Term
| What is the treatment of Acute Lymphoblast Leukaemia? |
|
Definition
1. Remission Induction: vincristine, prednisolone, L-asparaginase, daunorubicin
2. Intensification/consolidation: Vincristine, Prednisolone, daunorubicin, etoposide, cytarabine, thioguanine
3. Maintenance: MTX, 6-MP, vincristine, prednisolone |
|
|
Term
| When is stem cell therapy indicated for ALL? |
|
Definition
adult: after 1st remission
child: after 2nd remission |
|
|
Term
| What do lymphoblasts infiltrate in ALL? |
|
Definition
| lymph nodes, menegies, testis, liver, spleen |
|
|
Term
| What are 3 common manifestations of acute leukaemias? |
|
Definition
| infection, bleeding, anaemia |
|
|
Term
| What is prophylaxis/treatment for CNS disease of ALL? |
|
Definition
| MTX intrathecal, radiotherapy |
|
|
Term
| What do myeloblasts infiltrate in AML? |
|
Definition
|
|
Term
| What are the two classifications of AML? |
|
Definition
FAB: based on cell type - granulocytic, monocytic, erthroid, megakaryocytic
WHO: based on genetic, immunological markers - inv(16), t(15:17), t(8:12) |
|
|
Term
| What is the mainstay therapy of AML? |
|
Definition
|
|
Term
| What is the therapy for diagnosed AML? |
|
Definition
ADE (10+3+5): Cytarabine days 1-10; daunorubicin days 1,3,5; etoposide days 1-5;OR
ADE (8+3+5) |
|
|
Term
| What is the MACE therapy in leukaemia? What is MidAC? |
|
Definition
Intesification/consolidation after remission of AML
Amsacrine, Cytarabine, Etoposide (days 1-5); THEN
Mixantrone, Cytarabine (days 1-5) |
|
|
Term
| Is there maintenance therapy or CNS prophylaxis in AML? |
|
Definition
|
|
Term
| Which drug is acute promyelocytic leukaemia highly sensitive to? |
|
Definition
| all-trans retinoic acid (ARTA) |
|
|
Term
| What is the action of ATRA? |
|
Definition
| causes blast maturation and remission |
|
|
Term
| What is given in relapse of AML? |
|
Definition
| cytarabine, fludarabine, granulocyte colony stimulating factor (GCSF) |
|
|
Term
| What drug is used to normalise WBC levels in CML? |
|
Definition
| hydroxycarbamide (hydroxyurea) 2g/d till WBC under control |
|
|
Term
| Why should hydroxyurea dose be tappered down |
|
Definition
| so as not to cause WBC rebound |
|
|
Term
| What drugs are used in CML? |
|
Definition
| hyroxycarbamide, interferon-a, cytarabine, imatinib mesylate |
|
|
Term
| what is the action of interferon-a in CML? |
|
Definition
| promotes expression of suppressed normal haemopoiesis |
|
|
Term
| What are the specific and non-specific symptoms of CML? |
|
Definition
specific: weight loss, malaise, night sweats
non-specific: enlarged spleen, abdo discomfort, hepatmegaly |
|
|
Term
| What are the 3 phases of CML? |
|
Definition
Chronic (months-20yrs)
Accelerated - disease more aggresive to treatment; worsening symptoms: fevers, bones pain, thrombocytopenia, anaemia
Blast crisis (weeks-months) |
|
|
Term
| What is the goal of CML treatment to keep patients asymptomatic? |
|
Definition
|
|
Term
| What is the only curative option for CML patients? |
|
Definition
|
|
Term
| What is the therapy for CLL? |
|
Definition
No cure; palliative management
CHOP: cyclophosphamide, vincristine, hydroxydaunorubicin, prednisolone
radiotherapy
Campath-1H monoclonal CD52 Ab. |
|
|
Term
| What is the process of stem cell therapy in leukaemia? |
|
Definition
1. Harvest SC
2. Abative therapy (chemo+radiation)
3. Infuse stem cells |
|
|
Term
| How is the patient conditioned for stem cell therapy? |
|
Definition
cyclophosphamide, irradiation/mephalan, etoposide, busulphan, cytarabine
allow 2-3 days for elimination of conditioning |
|
|
Term
| How long does stem cell therapy take to restore normal haemopoiesis and peripheral blood counts after infusion? |
|
Definition
|
|
Term
| What antigens are matched for donor stem cells in CLL? |
|
Definition
| human leucocyte antigen (HLA) |
|
|
Term
| How are stem cells harvested? |
|
Definition
Haematopoietic growth factor (GCSF) (+ cyclophosphamide for autograft) for 7 days to stimulate release into PC
cell pheresis: harvest SC from PC
recovery period: 5-10 days |
|
|
Term
| What the complications of Stem Cell Therapy? |
|
Definition
Infection, interstitual pneumonitis, hepatic veno-occlusive disease
graft-versus host disease (GVHD) |
|
|
Term
| How is acute GVHD defined? |
|
Definition
| Within 100 days of transplant |
|
|
Term
| How is chronic GVHD defined? |
|
Definition
| after 3 months of transplant |
|
|
Term
| What are the symptoms of acute GVHD? |
|
Definition
| fever, rash, diarrhoea, liver dysfunction |
|
|
Term
| What are the symptoms of chronic GVHD? |
|
Definition
multisystem disorder
chronic hepatitis, severe skin inflammation, immunosuppression |
|
|
Term
| When is allogenic stem cell therapy indicated in CML? |
|
Definition
|
|
Term
| What oral hygeine measures can leukaemia patients take? |
|
Definition
| mouthwash, prophylactic antifungal therapy, regular cleaning with soft brush without causing trauma |
|
|
Term
| What type of leukaemia do patients need prophylactic treatment of herpes virus and P. jiroveci? |
|
Definition
|
|
Term
| What is can be given after chemotherapy to stimulate neutrophil production and reduce neutropenia? |
|
Definition
| haematopoietic growth factor (GCSF) |
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