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Flashcards in Acute Leukaemia Deck (18)
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What is acute leukaemia?

The accumulation of early MYELOID or LYMPHOID precursors in the BONE MARROW and other tissues


What is leukaemia usually the result of?

Mutations in haemopoietic stems cells

- Cannot differentiate into mature blood cells


What are the two main types of leukaemia?

Lymphoid leukaemia

Myeloid leukaemia

(further divided into various subgroups)


What are the features of blast cells in AML?

-High nucleus:cytoplasm ratio
- presence of granule


What are the feature of blast cells in ALL?

Higer nucleus:cytoplasm ration (very little cytoplasm)
- smaller than AML blasts
- rounder


What are the clinical features of acute leukaemia? What are the specific

Anaemia - hypochromic, microcytic

Infection (immunocompromised e.g. candida, perianal infection - E coli, strep faecalis)

Early bruising/haemorrhage - thrombocytopenia

Organ infiltration by leukaemia cells e.g. spleen, liver, meninges, testes, skin


How is acute leukaemia diagnosed?

Morphology - look at cells!

Immunological markers**



How are acute myeloid leukaemia classified? What are the two classification systems and what do they look at?

French American and British (FAB) - morphological features - see different points in maturation

WHO - risk adapted


How does immunological markers work?

Monoclonal antibodies with fluorochrome attached added

Attached to cell surface antigens

Fluorochrome absorbs light and releases wavelength

- Indicates presence of antigens which = diagnostic


What is trisomy 9:22? (T(9;22))

Philadelphia chromosome - driver for chronic myeloid leukaemia


What cytogenetic abnormalities are associated with a good and bad prognosis of Acute leukaemia?

T(15:17) (T8:21) = good prognosis

Mysomy -5, -7 = bad


What type of chromosomal abnormalities are associated with ALL?

Abnormalities in number of chromosomes


What are the poor prognostic factors for ALL?

-Increasing age (>10yrs)
-High white cell count (>50)
-Cytogenetic abnormalities (discussed)
- T cell - ALL (worse than B-cell ALL)


What genetic mutations are associated with a good and poor diagnosis?

NPM1 = good

FLT3 - bad


What is the management for AML?

Chemotherapy - 4 courses - 2 intensive, 2 consolidation (obtain remission)

Bone marrow transplant in young patient


What is the management for ALL?

Induction and intensive consolidation chemotherapy

Prophylaxis of meningeal leukaemia with methotrexate

Bone marrow transplant in bad risk patients


What is neutropenic sepsis? How is it diagnoses>

Intensive chemotherapy will destroy patient neutrophils

Pyrexia with neutrophil count being less than 1 x19^9


How is neutropenic sepsis managed?

Rapid administration of broad spectrum IV antibiotics

Protective isolation

Prophylactic antibiotics

Use of GCSF

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