Leukaemia

Question 1

What is Leukaemia? (2 points)

Answer 1

1. Cancer of stem cells in bone marrow
2. Causing unregulated prod of other types of blood cells

Question 2

What are the different types of Leukaemia in kids? (3 things)

Answer 2

1. Acute Lymphoblastic Leukaemia (ALL) (most common)
2. Acute Myeloid Leukaemia (AML)
3. Chronic Myeloid Leukaemia (CML) (rare)

Question 3

What ages does Acute Lymphoblastic Leukaemia (ALL) peak?

Answer 3

2-3 years

Question 4

What ages does Acute Myeloid Leukaemia (AML) peak?

Answer 4

Under 2 years

Question 5

What is the pathophysiology of Leukaemia? (3 steps)

Answer 5

1. Excess prod of one type of blood cell
2. Leading to underprod of other blood cells
3. Aka Pancytopenia (low RBC / WBC / Platelets)

Question 6

What are the RF for Leukaemia? (3 things)

Answer 6

1. Radiation exposure (main RF)
2. Downs syndrome
3. Kleinfelter syndrome

Question 7

What are the CF of Leukaemia? (11 things)

Answer 7

1. Fever (unexplained)
2. Fatigue
3. Pallor
4. Night sweats
5. Lymphadenopathy
6. Bone / joint pain
7. Petechiae (rash) / Bruising / Bleeding
8. Abd pain
9. Hepatosplenomegaly
10. Failure to thrive
11. WL

Question 8

What are some DDx that present similarly to Leukaemia? (7 things)

Answer 8

1. Immune thrombocytopaenia (bruising)
2. Trauma (bruising)
3. Immune deficiency
4. Reactive lymphadenopathy
5. Infection (CNS symptoms)
6. Raised ICP (CNS symptoms)
7. Other cancer met into bone marrow (pancytopaenia)

Question 9

How do you differentiate between Immune thrombocytopaenia and Leukaemia?

Answer 9

IT will have Normal RCB / WBC

Question 10

How do you differentiate between Trauma and Leukaemia?

Answer 10

Trauma will have normal bloods

Question 11

Which kids does NICE recommend you refer for Immediate specialist assessment? (2 things)

Answer 11

1. Unexplained petechiae
2. Unexplained hepatomegaly

Question 12

What investigations are involved in the Immediate specialist assessment? (4 things)

Answer 12

1. FBC (urgent within 48 hours)
2. Blood film
3. Bone marrow biopsy
4. Lymph node biopsy

Question 13

What may a FBC show you in sus Leukaemia? (4 things)

Answer 13

1. Anaemia
2. Leukopaenia
3. Thrombocytopaenia
4. High numbers of abnormal WBC

Question 14

What may a Blood film show you in sus Leukaemia?

Answer 14

Blast cells

Question 15

What further investigations can you do for Leukaemia to help with Staging? (5 things)

Answer 15

1. CXR
2. CT
3. Lumbar puncture
4. Genetic analysis
5. Immunophenotyping of abn cells

Question 16

What is the Primary Tx for Leukaemia?

Answer 16

Chemo

Question 17

What are the other Tx options for Leukaemia? (3 things)

Answer 17

1. Radiotherapy
2. Bone marrow transplant
3. Surgery

Question 18

What are the complications of Leukaemia? (7 things)

Answer 18

1. Failure to Tx it
2. Stunted growth + dev
3. Immunodeficiency + inf
4. Neurotoxicity
5. Infertility
6. Secondary malignancy
7. Cardiotoxicity

Question 19

What is the prognosis for Leukaemia? (2 things)

Answer 19

1. ALL: 80%
2. AML: Not good