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Leukaemia

Definition
  • Leukaemia: A group of blood cancers that result from the overproduction of immature or abnormal white blood cells, which interfere with the production of normal blood cells.
Classification
  • Acute: Rapid progression and accumulation of immature blood cells.
    • Acute Lymphoblastic Leukaemia (ALL)
    • Acute Myeloid Leukaemia (AML)
  • Chronic: Slower progression, accumulation of mature but abnormal cells.
    • Chronic Lymphocytic Leukaemia (CLL)
    • Chronic Myeloid Leukaemia (CML)
Epidemiology
  • Most common in children (ALL) and adults over 55.
  • More common in males than females.
Risk Factors
  • Ionising radiation exposure.
  • Previous chemotherapy or radiation therapy.
  • Genetic disorders like Down syndrome.
  • Exposure to certain chemicals (e.g., benzene).
  • Family history of leukaemia.
Clinical Features
  • Fatigue or anaemia.
  • Frequent infections due to leukocyte dysfunction.
  • Bruising or bleeding easily.
  • Fever or night sweats.
  • Swollen lymph nodes.
  • Bone or joint pain.
  • Unintended weight loss.
Investigations
  • Full Blood Count (FBC): Shows elevated white cell count and reduced platelets and haemoglobin.
  • Bone Marrow Biopsy: Confirms diagnosis and type of leukaemia.
  • Cytogenetic studies: To identify chromosomal abnormalities.
  • Immunophenotyping: Differentiates between ALL and AML.
Management
  • Chemotherapy: Mainstay of treatment for most types.
  • Radiation therapy: For areas with a bulk of disease or prior to stem cell transplant.
  • Stem cell transplantation: Can be curative for some types of leukaemia.
  • Targeted therapies: Specific for certain types of leukaemia (e.g., tyrosine kinase inhibitors for CML).
Prognosis
  • Varies widely based on type of leukaemia, age, overall health, and chromosomal abnormalities.
  • Early diagnosis and prompt treatment often lead to better outcomes.

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