Tuesday, 6 May 2014

Acute Leukaemia

As always, check out the Calgary Guide for the pathophysiology of leukaemias. The important thing to realise is that Chronic Myeloid Leukaemia (CML) can progress into AML or ALL.

Chronic Myeloid Leukaemia

Incidence of 1 per 100 000 population. Symptoms are usually chronic and non-specific, but splenomegaly is common and may extend beyond the umbilicus. Lymphadenopathy is not usually prominent. Neutrophilia is common and may be accompanied by thrombocytosis, basophilia, monocytosis, or eosinophilia.

Acute Leukaemias

Acute Lymphoblastic Leukaemia
Common at 2-10 years with a peak at 3-4 years
Secondary rise after 40 years
Acute lymphoblastic leukaemia is slightly more common among males than females

Acute Myeloid Leukaemia
10-15% of childhood leukaemia but is the commonest leukaemia of adulthood
Incidence increases with age, and the median age at presentation is 60 years.
Acute myeloid leukaemia is equally common among males and females

Clinical Features
Bone Failure - signs of anaemia.
  neutropenia - infections of the mouth, throat, skin or perianal region
  thrombocytopenia - spontaneous bruising, menorrhagia, bleeding from venepuncture sites, gingival bleeding or prolonged nose bleeds
Organ infiltration
“B symptoms”- fevers, night sweats, and unexplained weight loss

- Anaemia - normocytic
- Low platelets
- Low white cell count - neutropenia with lymphocytosis
- Coagulopathy
- Hyperuricaemia
- Chest radiography is mandatory to exclude the presence of a mediastinal mass



1 comment:

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