Flashcards in Malignancy Deck (18):
What is the most common leukaemia in children?
acute lymphoblastic (ALL)
What are other leukaemia's found in children?
acute myeloid (AML)
acute non-lymphocytic leukaemia (ANLL)
When is the peak presentation of ALL?
What is the underlying cause of sx in ALL?
infiltration of the bone marrow or other organs.w leukaemia blast cells
What is the nature of onset of ALL?
insidious over several weeks
What are the signs and symptoms of leukaemia? divide them into categories of effects of infiltration
1. general - malaise and anorexia
2. BM infiltration: anaemia (pallor, lethargy)
thrombocytopenia (bruising, nose bleeds, petechiae)
3. Reticuloendothelial infiltration:
4. CNS - headaches, vomiting, nerve palsies
5. Testes - testicular enlargement
What are the types of ALL? which is most common/?
Common ALL (75%) - CD10 present
T-cell ALL (15-20%)
What are Ix for ALL?
1. FBC - low Hb, thrombocytopenia, circulating leukaemic blast cells
2. bone marrow examination - confirms diagnosis
3. CXR - identify mediastinal mass characteristic of T cell disease
4. immunological phenotyping to sub classify ALL
What indicates poorer prognosis of ALL?
age < 2 years or > 10 years
WBC > 20 * 109/l at diagnosis
T or B cell surface markers
What are the three phases of treatment of ALL?
1. INDUCTION therapy
2. CONSOLIDATION phase
3. MAINTENANCE phase
Explain the induction phase of ALL
1. induction (4weeks):
Methotrexate +/- cytarabine + hydrocortisone
Explain the consolidation phase of rx of ALL
cranial irradiation if CNS disease
Explain the maintenance phase of rx of ALL
3monthly intrathecal drugs
What are complications of ALL
Hyperuricaemia due to massive cell death
What is given for renal protection in aLL
increased fluid intake
How is relapse of ALL treated?
Bone marrow transplant (if high risk e.g. WCC>200, MLL rearrangement gene)
Which phase of treatment intends to kill most of the leukaemia cells in ALL/