Leukaemia

• leukaemia?

  A group of closely related malignant disorders arising from immature blood-forming cells
• what occurs in leukaemia?

  • normal bone marrow breakdown produces abnormal cells
  • these take over and bone marrow no longer able to keep up production of normal cell types
• acute leaukemia:

  abnormality seen in blast cell
• chronic leukaemia:

  proliferation of more mature cells occur
• myeloid - monocyte/granulocyte production
• lymphoid - lymphocyte production
• 4 main types:

  • acute myeloid
  • chronic myeloid
  • acute lymphoblastic
  • chronic lymphoblastic
• acute myeloid leukaemia

  
• chronic myeloid leukaemia

  
• acute lymphoblastic leukaemia

  
• Chronic lymphoblastic leukaemia

  
• incidence: 5% of all cancers
• cause:

  • unknown
  • not infectious
• recognised RF for acute/chronic myeloid:

  • cigarette smoking
  • exposure to some chemicals
  • radiation
  • immune disorder
  • rare reaction to viral infection
• cause of acute lymphoblastic leukaemia?

  • unknown
  • maybe xray exposure in pregnancy
  • infection in early life = abnormal cells
• acute myeloid leakaemia:

  • death if no tx
  • more common in older people
  • irradiation exposure RF
• chronic myeloid leukaemia:

  • rare in young people
  • males more affected
• acute lymphoblastic leukaemia:

  • most common in children
  • 2-5 years
  • aetiology unknown
• chronic lymphocytic leukaemia:

  • increased number of immature lymphocytes
  • most common
  • in elderly
• can range from having no symptoms and a normal life expectancy or can be very aggressive, causing serious problems for the pt.
• twice as common in men than women
• signs and symptoms - acute

  • low energy, pallor
  • lack of WBC, recurrent infection
  • thrombocytopenia
  • lymphodenapathy
  • enlarged spleen - swollen abdomen
  • joint pain
• petechiae

  
• signs and symptoms - chronic

  • loss of energy
  • fever
  • night sweats
  • loss of appetite
  • unusual/prolonged bleeding
• what puts pt more at risk of infection?

  reduced PMNs
• likely cause of death?

  septicaemia
• oral signs?

  • excessive gingival bleeding
  • hyperplasia gingival
  • oral ulceration
• oral presentation of leukaemia

  
• acute leukaemia

  
• affects of chemotherapy/radiotherapy?

  • kills rapidly growing cells
  • drugs cause vomiting 10-20 days
• bone marrow transplantation is a treatment for leukaemia and other blood disorders
• synergenic transplantation

  donor identical twin
• allogenic transplantation:

  compatible close relative
• autologous transplantation:

  own bone marrow received, withdrawn at earlier stages of illness (frozen)
• remission?

  used when blood adn bone marrow are restored to normal, still low number of abnormal cells which could multiply if tx stopped too slowly
• relapse?

  recurrence of leukaemia after remission
• chemo on oral mucosa:

  • swelling of salivary glands
  • swelling of lips
  • ulceration on tongue lips pharynx mucosa
  • plaque + gingival inflammation increases
  • herpes simples common
• musositis

  
• acute herpetic gingivostomatitis
• prevention:

  • low sugar intake
  • fluoride supplement for children
  • fluoride rinses
  • fissure sealants
  • regular DHT visits to help with plaque control