensive then for ALL less- maintenance chemo

14

what is remission

normal FBC,

15

treatment AML

anthracycline- daunorubicin, cytosine arabinoside.

16

prognosis AML

80% 85% with 2 courses. 30-50% cured 15-55yrs

17

treatment ALL

remission induction with vincristine, dexamethasone and L-asparaginase; often with daunorubicin or cyclophosphamide.

18

what is maintenance and how long for in AML

mercaptopurine daily, weekly methotrexate, monthly vincristine and dexamethasone. for further 2-3 years

19

what system is commonly involved in ALL

CNS- so give intrathecal methotrexate and high dose systemic chemo

20

when can stem cell transplant be used

allogeneic stem cell transplantation in adults

21

prognosis ALL

80% children cured

22

what is tumour lysis syndrome

metabolic abnormalities due to the massive destruction of cells. hyperkalaemia, incr urate, decr calcium, renal injury

23

treatment tumour lysis syndrome

fluid intake and allopurinol

24

side effects cancer treatment

tumour lysis syndrome, hyperviscosity, DIC, neutropenic sepsis

25

what happens in hyperviscosity

if WCC >100x10^9/l thrombi in brain, lungs, heart.

26

treat hyperviscosity

lower WCC with hydroxycarbamide, transfusion

27

what is neutropenic sepsis

neutrophils

28

treatment neutropenic sepsis

piperacillin-tazobactam (tazocin)

29

what treatment can you give in promyelocytic leukaemia

trans retinoic acid