Haematology Module 1

Asciminib, a novel therapeutic agent, has been recently explored for its efficacy in newly diagnosed Chronic Myeloid Leukemia (CML).

Which of the following statements best describes the role and clinical impact of Asciminib in this patient population?

A 45-year-old male was admitted to the hospital with a history of leukemia. He recently underwent CAR-T cell therapy, and within 24 hours post-infusion, he developed a high fever of 40°C, severe fatigue, and diffuse muscle pain.

His blood pressure dropped, and he began experiencing difficulty breathing.

Laboratory tests revealed markedly elevated levels of inflammatory markers such as interleukin-6 (IL-6), tumor necrosis factor-alpha (TNF-alpha), and C-reactive protein (CRP).

The following intervention may be useful in this situation, except?

Which one of the following cytogenetic abnormality has the best prognosis in Acute myelogenous leukemia?

Clinical outcomes from acute myeloid leukemia is strongly related to which factor?

A 54-year-old man is diagnosed as having acute myeloid leukaemia. What is the single most important test in determining his prognosis?

A 36 year old patient with acute promyelocytic leukemia (APML) develops symptoms of cough,dyspnea, fever, weight gain and edema 10 days after commencing ATRA. Further imaging reveals pleural and pericardial effusion and pulmonary infiltrates.Serial blood test shows progressive renal failure. Clinically the patient is in severe respiratory distress with severe hypoxemia.

What is the most appropriate next step in management?

Which of the following chemotherapeutic agent is least likely to be beneficial in the treatment of AML?

Which one of the following is not an indication for treatment in chronic lymphocytic leukaemia?

A 65-year-old woman is reviewed. She is on the waiting list for a varicose vein operation but during the preoperative assessment was noted to have a raised lymphocyte count. She reports feeling well currently and clinical examination is normal. Her bloods were as follows:

Hb 118 g/l
Plt 184 (10⁹/l)
WBC 21.2 (10⁹/l)

There are no previous bloods to compare these results with. Following referral to haematology a diagnosis of chronic lymphocytic leukaemia was made. What is the most appropriate management?

A 71-year-old woman with no significant past medical history is investigated for lymphocytosis. She has recently lost 7kg in weight and complains of lethargy. The following blood results are obtained:

Four months previously her white cell count was 30.5 (10⁹/l).

Cytogenetics: TP53 mutation is not present and IGHV is mutated.

What is the most appropriate management?

A 77-year-old man with a history of chronic lymphocytic leukaemia is admitted to the Acute Medical Unit with pneumonia. This is his fourth admission for pneumonia in the past six months. Which one of the following factors is most likely to be responsible?

Venetoclax has recently been proven to be useful in the treatment of which condition?

Ibrutinib has a role in the treatment of all the following types of malignancy except?

A 52-year-old man with a history of anaemia and abdominal discomfort is diagnosed as having chronic myeloid leukaemia. He is commenced on imatinib.

What is the mechanism of action of imatinib?

A 45 year old man with Philadelphia chromosome positive acute lymphocytic leukemia(ALL) develops severe GI toxicity and fluid retention after using Imatinib.

What is the next appropriate step in management?

The following are appropriate therapy for chronic phase of CML except?

A patient with myelodysplasia is at risk of transformation into which type of malignancy?

The following are poor prognostic factors for ALL except?

Which of the following treatment is most effective in physically fit patients with previously untreated chronic lymphocytic leukemia (CLL)?

In the treatment of relapsed T-cell acute lymphoblastic leukemia (ALL) using base-edited CAR7 T cells, what primary mechanism is utilized to avoid graft-versus-host disease and enhance the safety profile of the therapy?

The risk of tumour lysis syndrome is most likely related to:

A 15 year old male undergoing induction for acute lymphoblastic leukaemia is at risk of tumour lysis syndrome due to a high white cell count. Twelve hours following initial chemotherapy, the following investigations were obtained:

• Calcium 2.0 mmol/L [2.15-2.65]
• Phosphate 3.0 mmol/L [1.3-2.3]
• Lactate Dehydrogenase (LDH) 9800 U/L [500-920]
• Uric Acid 0.4 mmol/L [0.1-0.3]
• Urinary pH 7.8
• Urinary specific gravity 1018
• Urinary nitrates +3

Which one of the following metabolites is most likely to precipitate within the renal tubules in the patient?

What is the most common mechanism of acute renal failure in tumour lysis syndrome?

A 15 year old man has a massive abdominal Burkitt lymphoma. What is the most useful treatment to prevent tumour lysis syndrome?

Among the following type of lymphoproliferative disorder, which one carries the lowest risk for developing tumour lysis syndrome?

In patients with previously untreated CLL and coexisting conditions, which monoclonal antibody resulted in better outcomes when combined with chlorambucil?