Acute Myeloid Leukemias Flashcards Preview

SBL Exam 1 WBCs, Spleen, and Thymus > Acute Myeloid Leukemias > Flashcards

Flashcards in Acute Myeloid Leukemias Deck (15)
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1

What is AML?

Acute myeloid leukemia

-neoplasm of immature myeloid cells (myeloblasts)

-myeloblasts >20% prevalence in bone marrow

-may have Auer rods (aggregates of MPO)

2

What is the common presentation of AML?

-most common in older adults (median age 60); can occur in all ages

-decreased bone marrow function; ie., fatigue (anemia), fever/infections (neutropenia), and bleeding (thrombocytopenia)

-petechia/ecchymoses/mucosal hemorrhage/hematuria

-opportunistic infections

3

Compare ALL to AML.

Both have similar sympoms in their effects on bone marrow causing anemia, neutrophila, and thrombocytopenia

 

Non-bone marrow related symptoms are less common in AML

 

CNS spread occurs in both, but more frequently in ALL

4

What are the FAB classifications of AML? (what is present in each)

Classified based of differentiation of the predominate cell (most other types will still be present):

 

M0: minimally differentiated; lack myleoid markers

M1: without maturation; few granules and Auer rods

M2: myelocytic maturation; granulocyte maturation, granules and Auer rods; t(8;21)

M3: promyelocytic; hypergranular promyelocytes; t(15;17)

M4: myelomonocytic maturation; MPO+ and nonspecific esterase+ (combined myelo- and mono- differentation); inv(16)

M5: monocyticnonspecific esterase+ w/o Auer rods

M6: erythroid

M7: megakaryocytic; lack MPO

5

What are the WHO classifications of AML? (what is present in each)

Class I: associated with genetic abnormalities

Class II: arose from MDS or has MDS features

Class III: therapy-related

Class IV: other (same as FAB classifications, just excluding cases with genetic causes, MDS origins, or that are therapy related)

6

What type of genetic abnormalities are frequently found on Class I, II, and III of the WHO classifications?

Class I: rearrangements

 

Class II and III: deletions/monosomies

7

What subtype of AML has unique tendency to infiltrate the skin and gingiva?

Acute monocytic leukemia

8

What subtype of AML has an unusual age of presentation compared to the others?

Acute promyelocytic leukemia (median age 35-40)

9

What subtype of AML has an increased risk of DIC?

Acute promyelocytic leukemia

 

(remember, these are the hypergraunlar type and release excess tissue factor resulting in coagulation)

10

What subtype of AML is related to the t(15;17) rearrangement?

What is the fusion product?

Acute promyelocytic leukemia (M3)

-hypergranular -> DIC

-younger presentation (35-40)

 

RARα/PML

-can be treated with RA antagonist due to RAR involvement

11

What subtype of AML is related to the t(8;21) rearrangement?

What is the fusion product?

Acute myelocytic leukemia (M2)

 

RUNX1/ETO

12

What subtype of AML is related to the inv(16) inversion?

What is the fusion product?

Acute myelomonocytic leukemia (M4)

-myelocytic and monocytic differentiation

 

CBFB/MYH1 1

13

What subtype of AML is most common with Down syndrome?

Acute megakaryocytic leukemia (M7)

 

those with Down syndrome have an increased risk of cancer, specifically AML/actue megakaryocytic leukemia

14

What is the immunophenotype of AML?

CD34+ (found on multipotent stem cells but not mature cells)

CD33+ (found immature myeloid cells)

 

CD64- (found on mature myeloid cells)

CD15- (found on mature myeloid cells)

15

What is the course/prognosis of AML subtypes?

-most translocations have favorable outcomes

-MDS-like have poor outcomes