ALL & CLL Flashcards
What does ALL stand for?
acute lymphoblastic leukemia
What is the definition of ALL?
Neoplastic lymphoblast (immature) proliferation
Mostly B cell lineage
What causes ALL?
t(12:21) with good prognosis
It is the most common what?
Most common childhood malignant - 75% cases
>6 y/o
What Is ALL associated with?
Downs (30 times risk)
radiation
Symptoms of ALL
General leukemia
except 6y/o with downs, hepatosplenomegaly (&pain in lymph nodes)
Diagnosis of ALL
FBC = pancytopenia
Blood film = increased lymphoblasts
BM Biopsy = >20% lymphoblasts (DIAGNOSTIC)
Immunofluorescence = TdT positive lymphoblasts (terminal deoxynucleotidyl transferase) - DNA polymerase in nucleus of lymphoblast
Treatment of ALL
Chemo
(consider allopurinol)
typically good
What does CLL stand for?
Chronic lymphocytic leukemia
What is CLL?
Neoplastic proliferation of lymphocytes
Mostly B cells
Which is the most common leukemia ?
CLL
Later life
Ok prognosis (75% 5 year survival)
Symptoms of CLL?
Patient?
70 year old men with general anemia
Lymphadenopathy (non tender) - build up of B cells in lymph nodes/system
Hepatosplenomegaly (abdominal fullness)
Diagnosis of CLL?
What tests?
FBC = pancytopenia (except lymphocytes)
Blood film = smudge cells (immature B cells broken during smear)
Immunoglobulins = hypogammaglobulinemia - B cells proliferate but don’t differentiate to plasma cells (these are Ig producing cells)
Treatment for CLL
Progressive =chemo, palliative (if old)
(+ consider allopurinol)
(Also IV for hypogammaglobulinemia)
Complications of CLL
Richter transformation; B cell massively accumulates in lymph nodes = massive lymphadenopathy + transformation from CLL to aggressive lymphoma
