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MBD/MI (Wothaya) > Introduction To Leukaemia > Flashcards

Introduction To Leukaemia Flashcards

1
Q

What is leukaemia?

A

Malignant disorders of haematopoetic stem cells characteristically associated with an increase number of white cells in bone marrow or land peripheral blood

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2
Q

What are haematopoeitic stem cells?

A

Multipotent and self-maintaining

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3
Q

What can progenitor cells divide to produce?

A

Many mature cells

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4
Q

What are examples of progenitor cells?

A

Lymphoid/myeloid

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5
Q

What are the two types of progenitor cells?

A

Undifferentiated and committed

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6
Q

What is a clonal disease?

A

When all malignant cells derive from a single mutant cell

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7
Q

What can you use to diagnose leukaemia?

A

Peripheral blood blast test
Bone marrow biopsy
Lumbar puncture

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8
Q

What does a peripheral blood blast test in the diagnosis of leukaemia?

A

To check the presence of blasts and cytopenia

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9
Q

Where is the bone marrow biopsy taken from?

A

Pelvic bone and results compared with peripheral blood

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10
Q

Why is a lumbar puncture done?

A

To determine if leukaemia has spread to the CSF

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11
Q

What are the possible predisposing factors for leukaemia?

A

Genetic risk factors
Environmental risk factors
Lifestyle-related risk factors

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12
Q

What syndromes increase the likelihood of leukaemia?

A

Downs and fanconi’s anaemia

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13
Q

What are the genetic risk factors for leukaemia?

A

Gene mutations involving oncogenes and/or tumour suppressors
Chromosome aberrations
Inherited immune system problems

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14
Q

What types of chromosomal abberations increase the risk for leukaemia?

A

Translocations

Numerical disorders

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15
Q

What are the environmental risk factors for leukaemia?

A

Radiation exposure
Exposure to chemicals and chemo
Immune system suppression

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16
Q

What type of radiation exposure is a risk factor for leukaemia?

A

Acute radiation accidents

Atomic bomb survivors

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17
Q

What type of exposure to chemicals and chemo is a risk factor for leukaemia?

A

Cancer chemo with alkylating agents

Industrial exposure to benzene

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18
Q

What lifestyle risk factors are there for leukaemia?

A

Smoking
Drinking
Excessive sun exposure
Overweight

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19
Q

What are the risk factors for childhood leukaemia?

A 
Exposure to EM fields
Infections early in life
Mothers age when the child is born
Nuclear power stations
Parents smoking history
Foetal exposure to hormone
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20
Q

What are the four main types of leukaemia?

A

Acute lymphoblastic leukaemia (ALL)
Acute myeloblastic leukaemia (AML)
Chronic lymphocytic leukaemia (CLL)
Chronic granulocytic leukaemia (CML)

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21
Q

What are the features of acute disease (in general)?

A

Rapid onset and short but severe course

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22
Q

What are the features of chronic disease (in general)?

A

Persisting over a long time

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23
Q

What are the features of acute leukaemia?

A

Undifferentiated cells decharacterised by uncontrolled cloning and accumulation of blast cells

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24
Q

What are the characteristics of chronic leukaemia?

A

Differentiated leukaemia

Uncontrolled cloning and accumulation of mature white blood cells (-cyte cells)

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25
What is the normal age of onset of acute leukaemia?
Childhood
26
What is the normal style of onset of acute leukaemia?
Sudden
27
What is the normal duration of acute leukaemia?
Weeks to months
28
What is the normal white blood cell count in acute leukaemia?
Variable
29
What is the normal age of onset of chronic leukaemia?
Middle age and elderly
30
What is the normal style of onset of chronic leukaemia?
Insidious
31
What is the normal duration of chronic leukaemia?
Years
32
What is the normal white blood cell count in chronic leukaemia?
High
33
What is ALL characterised by?
Large number of lymphoblasts
34
What is AML characterised by?
Large number of myeloblasts
35
What is the overarching issue in acute leukaemia?
Arrest of maturation that breaks the balance of proliferation and death
36
What are the typical lab symptoms of ALL/AML?
Thrombocytopenia Neutropenia Anaemia
37
What are the clinical symptoms of thrombocytopenia?
Purpura (bruising) Epistaxis (nosebleed) Bleeding from gums
38
What are the clinical features of neutropenia?
Recurrent infections and fever
39
What are the clinical symptoms of anaemia?
Weakness Tiredness Shortness of breath
40
What are the skin symptoms of leukaemia?
Night sweats Easy bleeding and bruising Purplish patches or spots
41
What are the bone symptoms of leukaemia?
Pain or tenderness
42
What are the resp symptoms of leukaemia?
Easy shortness of breath
43
What are the systemic symptoms of leukaemia?
Weight loss Fever Frequent infections
44
What is the most common childhood cancer?
ALL
45
How do you treat ALL?
Chemo
46
How is AML classified?
M0-M7
47
How do you treat AML?
Chemo, immunotherapy | With/without allogenic bone marrow transplant
48
What is chronic leukaemia characterised by?
Increased number of differentiated cells
49
What is the average age of CLL onset?
70
50
What is CLL characterised by?
Large number of mature lymphocytes in bone marrow and peripheral blood
51
What are the symptoms of CLL?
``` Recurrent infections Anaemia Thrombocytopenia Lymph node enlargement Hepatosplenomegaly ```
52
What is the treatment of CLL?
Regular chemo to reduce cell numbers
53
What is the average age of CML onset?
85-89
54
How is CML usually discovered?
Routine blood tests
55
What are the hallmarks of CML in the blood?
Neutrophilia in blood and bone marrow and the presence of the philadelphia chromosome
56
What is CML treated by?
Imatinib
57
What does the BCR gene encode?
A protein that needs to be continually active
58
What does the ABL gene encode?
tyrosine kinase
59
What does unregulated BCR-ABL cause?
Proliferation of progenitor cells in the absence of growth factors Decreased apoptosis Decreased adhesion to bone marrow
60
What is imatinib?
A small molecular inhibitor that targets specifically ABL-CML treatment

MBD/MI (Wothaya) (57 decks)

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