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Acute Leukaemia - Coggle Diagram

- - - - Cytopenia
        Anaemia
        Thrombocytopenia
        Neutropenia
      - Initially presents with cytopenia
        Evential cytosis as leukaemia cells spill into peripheral blood from bone marrow
    - - Electrolyte distrubance - TLS
      - Renal impairement
      - Liver imairement
    - - Marker of cell turnerover - not specific to malignancy
      - Directly proportional to aggressiveness of disease
      - Can be used to assess response to tx
    - - Co-existing infx / inflammation from acute leukaemia
    - - PT & APTT - prolonged or normal
      - Assess for DIC
  - - - Role
        
        First detection of an acute leukaemia
        Lab staff detec blasts circulating in periphreal blood
        Confirms diagnosis of leukaemia
        
        Cannot differentiate between subtypres - AML, ALL by morpology
        
        Can Identify particular type of acute leukaemia
        
        Acute promyelocytic Leukaemia (APML)
  - - - 1.Indentifies markers expressed on cell surafce or wtihin cell cytoplasms
      - can identify the maturation stage of blasts
      - Can differentiate cell lineages specific markers
        AML vs ALL
        B-ALL vs T-ALL
  - - - Look at all chromosome pairs
      - ID any nymberical lossess / gains / deletions
    - - Label genes on chromosomes
      - Can assess dublication / translocation / inversion
- - - - Recurrent inf
      - Disseminated viral infections HSV
    - - Fatigue
      - Breathlessness
      - Decreased exercise tolerance
      - Tachycardia
    - - Bleeding
      - Petechia
      - Bruising
      - Epistaxis
- - - - Antiviral medications - Posaconazole
      - Anti TLS meds - Allopurinal, Rasburicase
  - - - Non-Intensive Chemotherapy
        
        Indication
        
        Non-curative life prolonging
        
        Azacitadine
      - Intensitive
        
        Cytarabin
        
        Daunorubicin
    - - Induction
        
        Aim: Erradicate all detectable leukaemia cells and obtain remission
        
        Most intense
      - Consolidation
        
        Intermediate intensity
        
        Aim: Eradicate undetectable leukaemia cells
        Reinforce remission
      - Maintenance
        
        Low / least intestinty
        
        Aim: Keep leukaemia away
        Usually prolonged low dose tx
  - - - Monoclonal antibody
      - Drug-Anibody conjugates
      - BiTE: Bi-Specific T cell Engagers
  - - - HLA matched donor (10/10) match - Sibling or Unrelated Donor
      - High dose chemo - destroys / ablates marrow + any residual leukaemia
      - Donor bone marrow provides new cells to repopulate bone marrow
    - - Graft vs Host Disease
        
        New immune system recognises host body/ organs as abnormal
        
        Can be lifethreatening
        
        Good in small amounts
        
        Tx - Immunosuppressive therapy
  - - - ALL
      - Lymphoma
      - AML CAR-T cells being developed
- - - - Hyperphosphatemia
      - Hyperuricemia
      - Hyperkalaaemi
      - Reduced ionised calcium
  - - - Dyspnoea
      - Hypoxaemia
      - Diffuse alveolar haemorrhage
      - Respiratory failure
    - - Tinnitus
      - Impaired vision (retinal haemorrhage)
      - COnfusion
      - Comnolence
      - Dizziness
      - Headache
      - Delerium
      - Coma
      - focal neruological deficit
    - - DIC
      - MI
      - Infarctions
      - Limb Ischaemia
      - Renal vein thrombosis
      - Priaspism - painful erection
      - Retinal haemorrhage
    - - Leukaemia Cutis
      - Gum Hypertrophy
- - - - Anaemia
    - - Anaemia
      - Resp infx
    - - Infx
    - - Anaemia
      - Infx
    - - Infx
- - - - HSV
      - SMV
      - PCP
      - PJP
    - - Invasive aspergillosis