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 Answer BOF 3.82

 

   

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BOF: 3.82

An 18-year-old male presents with a history of feeling tired and having bleeding gums.

On examination he is noted to have hepatosplenomegaly. Investigations reveal anaemia with a high white cell count, predominantly lymphocytes with an excess of lymphoblasts. Bone marrow examination shows multiple lymphoblasts.

In this patient which of the following is indicative of a poor prognosis?

a)      Presence of Philadelphia chromosome

b)      White cell count > 50x 109/L

c)      Severe anaemia

d)      T cell disease

e)      Platelet count < 50 x109/L

Answer: a)

In acute lymphoblastic leukaemia (ALL) the indicators of a poor prognosis are:

      Adult

      Male

      Philadelphia chromosome present

      Presentation with CNS signs

      White cell count > 100 x 109 /L

      B-cell ALL

      Poor response to initial treatment

Revision Tip

Revise ALL KEYS to SUCCESS in Medicine page 399-402

 

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