FN: Acute Myeloid Leukaemia Flashcards Preview

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Flashcards in FN: Acute Myeloid Leukaemia Deck (15):
1

Epi

Increased risk w/ age: mean 65-70
Commonest acute leukaemia of adults

2

Aetiology

Neoplastic proliferation of myeloblasts

3

Risk factors

1. Chromosomal abnormalities
Radioation
Downs
Chemotherapy e.g. for lymphoma
Myelodysplastic and myeloproliferative syndromes

4

Classification

FAB classification

5

FAB classification

M2: granulocyte maturation
M3: acute promyelocytic leukaemia t(15;17)-DIC
M4: acute myelomonocytic leukaemia
M7: megakayoblastic leukaemia trisomy 21

6

Features

BM failure
Infiltration
Blood

7

BM failure

Cytopenias

8

Infiltration

GUM infitration - hypertrophy and bleeding (M4)
HSM
Skin involvement
Bone pain

9

Blood

DIC: APML (M3)
Hyperviscosity: very high WCC may - thrombi

10

Investigations

1. Raised WCC blasts (occasionally normal)
2. Anaemia and reduced platlets
3. BM aspirate

11

BM aspiration shows

20% blasts
Auer rods are diagnostic

12

Diagnosis

Made by immunological and molecular phenotyping - flow cytometry

Cytogenetic analysis affects Rx and guides prognosis

13

Management

Supportive: as for AML
Infections: as for ALL

14

Chemotherapy

V. intensive - long periods of neutropenia and reduced platelets
M3 ATRA for APML

15

BMT

Allogenic if poor prognosis
1. Destroy BM and leukaemia cells with chemotherapy and total body irradiation
2. Repopulate marrow with HLA - matched donor HSCs

Autologous if intermediate prognosis - HSCs taken from pt.

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