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Path - Leukaemias (ii) (ALL (meningeal syndrome (cancer cells get into CSF…
Path - Leukaemias (ii)
AML
malignant transformation of a myeloid precursor
most frequent leukaemia in neonate
rare in childhood (10-15% of cases)
2nd peak in adulthood (80%)
incidence increased with age
gum hypertrophy (cells migrate here for unknown reason)
hepatomegaly more common than lymphadenopathy
DIC
ALL
most common childhood malignancy (85%)
incidence decreases with age
then 2nd peak after 40 yrs
nowadays good prognosis + cure rate
bone pain common
lymphadenopathy (eso cervical + mediastinal) more common than hepatospenomegaly
testicular swelling
meningeal syndrome
cancer cells get into CSF + breakdown
irritates meninges
same symptoms as meningitis
CML
aka granulocytic
typical onset = middle-aged (40-60 y/o)
t(9;22) - BCR-Abl - Philadelphia chromo
can tx with imatinib (tyrosine kinase inhibitor, also used for GIST)
marked leukocytosis (> 50 000)
hepatosplenomegaly
CLL
older onset age
BM failure slowly develops over yrs
lymphocytosis
look for Jak2 (janus kinase 2) mutation
non-R tyrosine kinase
if +ve can give jak2 inhibitors