Acute myeloid leukaemia

Question 1

who are mostly affected ?

Answer 1

adults - incidence increases with age

Question 2

risk factors

Answer 2

previous chemotherapy
radiation
exposure to chemicals
predisposing diseases

Question 3

what are the predisposing diseases?

Answer 3

aplastic anaemia
myelodysplasia
myeloproliferative diseases

Question 4

diagnosis

Answer 4

> 20% of myeloblasts on bone marrow blood film

Question 5

symptoms

Answer 5

fatigue 
weight loss
gum bleeding 
petechial rash
leukaemia cutis 
spread to liver/spleen - hepatosplenomegaly

Question 6

what is leukaemia cutis?

Answer 6

infiltration of skin with leukaemia cells

Question 7

investigations

Answer 7

bone marrow aspirate
blood film
cytochemistry

Question 8

bone marrow aspirate findings

Answer 8

auer rods

Question 9

treatment

Answer 9

chemotherapy
stem cell transplant
supportive care

Question 10

supportive care

Answer 10

blood transfusions

Question 11

who are stem cell transplants for?

Answer 11

intermediate/high risk

Question 12

partial remission

Answer 12

5-25% blasts on bone marrow

Question 13

complete remission

Answer 13

<5% blasts on bone marrow - needs to be at least half of % of blasts on diagnosis for remission

Question 14

prognosis

Answer 14

good for children - 80% after chemo and 70% survival
younger adults = 40% 5 year survival
older adults = 10% 5 year survival

Question 15

what worsens prognisis?

Answer 15

secondary leukaemia
cytogenetic abnormalities
DIC