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Leukaemia & Lymphoma: Clinical Approach
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Lesson 2 of 14
Notes
Leukaemia & Lymphoma
Leukaemia Overview
| Type | Typical Age | Key Features | Genetics |
|------|-------------|-------------|----------|
| ALL | Children (<15) | Lymphoblasts, CNS involvement | t(12;21) TEL-AML1 good prognosis |
| AML | Adults >50 | Myeloblasts, Auer rods, M3=APML | t(15;17) APML — ATRA responsive |
| CLL | Elderly >60 | Lymphocytosis, smear cells, indolent | del(13q) good, del(17p) poor |
| CML | Middle age | Massive splenomegaly, basophilia | BCR-ABL t(9;22) Philadelphia chr. |
CML & Tyrosine Kinase Inhibitors
- BCR-ABL fusion → constitutively active tyrosine kinase → uncontrolled myeloid proliferation
- Treatment: imatinib (first-line TKI) — revolutionised prognosis
- Blast crisis: transformation to AML/ALL phenotype — poor prognosis
Hodgkin vs Non-Hodgkin Lymphoma
| | Hodgkin (HL) | Non-Hodgkin (NHL) |
|-|-------------|------------------|
| Age | Bimodal: 20s & >55 | >50 |
| Cell | Reed-Sternberg cells | B or T cell lymphocytes |
| Spread | Contiguous | Non-contiguous |
| B symptoms | Common | Less prominent |
B Symptoms
- Drenching night sweats
- Unexplained fever >38┬░C
- Weight loss >10% body weight in 6 months
Ann Arbor Staging
- I: single node region; II: 2 regions same side diaphragm; III: both sides; IV: extra-nodal
- A/B suffix: absence/presence of B symptoms