leukemia

Question 1

basic idea of leukemia

Answer 1

• clonal
• arising from single hematopoetic cell
• takes over bone marrow
• prevents normal cell produciton

Question 2

2 main types of leukemia

Answer 2

1. acute

2. chronic

Question 3

2 types of acute

Answer 3

AML and ALL

- without treatment, fatal in weeks

Question 4

at what stage does leukemia originate

Answer 4

common M or L progenitors

Question 5

when do Sx appear

Answer 5

when enough of the clones are there to make you sick

Question 6

what is problem with blasts

Answer 6

hard to tell them apart

Question 7

epi for ALL and AML

Answer 7

AML - mostly older

ALL - mostly young children

Question 8

presentation of AML

Answer 8

• over period of weeks

- anemia, leukopenia, thrombopenia

Question 9

2 differences in ALL presentation from AML

Answer 9

1. lymphadenopathy is common

2. CNS infiltration common

Question 10

what is phase 1 treatment of leukemia

Answer 10

chemo to induce remission

- not cure, will return

Question 11

what is phase 2

Answer 11

try for post-remissiokn therapy

• more chemo
• or transplant

Question 12

4 special Sx of acute leukemia

Answer 12

1. tissue infiltation ( gums in AML)
2. leukostasis - blasts gum everything up
3. CNS involvment in ALL
4. acute promyolotic leukemia

Question 13

what is treatment for CNS involvment in ALL

Answer 13

intrathecal chemo

- inject in LP

Question 14

what is no chemo treatment of promyelocytic leukemia

Answer 14

vit. A

Question 15

2 types of chronic leukemia

Answer 15

CLL and CML

Question 16

epi of CLL and CML

Answer 16

• both mostly afflict older adults

- CLL much more common than CML

Question 17

where does CLL and CML start

Answer 17

CLL - small lymphocyte

CML - hematopoetic stem cell

Question 18

presentation of CML

Answer 18

BCR-ABL

• incidental finding on CBC
• leukocytosis
• left shift
• basophilia
• usually asymtomatic
• splenomegaly

Question 19

presentation of CLL

Answer 19

incidental findin

• smudge cells
• usually symptomatic
• node and spleen later in the disease

Question 20

nat. Hx of CML

Answer 20

chronic > accelerated> blast crisis

Question 21

nat. Hx of CLL

Answer 21

lymphocytosis>lymphadenopathy>splenomegaly> cytopenia

Question 22

treatment of CML

Answer 22

• immed. start
• tirosine kinase inhibs. ( nibs)
• blocks function of BCR-ABL

Question 23

treatment of CLL

Answer 23

• start when Sx become problem
• chemo
• retuximab (anti CD20)
• aims to provide control