Malignant Haematology

Question 1

what cell type expresses the cell surface antigen glycophorin A?

Answer 1

red cells

Question 2

what type of cell expresses the enzyme myeloperoxidase?

Answer 2

neutrophils

Question 3

what is the underlying process behind acute myeloid leukaemia?

Answer 3

proliferation of abnormal progenitors with a block in differentiation/maturation

Question 4

describe the appearance of the blood film in acute leukaemia

Answer 4

all the cells just look the same

Question 5

what is the underlying process behind chronic myeloid leukaemia?

Answer 5

proliferation of abnormal progenitors but no block in differentiation or maturation

Question 6

describe the appearance of the blood film in chronic myeloid leukaemia?

Answer 6

presence of lots of cells of different types

Question 7

what is a clone cell?

Answer 7

a population of cells derived from a single parent cell

Question 8

what are the two types of malignancy if classified by lineage?

Answer 8

myeloid

lymphoid

Question 9

what cancer has a malignant change within primitive B cell precursors in the marrow?

Answer 9

acute lymphoblastic leukaemia

Question 10

what cancer has a malignant change in a more mature B lymphocyte?

Answer 10

chronic lymphocytic leukaemia

Question 11

what is myeloma?

Answer 11

a plasma cell malignancy

Question 12

what type of cancer has blood involvement?

Answer 12

leukaemia

Question 13

what is the cell of origin in chronic myeloid leukaemia?

Answer 13

LT and ST HSC’s

Question 14

what is the cell of origin in AML?

Answer 14

MPP

Question 15

what is the cell of origin in ALL?

Answer 15

CLP

Question 16

what is the cell of origin in CLL?

Answer 16

B cells

Question 17

what is the cell of origin in myeloma?

Answer 17

plasma cells

Question 18

what is acute leukaemia?

Answer 18

a rapidly progressive clonal malignancy of the marrow/blood with maturation defects

Question 19

how is acute leukaemia defined?

Answer 19

excess of blasts (>20%) in either blood or bone marrow

Question 20

what are the two types of acute leukaemia?

Answer 20

acute myeloid leukaemia (AML)

acute lymphoblastic leukaemia (ALL)

Question 21

what age groups is most commonly affected by AML?

Answer 21

elderly - >60

Question 22

how can acute promyelocytic leukaemia present?

Answer 22

with a coagulation defect causing DIC

Question 23

what is acute lymphoblastic leukaemia (ALL)?

Answer 23

a malignant disease of lymphoblasts

Question 24

what are lymphoblasts?

Answer 24

primitive lymphoid cells

Question 25

what is the most common childhood cancer?

Answer 25

ALL

Question 26

how does ALL present?

Answer 26

anaemia, infections and bleeding due to marrow failure | bone pain

Question 27

what three investigations are done for acute leukaemia?

Answer 27

blood count + film coagulation screen bone marrow aspirate

Question 28

what changes are seen in the blood count in acute leukaemia?

Answer 28

low Hb low neutrophils low platelets

Question 29

what can be seen in the blood film in acute leukaemia?

Answer 29

blasts

Question 30

why is a coagulation screen done for investigation of acute leukaemia?

Answer 30

to identify any life threatening coagulation problems e.g. DIC

Question 31

what test is needed for a definitive diagnosis of acute leukaemia?

Answer 31

immunophenotyping on. abone marrow aspirate

Question 32

what is the main curative treatment for acute leukaemia?

Answer 32

multi-agent chemotherapy

Question 33

what do patients with acute leukaemia often have to allow long term central venous access?

Answer 33

a hickman line

Question 34

where does the tip of a hickman line sit?

Answer 34

junction between the SVC and the RA

Question 35

what should be done if a neutropenic patient develops a fever?

Answer 35

immediate broad spectrum antibiotics + send blood cultures

Question 36

when are prophylactic platelets transfusions given for patients undergoing chemo?

Answer 36

cut off is 10-20x10^9

Question 37

what are some possible complications of intensive chemotherapy?

Answer 37

N+V hair loss liver and renal dysfunction infections

Question 38

when can tumour lysis syndrome occur?

Answer 38

during the first course of chemotherapy

Question 39

when is an acute leukaemia patient considered to be in remission?

Answer 39

<5% marrow blasts with recovery of normal haemopoiesis