Questions and Answers
Which type of leukaemia is characterized by cancer of the lymphoid tissue?
What regulates normal cell proliferation by promoting progression of the cell cycle?
What is the primary risk associated with genetic alterations in proto-oncogenes?
Which of the following statements regarding leukaemia is accurate?
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Which type of malignancy arises from plasma cells in the bone marrow?
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What does the term 'incidence' refer to in the context of disease?
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What is the typical number of new leukaemia cases diagnosed annually in the UK as of 2018?
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How do tumor suppressor genes influence cell cycle progression?
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What was the mortality rate of leukemia in the UK in 2019?
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Which type of leukemia is characterized by the gradual increase of myeloid cells?
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What is the genetic condition associated with an increased risk of leukemia?
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What does AML stand for in the context of leukemia?
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Which of the following is not a known cause of leukemia?
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How is leukemia primarily categorized?
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What is a common symptom of Acute Myeloid Leukemia (AML)?
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What is the incidence rate of Acute Myeloid Leukemia (AML) in the UK as of 2018?
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What factor is associated with an increased risk of developing Acute Myeloid Leukemia?
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Which type of leukemia is known to affect lymphoid cells?
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What is a common feature in the blood film of AML patients?
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Which type of anemia is commonly associated with AML?
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What is a common consequence of thrombocytopenia in AML?
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How does AML typically manifest in patients?
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What happens in the bone marrow of patients with AML?
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What is the typical outcome of chemotherapy in younger patients with AML?
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What does remission in AML indicate?
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What is a notable risk associated with neutropenia in AML?
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What is the significance of myeloperoxidase (MPO) positivity in AML?
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What does a 5-year survival rate represent in AML prognosis?
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What systemic complications are commonly associated with Multiple Myeloma?
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What condition is characterized by the deposition of abnormally folded proteins in Multiple Myeloma patients?
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Which of the following blood test findings is indicative of anemia in Multiple Myeloma?
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What is often seen in blood tests associated with Multiple Myeloma that suggests metabolic imbalance?
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In patients with Multiple Myeloma, what is essential for their prognosis?
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What is typically the survival rate for Multiple Myeloma patients after 10 years with treatment?
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What is the typical characteristic of anaemia in Chronic Myeloid Leukaemia (CML)?
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Which of the following manifestations is most commonly associated with Chronic Lymphoid Leukaemia (CLL)?
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What is the effect of lymphocyte over-production on the bone marrow in CLL?
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Which test is specifically used to detect the Philadelphia chromosome in Chronic Myeloid Leukaemia (CML)?
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What is the preferred initial therapy for Chronic Myeloid Leukaemia (CML)?
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In which demographic is Chronic Lymphoid Leukaemia (CLL) most common?
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Which of the following is a characteristic finding in the neutrophil alkaline phosphatase score in CML?
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What is the approximate 5-year survival rate for patients diagnosed with Chronic Myeloid Leukaemia (CML)?
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What type of cells predominantly monoclonally proliferate in Chronic Lymphoid Leukaemia (CLL)?
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Which statement best describes the typical clinical course of CLL?
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What is the primary age range affected by Hodgkin's Lymphoma?
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Which hematological finding is most commonly associated with Hodgkin's Lymphoma?
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Which diagnostic procedure is essential for confirming Hodgkin's Lymphoma?
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What is the primary factor that determines the prognosis of Hodgkin's Lymphoma?
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Which of the following is a common symptom associated with Non-Hodgkin's Lymphoma?
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What is the typical incidence of Non-Hodgkin's Lymphoma in the UK as of 2018?
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In contrast to Hodgkin's Lymphoma, how does Non-Hodgkin's Lymphoma typically present?
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Which cell marker is associated with Reed-Sternberg cells in Hodgkin's Lymphoma?
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What type of anaemia may occur as a hematological finding in Non-Hodgkin's Lymphoma?
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What is a significant late side effect of treatment for Hodgkin's Lymphoma?
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What age range does Acute Lymphoblastic Leukemia (ALL) peak in incidence?
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What is the most common subtype of Acute Lymphoblastic Leukemia (ALL)?
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What percentage of childhood leukemias does Acute Lymphoblastic Leukemia (ALL) account for?
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What is a common physical manifestation observed in patients with ALL?
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What genetic abnormality is commonly associated with Chronic Myeloid Leukemia (CML)?
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What is the typical age range for peak onset of Chronic Myeloid Leukemia (CML)?
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Which of the following symptoms is associated with bone marrow failure in ALL?
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What is a common consequence of the BCR-ABL fusion gene in CML?
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What is a common symptom of ALL involving the central nervous system (CNS)?
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What is the typical prognosis for children diagnosed with ALL when treated with standard chemotherapy?
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Study Notes
Overview of Haematological Malignancies
- Leukaemia: Cancer of white blood cells (WBCs).
- Types include Acute Myeloid Leukaemia (AML), Acute Lymphoblastic Leukaemia (ALL), Chronic Myeloid Leukaemia (CML), Chronic Lymphoid Leukaemia (CLL), and others.
- Lymphoma: Cancer of lymphoid tissues.
- Divided into Hodgkin's Lymphoma and Non-Hodgkin's Lymphoma.
- Myeloma: Cancer of clonal plasma cells in the bone marrow (B-cells).
Regulation of the Cell Cycle
- Normal cell proliferation regulated by growth factors.
- Proto-oncogenes promote cell cycle progression (analogous to a gas pedal).
- Tumor suppressor genes inhibit cell cycle progression (similar to a brake pedal).
Genetic Alterations and Malignancies
- Haematological malignancies arise from genetic alterations in single marrow or lymphoid cells.
- Oncogenes: Mutated proto-oncogenes cause uncontrolled cell growth.
- Tumor Suppressor Genes: Mutations lead to compromised inhibition of cell growth.
- Clonal populations form through successive mitotic divisions of an abnormal cell.
Incidence and Prevalence
- Incidence: Rate of new cases over a given period, often expressed per 100,000.
- Prevalence: Total number of people with a condition.
Leukaemia Facts
- Characterized by uncontrolled growth of blood cells in the bone marrow, resulting in elevated white cell counts and bone marrow failure.
-
2018 UK Stats:
- 9,900 annual diagnoses.
- Incidence: 15.8 cases per 100,000.
- Mortality: 7.6 cases per 100,000 (2019).
- More prevalent in adults than children; most common childhood cancer.
Causes of Leukaemia
- Most cases have unknown causes.
- Known factors:
- Previous chemotherapy (alkylating agents).
- Radiation exposure.
- Chemicals like benzene and formaldehyde.
- Genetic conditions (e.g., Down's syndrome, myelodysplasia).
Types of Leukaemia
- Acute Leukaemia: Little or no maturation of cells; >20% blast cells present.
- Chronic Leukaemia: Many maturing cells; gradual disease progression.
Acute Myeloid Leukaemia (AML)
- Characterized by abnormal proliferation of myeloid stem cells and immature white cells.
- Median diagnosis age: ~60 years.
- 2018 UK Incidence: 4.9 cases per 100,000.
Symptoms and Diagnosis of AML
- Common symptoms: malaise, fever, sweats, anemia, infections (neutropenia), and bleeding (thrombocytopenia).
- Blood tests show >20% blast cells; leukocytosis, leukopenia, or normal WBC count possible.
- Anemia is typically normocytic and normochromic.
Prognosis of AML
- Successful chemotherapy can lead to remission (less than 5% blast cells).
- Cure rates: ~80-90% in younger patients, ~45% overall.
- 5-year survival rate is significant for assessing treatment effectiveness.
Acute Lymphoblastic Leukaemia (ALL)
- Results from proliferation of lymphoid stem cells, producing numerous lymphoblasts.
- Peak incidence between ages 0-4; accounts for 80% of childhood leukemia cases.
- 2018 UK Incidence: 1.1 cases per 100,000.
Symptoms of ALL
- Abrupt onset with symptoms like bone and joint pain, anemia, hepatosplenomegaly, and potential CNS involvement.
- Prognosis better in children; adults have lower cure rates.
Chronic Myeloid Leukaemia (CML)
- Involves uncontrolled proliferation of myeloid stem cells, mainly producing neutrophils.
- Peak onset ages: 65-85; more common in males.
- 2018 UK Incidence: 1.3 cases per 100,000, linked to Philadelphia chromosome.
Symptoms and Diagnosis of CML
- Common symptoms: fatigue, weight loss, splenomegaly, gout, easy bruising.
- Blood tests show elevated WBC counts, often >50 x 10^9/L, with normocytic anemia, thrombocytosis, or thrombocytopenia.
- Positive for BCR-ABL fusion gene linked to CML.
Chronic Lymphoid Leukaemia (CLL)
- Characterized by uncontrolled B-lymphocyte proliferation.
- Typically affects older adults (>50 years).
- 2018 UK Incidence: 5.7 cases per 100,000; often asymptomatic and can result in lymphocytosis.
Prognosis of CLL
- Often indolent; early chemotherapy may not be needed.
- Around 70% 5-year survival; patients may die from other causes.
Lymphoma Overview
- Hodgkin's Lymphoma: Malignant B-cells, characterized by Reed-Sternberg cells; inc. 3.3 cases per 100,000 (2018).
- Non-Hodgkin's Lymphoma: Comprises a greater variety of lymphoid tumors; highest incidence among hematological cancers at 22.8 cases per 100,000 (2018).
Key Features of Hodgkin's vs Non-Hodgkin's Lymphoma
- Hodgkin's: Age peaks at 15-35 and over 50; good prognosis (~80% 10-year survival).
- Non-Hodgkin's: More variable presentation, often presents as painless lymphadenopathy.
Key Diagnostic Procedures
- Lymph node biopsy for lymphoma diagnosis.
- FISH for detection of Philadelphia chromosome in CML cases.
Final Remarks
- Understanding the type and characteristics of leukaemia and lymphomas is crucial for effective diagnosis and treatment.
Gastrointestinal Involvement in Non-Hodgkin's Lymphoma
- Abdominal symptoms can arise from splenic or hepatic enlargement and GI tract involvement.
Hematological Findings in Non-Hodgkin's Lymphoma
- Normocytic, normochromic anemia is common; autoimmune hemolytic anemia may also occur.
- Advanced disease can lead to neutropenia and thrombocytopenia from bone marrow involvement.
Diagnostic Procedures
- Lymph node biopsy is essential for diagnosis.
- Cytogenetic tests, such as chromosome mapping, may be performed for further analysis.
Prognosis of Non-Hodgkin's Lymphoma
- The 10-year survival rate is approximately 55%.
Response to Chemotherapy in Non-Hodgkin's Lymphoma
- Indolent types respond well to chemotherapy, but a complete cure is rare.
Cure for Aggressive Non-Hodgkin's Lymphoma
- Aggressive forms may be cured through chemotherapy combined with rituximab.
Stem Cell Transplants
- Stem cell transplants are increasingly utilized in the treatment of Non-Hodgkin's Lymphoma.
Definition of Multiple Myeloma
- Multiple Myeloma is characterized as cancer of clonal plasma cells in the bone marrow, originating from B-cells.
Characteristics of Ab-secreting B-cells
- These cells produce a paraprotein, a homogeneous immunoglobulin detectable in serum and/or urine.
Age-related Incidence of Multiple Myeloma
- Rare before age 40, with peak incidence at ages 85-89.
Incidence of Multiple Myeloma in the UK
- Reported incidence is 9.6 cases per 100,000 population (2018 data).
Gender and Ethnicity Predominance
- Males are more affected than females.
- African Americans show higher incidence rates than Caucasians.
Common Presenting Symptoms of Multiple Myeloma
- Bone pain is the most common symptom, often leading to fractures.
- Associated symptoms may include anemia, thrombocytopenia, and leukopenia.
Systemic Complications in Multiple Myeloma
- Complications may include renal failure and hypercalcemia.
Amyloidosis in Multiple Myeloma
- Amyloidosis involves deposition of misfolded proteins, causing additional clinical issues.
Effect on Bone Marrow
- Plasma cells accumulate in the bone marrow, leading to overcrowding and increased plasma cell count (usually exceeding 20%).
Diagnostic Indicators in Blood Tests for Multiple Myeloma
- Detection of paraprotein in serum and/or urine is a key diagnostic indicator.
Hematological Findings in Blood Tests for Multiple Myeloma
- Anemia may present as normocytic, normochromic, or macrocytic.
- Pancytopenia, a reduction in all blood cells, can occur.
Metabolic Imbalance in Blood Tests
- Hypercalcemia, elevated blood calcium levels, may be indicative of Multiple Myeloma.
Prognosis of Multiple Myeloma
- A complete cure is often elusive.
- Treatment typically involves chemotherapy followed by stem cell transplant, with a 10-year survival rate of about 29%.
- Good palliative care is crucial for pain management.
Summary of Hematological Cancers
- Leukaemia is classified into types such as Acute Myeloid Leukaemia (AML), Acute Lymphoblastic Leukaemia (ALL), Chronic Myeloid Leukaemia (CML), and Chronic Lymphoid Leukaemia (CLL).
- Lymphoma includes Hodgkin's and Non-Hodgkin's lymphoma.
- Myeloma refers to the cancer of clonal plasma cells in the bone marrow derived from B-cells.
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Description
Test your knowledge on leukemia, its types, and related concepts. This quiz covers the characteristics of various leukemias, the regulation of cell proliferation, and the implications of genetic alterations. Perfect for students studying hematology or oncology.