Myeloid Malignancy Flashcards
AML
Acute myeloid leukaemia
CML
Chronic myeloid leukaemia
MDS
Myelodysplastic syndromes
MPN
Myeloproliferative neoplasms
Sub groups of acute leukaemia
Acute myeloblastic leukaemia
Acute lymphoblastic leukaemia
Clinical features of AML
Bone marrow failure
Anaemia
Thrombocytopenic bleeding
Infection due to neutropenia
Investigations for AML
Blood count and blood film
Bone marrow aspirate
Treatment of AML
Supportive care
Anti-leukaemic Chemotherapy
Allogeneic stem cell transplantation
Clinical presentation of CML
Anaemia Splenomegaly Weight loss Hyperleukostasis Gout
What is hyperleukostasis?
Extremely elevated blast cell count and symptoms of decreased tissue perfusion
Laboratory features of CML
High WCC
High platelet count
Anaemia
Blood film shows all stages of white cell differentiation with increased basophils
Bone marrow is hypercellular
Bone marrow and blood cells contain the Philadelphia chromosome
CML treatment
Tyrosine kinase inhibitor
Bositinib
Ponatinib
Myeloproliferative neoplasms
Polycythaemia vera
Essential thrombocythaemia
Idiopathic myelofibrosis
Which cells are affected by myeloproliferative neoplasms?
Neutrophils Eosinophils Basophils Monocytes Platelets Red cells
What is the mutation involved in the majority of PV and 50% of ET?
JAK2 V617F mutation
PV
Polycythaemia vera
PV clinical features
Headaches Itch Vascular occlusion Thrombosis TIA/stroke Splenomegaly
Laboratory features of PV
Increased => Haemoglobin concentration Haematocrit White cell count and platelet count Uric acid
What is the haematocrit?
The ratio of the volume of red blood cells to the total volume of blood
PV treatment
Venesection to keep haematocrit below 0.45
Aspirin
Hydroxycarbamide (HC)/Alpha Interferon
Venesection
Phlebotomy
Complications of PV
Stroke or other thromboses if poorly controlled
Bone marrow failure from development of secondary myelofibrosis
Transformation to AML
What is essential thrombocythaemia
Myeloproliferative disease with predominant feature of raised platelet count
Presentation of ET
Arterial and venous thromboses Digital ischaemia Gout Headache Mild splenomegaly
