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Flashcards in Leukaemia Deck (33):
1

What is leukaemia?

Clonal proliferation of malignant blood cells

2

How does leukaemia happen?

Malignant cells undergo uncontrolled expansion in bone marrow leading to bone marrow failure and the cells circulate in blood and can infiltrate various organs

3

What are the 2 types of leukaemia?

Acute and chronic

4

What is acute leukaemia?

Malignant transformation occurs in haemopoietic stem cell
Defined by presence of over 20% blasts in blood or bone marrow

5

What are 2 types of acute leukaemia?

Acute myloid leukaemia AML (80%)
Acute lymphoblasitc leukaemia ALL (20%)

6

What is chronic leukaemia?

Proliferation of more mature precurser cell. Slower progression with relatively benign cause

7

What are 2 types of chronic leukaemia?

Chronic myloid leukaemia CML
Chronic lymphocytic leukaemia CLL

8

What are the causes of leukaemia?

INHERITED - Downs, klinefelters, immuno deficiencies
ENVIRONMENTAL - radiation, chemo, infection, myeloproliferative disease

9

What is AML?

Acute myloid leukaemia
Most common acute leukaemia in adults, 70 yrs
PRIMARY - de novo
SECONDARY - after another cause, eg chemo

10

What are the clinical features of acute leukaemia (AML and ALL)?

BONE MARROW FAILURE
anaemia
neutropoenia
thrombocytopoenia

ORGAN INFLITRATION
lymadenopathy
hepatomegaly
splenomegaly

11

What investigations would you do for AML?

FBC
blood film - to see myloblasts
bone marrow biopsy

12

What is the treatment for AML?

combination chemo
supportive treatment
bone marrow transplant

13

What is the prognosis of AML dependant on?

Age. Higher cure rate if less than 60 yrs

14

What is ALL?

Acute lymphoblastic leukaemia
Most common leukaemia in children, 2-10 yrs

15

What investigations would you do for ALL?

FBC
blood film - to see lymphoblasts
bone marrow biopsy

16

How would you treat ALL?

combo chemo
bone marrow transplant

17

What is the prognosis for ALL?

70 -80% cure rate in childhood

18

What is the difference between lymphblasts and myloblasts?

Lymphoblasts have less granules than myloblasts

19

What is CML?

Chronic myloid leukaemia
Rare clonal myloproliferative disorder charaterised by an increase in mature myelocytes -esp. neutrophils
Adults, 40- 60 yrs

20

What shows up in CML?

Philadelphia chromosome

21

What are the 3 phases of CML?

Chronic
Accelerated
Blast transformation to acute

22

What are the clinical features of CML?

anaemia
thrombocytopoenia
lymphadenopathy
splenomegaly
hypermetabolim
hepatomegaly

23

What investigations would you do for CML?

FBC
blood film to be myloid cells
bone marrow biopsy
cytogenics for philadelphia chromosome`

24

What treatment would you give for CML?

chemo
splenectomy
bone marrow transplant
tyrosine kinase inhibitors

25

What is CLL?

Chronic lymphocytic leukaemia
Clonal lymphoproliferative disease where lymphocytes accumulate in the blood, bone marrow and spleen as a result of longer life expectancy or reduced apoptosis
Largely elderly, 70 yrs

26

What are the symptoms of CLL , if it is symptomatic?

lymphadenopathy
splenomegaly
hepatomegaly
immunosuppression

27

What investigations would you do for CLL?

FBC - see increased WBC
blood film - increase lymphocytes
bone marrow biopsy - see heavy lymphocyte infiltration

28

What is the treatment for CLL?

chemo - if symptomatic

29

What is the prognosis?

Deteriorates if any organ is infiltrated

30

What is a stem cell transplant?

Transplant of multipotent haemopoeitic stem cells, usually derived from bone marrow or peripheral blood

31

What happen when recipient recieves transplant?

Body wants to reject it so they are given radiation or chemo prior to destroy their own immune system

32

What is the difference between an autologous stem cell transplant and an allogenic stem cell transplant?

Autologous = patients own stem cells used
Allogenic = stem cells from a donor

33

What does chemo cause in the oral cavity?

ulcers
reduced saliva