Leukaemia Flashcards
(36 cards)
What is acute lymphoblastic leukaemia (ALL)?
Acute lymphoblastic leukaemia (ALL) is the most common malignancy affecting children and accounts for 80% of childhood leukaemias.
What is the peak incidence age for ALL?
The peak incidence is at around 2-5 years of age.
Which gender is more commonly affected by ALL?
Boys are affected slightly more commonly than girls.
What are the predictable features of bone marrow failure in ALL?
Anaemia: lethargy and pallor; Neutropaenia: frequent or severe infections; Thrombocytopenia: easy bruising, petechiae.
What are other features of ALL?
Bone pain, splenomegaly, hepatomegaly, fever (present in up to 50% of new cases), testicular swelling.
What are the types of ALL?
Common ALL (75%), T-cell ALL (20%), B-cell ALL (5%).
What are the poor prognostic factors for ALL?
Age < 2 years or > 10 years; WBC > 20 * 10^9/l at diagnosis; T or B cell surface markers; non-Caucasian; male sex.
What is acute myeloid leukaemia?
Acute myeloid leukaemia is the more common form of acute leukaemia in adults. It may occur as a primary disease or following a secondary transformation of a myeloproliferative disorder.
What are the features of acute myeloid leukaemia?
Features are largely related to bone marrow failure: anaemia (pallor, lethargy, weakness), neutropenia (frequent infections), thrombocytopenia (bleeding), splenomegaly, and bone pain.
What are poor prognostic features of acute myeloid leukaemia?
> 60 years, > 20% blasts after first course of chemo, cytogenetics (deletions of chromosome 5 or 7).
What is acute promyelocytic leukaemia (M3)?
Acute promyelocytic leukaemia is associated with t(15;17) fusion of PML and RAR-alpha genes, presents younger than other types of AML (average = 25 years old), and often has DIC or thrombocytopenia at presentation.
What are the characteristics of acute promyelocytic leukaemia?
Auer rods are seen with myeloperoxidase stain, and it has a good prognosis.
What is the French-American-British (FAB) classification of acute myeloid leukaemia?
MO - undifferentiated, M1 - without maturation, M2 - with granulocytic maturation, M3 - acute promyelocytic, M4 - granulocytic and monocytic maturation, M5 - monocytic, M6 - erythroleukaemia, M7 - megakaryoblastic.
What is acute promyelocytic leukaemia (APML)?
APML is the M3 subtype of acute myeloid leukaemia (AML) and is important for its presentation and management.
What genetic translocation is associated with APML?
APML is associated with the t(15;17) translocation, causing fusion of the PML and RAR-alpha genes.
What is the average age of presentation for APML?
APML presents at a younger age than other types of AML, with an average of 25 years old.
What are common features at presentation for APML?
Common features include disseminated intravascular coagulation (DIC) or thrombocytopenia.
What is the prognosis for APML?
APML has a good prognosis.
How is APML treated?
APML is treated with all-trans retinoic acid (ATRA) to mature immature granulocytes and resolve a blast crisis before chemotherapy.
What are the complications of chronic lymphocytic leukaemia?
Anaemia, hypogammaglobulinaemia leading to recurrent infections, warm autoimmune haemolytic anaemia in 10-15% of patients, transformation to high-grade lymphoma (Richter’s transformation).
What is Richter’s transformation?
Richter’s transformation occurs when leukaemia cells enter the lymph node and change into a high-grade, fast-growing non-Hodgkin’s lymphoma. Patients often become unwell very suddenly.
What are the symptoms indicating Richter’s transformation?
Lymph node swelling, fever without infection, weight loss, night sweats, nausea, abdominal pain.
What is chronic lymphocytic leukaemia (CLL)?
CLL is caused by a monoclonal proliferation of well-differentiated lymphocytes, almost always B-cells (99%). It is the most common form of leukaemia seen in adults.
What are the common features of CLL?
Features often include none, but may be picked up by incidental finding of lymphocytosis, constitutional symptoms like anorexia and weight loss, bleeding, infections, and marked lymphadenopathy compared to chronic myeloid leukaemia.
