Haematological Malignancies

Haematological MalignanciesRaymond Man1ContentIntroductionMyeloid LeukaemiaLymphoblastic LeukaemiaLymphomaMultiple Myeloma

(Myelodysplasia)2Haematological Malignancies3Haematological MalignanciesGeographical Variation (CLL common in West, but rare in Far East)

4Aetiology of Haematological MalignanciesLargely Unknown

As with most disease, combo of genetic + environmental that determine risk.5Inherited FactorsMajor FactorE.g. Downs Syndrome 20-30x likely to develop acute leukaemia)

AML, CLL, Lymphomas have weak familial tendency, although largely unknown predisposing genes.6EnvironmentalChemicalsBenzenes

DrugsAlkylating agents (esp with Rtx)

RadiationIncreased rates following survivors of atom bomb explosion in Japan

7InfectionViralEBVHerpesHIVBacteriaH. PyloriProtozoaMalaria

EnvironmentalInfectionViralBurkitt LymphomaKaposis sarcomaHIV-associated LymphomaBacteriaGastric Mucosa B-cell (MALT) LymphomaProtozoaAlter host immunity predisposing to tumour formation e.g. EBV infection8leukaemia9LeukaemiaChronic vs AcuteAcute usually aggressive

Myeloid vs Lymphoblastic

10

11LeukaemiaAccumulation of white cells in:Bone MarrowBlood

Cause:Bone Marrow FailureOrgan Infiltration12acute Myeloid leukaemia

13Incidencemost common form of acute leukaemia in adultsIncreasingly common with ageMedian onset 65 years.

14Diagnosis>20% blast cells in blood / marrow

or

(70yrs