Podcast
Questions and Answers
What percentage of all leukaemias does Chronic Myeloid Leukaemia (CML) represent?
What percentage of all leukaemias does Chronic Myeloid Leukaemia (CML) represent?
CML progresses faster than Acute Myeloid Leukaemia (AML).
CML progresses faster than Acute Myeloid Leukaemia (AML).
False
What is the defining genetic abnormality associated with CML?
What is the defining genetic abnormality associated with CML?
Philadelphia chromosome
CML is characterized by massive overproduction of __________ precursors.
CML is characterized by massive overproduction of __________ precursors.
Signup and view all the answers
Which laboratory parameter would typically indicate anaemia in CML?
Which laboratory parameter would typically indicate anaemia in CML?
Signup and view all the answers
Patients in the chronic phase of CML are typically asymptomatic.
Patients in the chronic phase of CML are typically asymptomatic.
Signup and view all the answers
Name one common symptom of CML upon presentation.
Name one common symptom of CML upon presentation.
Signup and view all the answers
Match the lab parameters with their corresponding results in CML:
Match the lab parameters with their corresponding results in CML:
Signup and view all the answers
The BCR-ABL fusion gene leads to __________ tyrosine kinase activity.
The BCR-ABL fusion gene leads to __________ tyrosine kinase activity.
Signup and view all the answers
What causes the overproduction of myeloid cells in CML?
What causes the overproduction of myeloid cells in CML?
Signup and view all the answers
What is the hallmark genetic change associated with Chronic Myeloid Leukaemia (CML)?
What is the hallmark genetic change associated with Chronic Myeloid Leukaemia (CML)?
Signup and view all the answers
Stem cell transplant is considered a curative treatment for Chronic Myeloid Leukaemia (CML).
Stem cell transplant is considered a curative treatment for Chronic Myeloid Leukaemia (CML).
Signup and view all the answers
What laboratory techniques are used for the diagnosis of CML?
What laboratory techniques are used for the diagnosis of CML?
Signup and view all the answers
Chronic Lymphocytic Leukaemia (CLL) is characterized by clonal proliferation of __________ cells found in the blood.
Chronic Lymphocytic Leukaemia (CLL) is characterized by clonal proliferation of __________ cells found in the blood.
Signup and view all the answers
What is the normal reference range for haemoglobin levels?
What is the normal reference range for haemoglobin levels?
Signup and view all the answers
Match the CLL stages with their corresponding life expectancy:
Match the CLL stages with their corresponding life expectancy:
Signup and view all the answers
What is the first line treatment typically used for CML?
What is the first line treatment typically used for CML?
Signup and view all the answers
Lymphocytosis is indicated when the white cell count is within the normal range.
Lymphocytosis is indicated when the white cell count is within the normal range.
Signup and view all the answers
What treatment combines Rituximab with chemotherapy for significant symptoms?
What treatment combines Rituximab with chemotherapy for significant symptoms?
Signup and view all the answers
Chronic Lymphocytic Leukaemia (CLL) can present with symptoms such as fatigue and swollen abdomen.
Chronic Lymphocytic Leukaemia (CLL) can present with symptoms such as fatigue and swollen abdomen.
Signup and view all the answers
What is the most common type of white cell malignancy?
What is the most common type of white cell malignancy?
Signup and view all the answers
Acute Myeloid Leukaemia typically has a slow onset.
Acute Myeloid Leukaemia typically has a slow onset.
Signup and view all the answers
The most common leukaemia in the Western world is _____ .
The most common leukaemia in the Western world is _____ .
Signup and view all the answers
What are the two subcategories of Chronic Lymphocytic Leukaemia based on the immunoglobulin heavy chain variable region?
What are the two subcategories of Chronic Lymphocytic Leukaemia based on the immunoglobulin heavy chain variable region?
Signup and view all the answers
What are the two classifications of leukaemia based on the maturity of cells?
What are the two classifications of leukaemia based on the maturity of cells?
Signup and view all the answers
Match the following laboratory tests to their results or findings:
Match the following laboratory tests to their results or findings:
Signup and view all the answers
The primary symptom of CLL that relates to the immune system is __________.
The primary symptom of CLL that relates to the immune system is __________.
Signup and view all the answers
Which of the following markers is used in the immunophenotyping for CLL diagnosis?
Which of the following markers is used in the immunophenotyping for CLL diagnosis?
Signup and view all the answers
CML stands for _______.
CML stands for _______.
Signup and view all the answers
Which of the following is NOT a characteristic symptom of CLL?
Which of the following is NOT a characteristic symptom of CLL?
Signup and view all the answers
Match the leukaemia types with their characteristics:
Match the leukaemia types with their characteristics:
Signup and view all the answers
Corticosteroids are primarily used to treat CLL by improving immune response.
Corticosteroids are primarily used to treat CLL by improving immune response.
Signup and view all the answers
Which statement describes the clinical features of chronic leukaemias?
Which statement describes the clinical features of chronic leukaemias?
Signup and view all the answers
List one common symptom of CLL.
List one common symptom of CLL.
Signup and view all the answers
Laboratory diagnosis is not important in the classification of leukaemias.
Laboratory diagnosis is not important in the classification of leukaemias.
Signup and view all the answers
Low antibody levels in CLL are assessed during _____ tests.
Low antibody levels in CLL are assessed during _____ tests.
Signup and view all the answers
What should be done when symptoms become significant in CLL?
What should be done when symptoms become significant in CLL?
Signup and view all the answers
Name one type of acute leukaemia.
Name one type of acute leukaemia.
Signup and view all the answers
Chronic leukaemia is generally considered _______.
Chronic leukaemia is generally considered _______.
Signup and view all the answers
Match the following terms with their corresponding leukaemia type:
Match the following terms with their corresponding leukaemia type:
Signup and view all the answers
Study Notes
Haematological Malignancies - Part 3: Chronic Myeloid Leukaemia (CML)
- CML is a type of cancer affecting the blood.
- 15-20% of all leukemias are CML.
- CML progresses more slowly than Acute Myeloid Leukemia (AML).
- CML is characterised by an acquired genetic change in a single pluripotent stem cell.
- This change leads to a massive overproduction of myeloid precursors and mature effector cells.
CML - Philadelphia Chromosome
- The Philadelphia chromosome is a hallmark of CML.
- It is formed by a translocation between chromosomes 9 and 22.
- This translocation results in the BCR-ABL gene fusion.
- The BCR-ABL protein results in constitutive tyrosine kinase activity and disrupts cell growth control.
CML - Symptoms
- Typically asymptomatic in the chronic phase.
- Symptoms in the chronic phase can include weight loss, and an enlarged spleen.
- Other potential symptoms include:
- Fatigue
- Pallor
- Raised metabolism
- Neutrophil sequestration in spleen
CML - Laboratory Diagnosis
-
Complete Blood Count (FBC):
- Shows anaemia, raised white blood cell count (hyperleukocytosis), and potentially abnormal platelet count or high numbers of neutrophils, monocytes and eosinophils.
-
Peripheral Blood Film: Analysis of blood cells under a microscope. Shows myeloid precursors.
-
Polymerase Chain Reaction (PCR): Used to detect the BCR-ABL1 fusion gene.
CML - Treatment
- Tyrosine Kinase Inhibitors (TKIs): Effectively control the disease, but need to monitor regularly. Treatment effectiveness is monitored through bone marrow and blood analysis using BCR-ABL1 PCR.
- Stem Cell Transplant: A potentially curative treatment option.
Leukemia Classification
- Leukaemia is the most common type of white cell malignancy.
- Leukaemia involves the accumulation of malignant white cells in the bone marrow or blood.
- Malignant cells can arise from haemopoietic stem cells or progenitor cells.
- Leukaemias are classified as either acute or chronic based on the rate of onset, the maturity of the cells and the aggressiveness of treatment needed.
- Acute leukemias have a rapid onset, involve immature cells, and require aggressive treatment.
- Chronic leukemias have a slower onset, involve more mature cells, and generally respond better to treatment.
Chronic Lymphocytic Leukaemia (CLL)
- Most common leukemia in the West.
- Characterised by clonal proliferation of B lymphocytes.
- Often asymptomatic in early stages.
- Diagnosis includes FBC, blood film, bone marrow biopsy and immunophenotyping.
- Staging is important to determine prognosis. This includes Binet staging.
CLL - Symptoms
- Common symptoms include fatigue, recurrent infections, weight loss, swollen lymph nodes (lymphadenopathy), and an enlarged spleen or liver (hepatosplenomegaly).
- Other potential symptoms include:
- Lethargy
- Pallor
- Bruising
CLL - Laboratory Diagnosis
-
Complete Blood Count (FBC): Shows low hemoglobin, elevated white blood cell count (especially lymphocytes), and sometimes low platelet count.
-
Peripheral Blood Film: Shows small lymphocytes and smudge cells.
-
Immunophenotyping: Identifies the type and characteristics of the cancerous B cells using flow cytometry.
-
Additional Tests: Includes low antibody levels, and genetic testing (cytogenetics). DAT (direct antiglobulin test) may identify autoantibodies.
CLL - Treatment
- Treatment usually starts when symptoms become significant.
- Common treatments include Rituximab (anti-CD20), fludarabine, and cyclophosphamide.
- Corticosteroids can be used to aid recovery from pancytopenia.
- Splenectomy may be considered for pain relief in some cases, if other treatments are unsuccessful.
- Immunoglobulin replacement can improve quality of life.
Studying That Suits You
Use AI to generate personalized quizzes and flashcards to suit your learning preferences.
Related Documents
Description
This quiz explores Chronic Myeloid Leukaemia (CML), a cancer of the blood characterized by the Philadelphia chromosome and the BCR-ABL gene fusion. Learn about its incidence, progression, and symptoms. Test your knowledge on this significant type of leukemia affecting patients.
