Define leukamia
Neoplastic proliferation of haemopeoietic or lymphoid cells
Neoplastic proliferation of lymphoid cells
Neoplastic proliferation of bone marrow
In acute leukaemia, abnormality occurs in mature cells
Acute leukaemia is described as a block in differentiation
Acute leukaemia is caused by acute proliferation of...
Myeloblasts
Lymphoblasts
Both (rare)
Both (most common)
What are the symptoms of chronic leukaemia?
No block in differentiation
Block in differentiation
Low proliferation
High proliferation
Acute leukaemia is recognised by a certain type of cell being up to 50% of bone marrow cells?
Blasts
Reticulocytes
Lympocytes
In A.L, there are often reticulocytes in the peripheral blood
Leukaemia is caused by clonal proliferation from a single cell
How can you (sometimes) differentiate between a myeloblast and a lymphoblast?
Myeloblasts have auer rods
Lymphoblasts have auer rods
Myeloblasts have a large, pale nucleus
Lymphoblasts have a large, pale nucleus
MUD stands for
Matched Unrelated Donor
Myeloblast Unknown Death
Myeloblasts Under Duress
Remission - no disease in the blood
Why use the Minimal Residual Disease (MUD)?
Assess chances at relapse/need for further treatment
Assess effectiveness of drug
Prevent remission
BMT - Bone Marrow Transplant
B Cell Acute Lymphoblastic Leukaemia has a poor prognosis for children but a good one for adults
Which of the following is has the poorer prognosis
Acute T-Cell Precursor Lymphoblastic
Acute B-Cell Precursor Lymphoblastic
What is found in cytogenetic testing of ALL?
Hyperploidy
Aneuploidy
Nullosomy
Which of the following are found in ALL cytochemistry?
MPX/SB are neg
MPX/SB are pos
PAS block pos
PAS block neg
Which of the following are found in Immunophenotyping for ALL?
CD19
CD7
CD10
What is true of AML?
Inc WBC
Dec RBC
Dec Plateles
Inc RBC
Inc Platelets
AML means there is no normal cells
What markers are used in Flow Cytometry to identify AML?
CD13
CD33
CD12
CD4
AML is more common in adult women
When is AML called 'De Novo'
When it occurs for the first time
If it occurs secondary to other malignancies
If it never relapses
Which of the following is common in AML (as opposed to ALL)
CNS leukaemia
Lymph, spleen and gum problems
Lymphodenopathy
Match up the following- A = Fatigue, B= Fever/Infections, C= Spontaneous Bruising 1 = Low Platelets 2= Low Hb 3 = Low WBC
A2, B3, C1
A1, B2, C3
A3 B2 C1
CML- accumulation of mature myeloid cells
Genetic anomalies in CML occur low down where they effect cells
What happens in 95% of cases to cause AML?
Chromosome 22 shortens
Linking BCR & ABL genes together
Chromosome 22 inverts
Chromosome 22 lengthens
In indentifying CML, immunophenotyping is useless
CML is more common in adult men
What is the WBC in CML?
>50 x 10^9/l
<30 x 10^9/l
>75 x 10^9/l
What will be found in a CML bone marrow sample?
Bone marrow is hypercellular
Bone marrow is hypocellular
Myeloid cells are present at all developmental stages
Inc Neutraphil Alkaline Phosphatase
Red Neutraphil Alkaline Phosphatase
Glivec stops CML cells dividing, but is expensive
CLL- Neoplastic proliferation of mature looking lymphocytes
What ususally happens in CML?
Lymphoids form masses in the bone marrow, spleen and lymph nodes
Lymphoids lyse and release contents as they are made poorly
Lymphs begin attacking body cells
In CLL, the lymph population can be over 300x the normal
What are smear cells?
Cells that rupture during a smear
Cells so malleable they look like smudges
Cells so deformed they form masses, which look like smears
In CLL, the bone marrow is <25% lymphocytes
What does immunophenotyping in CLL tell us?
Clonality
Which lymph cells they are
The markers
CLL is more common in old men