Leukaemia

Question 1

What symptoms occur in acute myeloid leukaemia?

Answer 1

Lethargy
Infection
Bleeding and bruising
Bone pain
Gum swelling
Lymphadenopathy
Skin rash

Question 2

What syndromes are associated with acute myeloid leukaemia?

Answer 2

Down’s syndrome

Fanconi’s syndrome

Question 3

What is the percentage of blast cells in leukaemia in the bone marrow?

Answer 3

> 20%

Question 4

In the peripheral blood what abnormalities will be seen with leukaemia?

Answer 4

Anaemia
Thromvocytopaenia
neutropenia
Blasts

Question 5

How is leukaemia diagnosed?

Answer 5

Via a bone marrow aspirate

Question 6

How is acute myeloid leukaemia treated for patients <60 years?

Answer 6

Intensive chemotherapy

Question 7

How is acute myeloid leukaemia treated for patients >60 years?

Answer 7

Low dose chemotherapy

Question 8

How is acute myeloid leukaemia treated in elderly patients with co-morbidities?

Answer 8

Supportive care only

Question 9

Most young patients with acute myeloid leukaemia are entered into trials. T/F?

Answer 9

True

Question 10

What factors would worsen the prognosis of an acute myeloid leukaemia diagnosis?

Answer 10

Secondary AML
Relapsed AML
AML derived form myelodysplasric syndrome
Biphenotypic disease
Elderly patients
Refractory to induction

Question 11

The chemotherapy for acute myeloid leukaemia Is based on what drugs?

Answer 11

Anthracycline and cytarabine

Question 12

What kind of rash is present in acute lymphoblastic leukaemia?

Answer 12

Purpuric rash

Question 13

The Philadelphia chromosome can cause acute lymphoblastic leukaemia. T/F?

Answer 13

True

Question 14

What drugs are used for chemotherapy to treat acute lymphoblastic leukaemia?

Answer 14

Prednisolone
Cyclophosphamide
Anthracycline
Asparaginase
Vincristine
Etoposide
Cytarabine

Question 15

It is essential in acute lymphoblastic leukaemia to direct treatment towards which body system?

Answer 15

CNS

Question 16

What supportive treatments can be used in acute lymphoblastic leukaemia?

Answer 16

Blood transfusion
Fresh frozen plasma for coagulopathy
Platelet transfusion for purpora and bleeding
Antibiotics / growth factors / granulocytes during sepsis or fever

Question 17

When would transplants be used in acute lymphoblastic leukaemia?

Answer 17

Relapsed patients
Refactory patients
Poor risk disease in first CR
Age less than 60 years 
Good performance

Question 18

What is the most common type fo leukaemia?

Answer 18

Chronic lymphocytic leukaemia

Question 19

What are the symptoms of chronic lymphocytic leukaemia?

Answer 19

Letahrgy
Night sweats
Weight loss
Symptoms of anaemia
Lymphadenopathy
Infection

Question 20

What antigens are expressed in chronic lymphocytic leukaemia?

Answer 20

CD5, CD19, CD20 and CD23

Question 21

What mutation in chronic lymphocytic leukaemia is particularly aggressive and refractory to chemotherapy?

Answer 21

17p deletions resulting in the loss of p53

Question 22

What are the possible immune complications of chronic lymphocytic leukaemia?

Answer 22

Autoimmune haemolytic anaemia

Autoimmune thrombocytopenia

Question 23

How are the immune complications of chronic lymphocytic leukaemia treated?

Answer 23

Steroids and treatment of underlying CLL

Question 24

What are the consequences of the immune complications of chronic lymphocytic leukaemia?

Answer 24

Increased risk of infection due to:
Hypogammaglobulinaemia
Cell mediated immunity impairment
T lygmphopaenia
Neutropaeni and defects in complement activation

Question 25

What symptoms can occur as a result of the treatment of CLL?

Answer 25

Sweats Weigth loss Symptomatic nodes Bone marrow failure causing anaemia and thrombocytopenia

Question 26

Asymptomatic patients are treated with chemotherapy in chronic lymphocytic leukaemia. T/F?

Answer 26

False

Question 27

What are the symptoms of chronic myeloid leukaemia?

Answer 27

``` Fatigue Weight loss Night sweats Abdominal discomfort Splenomegaly ```

Question 28

Which abnormal protein is present in chronic myeloid leukaemia?

Answer 28

BRC-ABL

Question 29

How does the Philadelphia chromosome result in chronic myeloid leukaemia?

Answer 29

This codes for a abnormal protein BRC-ABL which is a tyrosine kinase which phosphorylates downstream molecules and results in increased cell proliferation

Question 30

How is chronic myeloid leukaemia treated?

Answer 30

TKI inhibitors such as imatinib

Question 31

What is the name of the acute stage which chronic myeloid leukaemia can progress to?

Answer 31

Blast crisis

Question 32

Which type of acute leukaemia is more common in children?

Answer 32

Acute lymphoblastic leukaemia

Question 33

CLL can develop into acute leukaemia. T/F?

Answer 33

False - it can progress but will not turn into acute leukaemia

Question 34

CML can develop into acute leukaemia. T/F?

Answer 34

True - it can develop into either ALL or AML

Question 35

What are the possible causes of pancytopenia?

Answer 35

Lack of production of blood cells due to severe vitamin B12/folate deficiency, aplastic anaemia, metastasis to the bone marrow, congenital causes and glucose/glycogen storage diseases Due to destruction of blood. cells due to splenohepatomegaly (infections, cirrhosis), RA,

Question 36

Define hyposplenism

Answer 36

The combination of splenomegaly and pancytopenia

Question 37

What can cause a purpuric rash?

Answer 37

Platelet disorders (thrombocytopaenia), vascular disorders (hypotensive states, vasculitis), coagulation disorders (DIC, scurvy), meningococcaemia

Question 38

What is the name of the rash caused by pinpoint bleeding which results in sports smaller than in purpora?

Answer 38

Petechia

Question 39

Bleeding which causes sports larger than 1cm is called?

Answer 39

Ecchymosis

Question 40

Blast cells should never be seen in the peripheral blood. T/F?

Answer 40

True

Question 41

Hyperploidy is associated with better outcomes in patients with ALL. T/F?

Answer 41

True

Question 42

AML can spread to cause meningeal leukaemia. T/F?

Answer 42

False - ALL can do this