Haematological Malignancies Flashcards

(30 cards)

1
Q

What is the epidemiology of haematological malignancies?

A
  • Haematological Malignancies account for approximately 10% of all human cancers
  • They occur in all age groups, including children
  • Adult males are more commonly affected than females
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2
Q

How does the incidence of lymphomas compare to other cancers?

A

Significantly lower in comparison to lung, colorectal and breast

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3
Q

What is the age distribution of new Hodgekin lymphoma cases?

A

Increase in incidence between 20-35 and 70+

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4
Q

What is the age distribution of Non-Hodgkin lymphoma?

A

Increases with age with peak between 70 and 85

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5
Q

What is the pathogenesis of haematological malignancy?

A
  • Multi step process
  • Result of acquired genetic alterations to a long lived cells
  • Proliferative/survival advantage to that mutated cell
  • Production of malignant cone
  • Malignant clone grows to dominate the tissue
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6
Q

What are the properties of stem cells?

A
  • Able to re-new

- Able to differentiate

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7
Q

What is the origin of myeloid malignancies?

A
  • RBC
  • Platelets
  • Granulocytes
  • Monocytes
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8
Q

What is the origin of lymphoid malignancies?

A
  • B-cell

- T-cell

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9
Q

What type of cancer arises from myeloid progenitor cells?

A

Acute myeloid leukaemia

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10
Q

What type of cancer arises from lymphoid progenitor cells?

A

Acute lymphoblastic leukaemia

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11
Q

What occurs in acute myeloid leukaemia?

A
  • Ongoing proliferation

- Failure to differentiate

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12
Q

What occurs in myeloproliferative disorders?

A
  • Ongoing proliferation at a high rate

- Ongoing differentiation

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13
Q

What occurs in acute lymphoblastic leukaemia?

A

-Proliferation without differentiation

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14
Q

What type of cancer arises from WBC, platelets and RBCs?

A

Myeloproliferative disorder

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15
Q

Leukaemia vs Lymphoma

A

Descriptive terms related to distribution of disease

  • Leukaemia is in the blood and bone marrow
  • Lymphomas is in the lymph glands and other solid tissues
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16
Q

What are the major groups of haematological malignancies?

A
  • Acute leukaemias
  • Chronic leukaemias
  • Malignant lymphomas
  • Multiple myeloma
  • Myelodysplastic syndromes
  • Chronic myeloproliferative neoplasms
17
Q

Name 2 types of acute leukaemia.

A
  • Acute lymphoblastic leukaemia

- Acute myeloid leukaemia

18
Q

Name 2 types of chronic leukaemia.

A
  • Chronic myeloid leukaemia

- Chronic lymphocytic leukaemia

19
Q

Name 2 types of malignant lymphomas.

A
  • Non-Hodgekin lymphoma

- Hodgekin Lymphoma

20
Q

What are the features of acute leukaemia?

A
  • Leukaemic cells do not differentiate
  • Bone marrow failure
  • Rapidly fatal if untreated
  • Potentially curable
21
Q

What are the features of chronic leukaemia?

A
  • Leukaemic cells retain ability to differentiate
  • Proliferation without bone marrow failure
  • Survival for a few years
  • Potentially curable with modern therapy
22
Q

What are the clinical features of acute leukaemia?

A

Triad of bone marrow failure

  • Anaemia
  • Thrombocytopenic bleeding (purpura and mucosal membrane bleeding)
  • Infection because of neutropenia (predominantly bacterial and fugal)
23
Q

When do lymphomas commonly occur?

A

As lymphocytes pass through the germinal centres of lymph node follicles

24
Q

Briefly describe B cell maturation.

A
  • Progenitor B cell> Pre B cell>Immature B cell in the bone marrow
  • Naïve B cells migrate to the germinal centres of lymph node follicles where they are prented with antigens as centroblasts and undergo somatic hypermutation to form centrocytes
  • They can mature into memory B cells or plasma cells
25
How do lymphomas present?
Lymphadenopathy - > 90% HL present with nodal disease - 60% NHL present with purely nodal disease Extranodal disease -40% of NHL present with an extranodal component Systemic symptoms -Fever, drenching sweats, loss of weight, pruritus, fatigue
26
What does localised and painful lymphadenopathy suggest?
Bacterial infection in draining site
27
What does localised and painless lymphadenopathy suggest?
Rare infections, catch scratch fever, TB - Metastatic carcinoma from draining site- hard - Lymphoma-rubbery - Reactive, no cause identified
28
What does generalised and painful/tender lymphadenopathy suggest?
Viral infections like EBV, CMV, hepatitis and HIV
29
What does generalised and painless lymphadenopathy suggest?
- Lymphoma - Leukaemia - Connective tissue disease, sarcoidosis - Reactive, no cause identified - Drugs
30
What are the clinical features of myeloma?
- Bone pain and lytic lesions - Anaemia - Recurrent infection - Renal failure - Amyloidosis - Bleeding tendency - Hyperviscosity syndrome