malignant bone disorders

Question 1

describe leukaemia

Answer 1

• proliferation of immature WBCs in bone marrow (haematopoietic stem cells)
• expand and replace normal marrow cells
• abnormal cells spill over into blood

Question 2

pathogenesis

Answer 2

• congenital/inherited risk factors (trisomy 21)
• viral infections
• radiation, chemicals, DNA damaging drugs

Question 3

presentation

Answer 3

anaemia = fatigue, dysponea, pale

neutropenia = infections, wounds slow to heal

thrombocytopenia = bleeding, bruising

organ infiltration = bone pain, enlarged liver, spleen, lymph nodes

Question 4

diagnose results

Answer 4

full blood count

• low Hb
• high WBCs but low neutrophils
• low platelets

bone marrow biopsy

• aspirate
• trephine

specialised testing (ALL vs AML)

• immunophenotype
• chromosomes
• molecular studies

Question 5

general therapy

Answer 5

• intensive transfusion of red cells, platelets
• management of infection
• tunnelled line for vascular access
• patient and family support

Question 6

chemotherapy (cytotoxic drug therapy)

Answer 6

• induction therapy = to reduce remission
• consolidation = to mop up residual leukaemia cells
• maintenance therapy = to keep patients in remission (only ALL)

Question 7

haematopoietic stem cell transplantation

Answer 7

autologous = own stem cells taken in remission

allogeneic = matched siblings or unrelated donor

cells is from marrow, peripheral blood or umbilical cord blood

Question 8

describe trephine/biopsy compared to aspirate

Answer 8

• maintains the architecture of the bone.

- aspirate sucks out fragments of marrow and smears them onto a glass slide