(which one is to do with chilblains in elderly males)
Most due to specific gene mutations.
Acute lymphoblastic leukaemia (ALL):
commonest form in childhood <5yrs; rapid course
massive infiltration of bone marrow by immature lymphoid cells
generalised infections and weakness; bleeding; anaemia; bone pain
50% cure rate with chemotherapy; marrow transplant

Acute myelogenous leukaemia (AML):
• most common form; more common in elderly
• heterogenous disorder
• acute course; fatal in 2 months if untreated; 20% 3 year survival with chemotherapy
• infection is major complication

Chronic myeloid leukaemia (CML):
• 15% of leukaemia’s; annual incidence in UK of 1/100 000
• usually between ages 30-80yrs (peak at 55yrs)
• slow onset of non-specific symptoms (tiredness, weight loss, breathlessness, abdominal pain, lethargy, anorexia, sweating, abdominal fullness, bruising); 90% have splenomegaly
• 90% have Philadelphia (Ph1) chromosome (a shortened chromosome 22)
• management – chemotherapy (hydrozyurea most widely used); alpha interferon
• prognosis – 15% die in first 12 months; median survival is about 45 months

Chronic lymphocytic leukaemia (CLL):
• 25%; most >50yrs; M2x>F;
• 85-95% are B-cell origin
• insidious onset – up to 25% diagnosed incidentally; present with anaemia, painful lymphadenopathy, infections, fatigue and weakness
• Staging:
• A – no anaemia or thrombocytopenia; < 3 areas of enlarged lymph glands • B - no anaemia or thrombocytopenia; > 3 areas of enlarged lymph glands
• C – anaemia and/or thrombocytopenia
• Management – Stage A – no specific treatment; Stage B – chemotherapy if symptomatic, local radiotherapy to lymph nodes; Stage C – transfusion for anaemia


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Page last updated: Jul 16, 2022 @ 12:50 am

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