FN: Acute Lymhoblastic Leukaemia Flashcards Preview

Final Notes > FN: Acute Lymhoblastic Leukaemia > Flashcards

Flashcards in FN: Acute Lymhoblastic Leukaemia Deck (18):
1

epi

Children 2-5 years (commonest childhood cancer)
Rare in adults

2

Aetiology

Arrest of maturation and proliferation of lymphoblasts
-80% B lineage
20% T lineage

3

B lineage

t12,21

4

T lineage

T cells present
Thymus mass
Teenage
forms lymphoma

5

risk factors

Genetic susceptibility (often Chr translocations)
Environmental triggers
-radiation (e.g. during pregnancy)
- Downs

6

Features

BM failure
Infiltration

7

Bm failure features

anaemia
Thrombocytopenia - bleeding
Leukopenia - infection

8

Infiltration features

Lymphadenopthy
Orchidomegaly
Thymic enlargemebt
HSM
CNS: CNS palsies, meninigism
Bone pain

9

Investigations bloods show

raised WCC: lymphoblasts
Reduced RBC, reduced PMN, reduced platelets

10

BM aspirate shows

20% blasts
Cytogenic and molecular analuysis

11

CXR and CT shows

Mediastinal and abdominal LNS

12

LP shows

CNS involvement

13

Management

Supportive
Infections
Chemo
BMT

14

Supportive therapy

Blood products
Allopurinol
Hickman line or Portacath

15

Infections

Gentamicin + tazocin
Prophylaxis e.. co-timoxazole, ciprofoxacin

16

Chemotheray (recruited into national trials)

1. Remission induction
2. consolidation + CNS Rx
3. Maintenance for 2-3 yrs

17

BMT

Best option for younger adults

18

Prognosis

85% survival in children
Worse in adults

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