Acute Lymphoblastic Leukaemia Flashcards Preview

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Flashcards in Acute Lymphoblastic Leukaemia Deck (90)
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What is leukaemia?

A cancer in the white blood cell producing cells of the bone marrow


What are the types of leukaemia?

- Acute lymphoblastic leukaemia
- Acute lymphocytic leukaemia
- Acute myeloid leukaemia
- Chronic myeloid leukaemia


What is lymphoblastic/lymphocytic mean?

That the abnormal cancerous cells arise from a lymphoid stem cell


What does myeloid mean?

That the abnormal cancerous cell originated from a myeloid stem cell


When should you refer a patient for immediate specialist assessment for suspicion of leukaemia?

If a child or young person has unexplained petechiae or hepatosplenomegaly


In what period of time should a very urgent blood test for leukaemia be performed?

Within 48 hours


When should you offer a very urgent FBC for suspicion of leukaemia in children and young people?

In children and young people with any of following signs and symptoms of leukaemia;
- Pallor
- Persistent fatigue
- Fever
- Persistent infection
- Generalised lymphadenopathy
- Persistent or unexplained bone pain
- Bruising
- Bleeding


When should you offer a very urgent FBC for suspicion of leukaemia in adults?

As with children and young people, and also hepatosplenomegaly


How many adults does acute lymphoblastic leukaemia affect in the UK?

About 800/year


How does the incidence of ALL compare to other cancers?

It is the most common cancer in children and young people under the age of 35, and in older adults over 75


How does the incidence of ALL compare between the genders?

It is slightly more common in males than females


What is ALL a cancer of?



What is the mechanism of disease in ALL?

The process by which cells divide in an orderly and controlled way becomes out of control, and signals to stop the production of white blood cells are ignored


Do the dividing cells in ALL mature into normal lymphocytes?

Many do not


What is the result of many of the dividing cells not maturing into normal lymphocytes?

Too many immature blood cells (lymphoblasts) are produced


What is the problem with the lymphoblasts in ALL?

They are unable to fight infection, and fill up the bone marrow so there is insufficient space to make other blood cells


What are the types of ALL?

- B-lymphoblastic leukaemia
- T-lymphoblastic leukaemia


What is the most common type of ALL?

B-lymphoblastic leukaemia


Where is the typing of ALL important?

In determining treatment


What is the typing of ALL based on?

What type of blood cell has become cancerous


What are the risk factors for ALL?

- Radiation exposure
- Genetic conditions
- Exposure to chemicals
- Infection


When can radiation exposure increase the risk of ALL?

When the person has been exposed to very high radiation levels, e.g. following a nuclear accident


Why is radiation exposure not much of a concern in the UK?

Because very few people in the UK will have been exposed to sufficient levels of radiation to increase their risk


Does living near a power plant increase the risk of ALL?

There is very little evidence for this


Give 2 examples of genetic conditions that increase the risk of ALL?

- Down's syndrome
- Fanconis anaemia


What chemicals can increase the risk of ALL?

Industrial chemicals, e.g. benzene and other solvents


How is infection linked to the development of ALL?

ALL develops because of changes to certain types of immature blood cells. What causes these changes is unknown, but infection may be involved


Are there any specific infections that have been found to cause leukaemia?



What are the symptoms of ALL?

- Fatigue, dizziness, and palpitations
- Severe and usual bone and joint pain
- Recurrent and severe infections
- Fever without obvious infection
- LUQ fullness and early satiety
- Dyspnoea
- Headache, irritability, or altered mental status
- Haemorrhagic or thrombotic complications


What are the most common sites of recurrent and severe infection in ALL?

- Oral
- Throat
- Skin
- Perianal