Leukaemia

Question 1

Acute lymphoblastic leukaemia, who gets it?

Answer 1

ALL is the most common childhood cancer.

Characterised by presentation:

• Due to marrow failure (anaemia, infections, bleeding)
• Leukaemic effects (high ECC and involvement of extramedullary areas)
• Bone pano

Question 2

Who gets AML?

Answer 2

AML is a disease of the elderly, most people who have it are over 60.

Presentation similar to ALL (marrow failure)

Question 3

Subgroups of AML may have characteristic presentation?

Answer 3

Coagulation defect : DIC

Gum infiltration.

Question 4

3 key investigation for acute leukaemia?

Answer 4

1) Blood count and film
2) Coagulation screen

3) Bone marrow aspirate
- Morphology
- Immunophenotype by flow cytometry

Question 5

What is seen on blood film in acute myeloid leukaemia?

Answer 5

Auer rods

Question 6

What type of bacteria can cause fulminant life threatening sepsis in neutropenia p[atients?

Answer 6

Gram NEGATIVE.

Question 7

Complications of chemotherapy treatment?

Answer 7

Neutropenic sepsis (Give broad spectrum ABx particularly covering gram negative organisms)

Patients also at risk of fungal infections

Tunmour lysis syndrome (during first course of treatment)

Question 8

An AML subtype (acute promyelocytic leukaremia) has a specific chromosome translocation, what is it?

Answer 8

T(15,17). Appears to be curable using vitamin A analogues and arsenic derivatives.