Haematological: Key Points

    Leukaemias : Acute and Chronic

    • Approx 5000 adult cases p.a. (all types) in England and Wales.
    • 75% occur in patients aged over 60 years, but all ages can be affected.
    • Risk factors include previous chemotherapy/radiotherapy and exposure to radiation.
    • Most cases are diagnosed following a blood count undertaken because of symptoms and/or signs of bone marrow failure (fatigue, pallor, bruising, bleeding, infections, etc).
    • Some leukaemias may present with lymphadenopathy and/or hepatosplenomegaly.
    • Chronic lymphocytic leukaemia (CLL) is an indolent disease normally diagnosed on blood film, which does not usually require urgent referral.

    Non Hodgkin’s Lymphoma

    • Approx 7000 adult cases p.a. in England and Wales.
    • 67% of cases occur in patients aged over 60 years, but all ages can be affected.
    • Presenting features include:
      • Lymphadenopathy
      • Hepatosplenomegaly
      • Fatigue
      • Weight loss
      • Night sweats
    • 40% present with tumour outside lymph glands.

    Hodgkin’s Disease

    • Approximately 1200 new cases p.a. in England and Wales.
    • Over 50% of cases occur below the age of 40 years.
    • Clinical features similar to those for Non-Hodgkin’s lymphomas (but 95% present with lymph gland involvement).

    Myeloma

    • Approximately 3000 new cases p.a. in England and Wales.
    • 99% of cases are aged over 40 years and 95% are aged over 50 years.
    • Clinical features include:
      • Bone pain +/- bone fractures
      • Symptoms of anaemia
      • Renal impairment
    • Erythrocyte sedimentation rate (ESR) or plasma viscosity may be grossly elevated.

 

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