Author: John Wilson, David Quinn / Editor: Frances Balmer / Codes: / Published: 14/02/2022
Description:
Leukaemia is a rare disorder. Patients often present acutely and often via the emergency department.
This session outlines the pathophysiology of acute leukaemia, the first-line investigations and management, with a particular focus on scenarios likely to be encountered in the emergency department.
Learning objectives:
- Outline the pathophysiology and epidemiology of leukaemia.
- Recognise how patients with acute leukaemia may present to the emergency department.
- Arrange appropriate investigations within the emergency department.
- Recognise the complications of leukaemia and manage the initial stabilisation of these patients, whilst awaiting haematology input.
References
- National Cancer Registration and Analysis Service. Cancer Data [Internet]. 2018 [cited 2021 Aug 11].
- National Cancer Registration and Analysis Service. Routes to Diagnosis [internet]. 2017 [cited 2021 Aug 11].
- Swerdlow SH, Campo E, Harris NL, Jaffe ES, Pileri SA, Stein H, Thiele J, Arber DA, Hasserjian RP, Le Beau MM, Orazi A, Siebert R, (eds). WHO Classification of Tumours of Haematopoietic and Lymphoid Tissues. 4th edition(revised). Lyon: International Agency for Research on Cancer. 2017.
- Bain B. Leukaemia Diagnosis. 4th Edition. Oxford: John Wiley and Sons. 2010.
- Burnett AK, Grimwade D. Acute myeloid leukaemia. In: Hoffbrand AV, Higgs DR, Keeling DM, Mehta AB (eds). Postgraduate Haematology. 7th edition: Oxford: John Wiley and Sons; 2016.
- Rubin R, Strayer DS. Rubins Pathology. 6th Ed. Baltimore: Lipincott Williams & Wilkins. 2012.
- de Pater E, Dzerzak E. Stem cells and haemopoiesis. In: Hoffbrand AV, Higgs DR, Keeling DM, Mehta AB (eds). Postgraduate Haematology. 7th edition: Oxford: John Wiley and Sons; 2016.
- Bolli N, Vassiliou G. The molecular basis of leukaemia and lymphoma. In: Hoffbrand AV, Higgs DR, Keeling DM, Mehta AB (eds). Postgraduate Haematology. 7th edition: Oxford: John Wiley and Sons; 2016.
- Rllig C, Ehninger G. How I treat hyperleukocytosis in acute myeloid leukemia. Blood. 2015; 125 (21):3246-3252.
- Bakst RL, Tallman MS, Douer D, Yahalom J. How I treat extramedullary acute myeloid leukemia. Blood. 2011; 118(14):3785-3793 . Doi 10.1182/blood-2011-04-347229
- Jonson OG, Sartain P, Ducore JM, Buchanan GR. Bone pain as an initial symptom of childhood acute lymphoblastic leukaemia: association with nearly normal hematologic indexes. The Journal of Pediatrics. 1990 Aug; 117: 233-237. Doi 10.1016/s0022-3476(05)80535-9
- Brix N, Rosthj S, Herlin T, Hasle H. Arthritis as presenting manifestation of acute lymphoblastic leukemia in children. Archives of Disease in Childhood. 2015;100:821-825.
- Freifeld AG, Bow EJ, Sepkowitz KA, Boeckh MJ, Ito JI, Mullen CA et al. Clinical Practice Guideline for the Use of Antimicrobial Agents in Neutropenic Patients with Cancer: 2010 Update by the Infectious Diseases Society of America. Clinical Infectious Diseases. 2011; 52(4): e56-e93.
- Samuelson Bannow BT, Lee AA, Khorona JI, Zwicker I, Noble S, Ay C, Carrier M. Management of cancer-associated thrombosis in patients with thrombocytopaenia: guidance from the SSC of the ISTH. Journal of Thrombosis and Haemostasis. 2018; 16(6): 1246-1249
- Foukaneli T, Kerr P, Bolton-Maggs PHB, Cardigan R, Coles A, Gennery A et al. Guidelines on the use of irradiated blood components. British Journal of Haematology. 2020, 191(5):704-724.
- Advisory committee on the safety of blood, tissues and organs. Cytomegalovirus tested blood components position statement. [Internet] 2012 [Cited 2021 October 29].