Acute Leukemias Flashcards
How does leukemia arise?
Clonal proliferation of a single hematopoietic stem cell in the bone marrow, preventing normal blood cell production
What is diagnostic of acute leukemia on bone marrow aspirate/biopsy?
> 20% blasts in bone marrow
What are the signs/symptoms of bone marrow failure?
Bony pain, pancytopenia
Pallor, breathlessness, fatigue
Increased infections
Bruising, bleeding
What is the age group of patients affected by AML?
Older adults
What is the age group of patients affected by ALL?
Children
What is the prognosis of AML?
Poor
Median survival 12-24 months
What is the prognosis of ALL?
Good
80% longterm remission in childhood ALL
Where does AML tend to infiltrate?
Gingiva
Where does ALL tend to infiltrate?
Lymph nodes (lymphadenopathy) CNS (meningeal signs), uncharacteristic of AML
What is seen on peripheral blood film for AML?
Auer Rods, granules
What is seen on peripheral blood film for ALL?
No granules.
Which acute leukemia is leukostasis characteristic of?
AML
“sticky” blasts sludge the microvasculature, leading to hypoxia and hemorrhage
What is special about acute promyelotic leukemia?
Subset of AML
No chemo
ATRA to induce differentiation
How is AML treated?
Induction chemo for complete remission (no peripheral blasts, <5% blasts in BM)
Consolidation chemo to prevent recurrence
How is ALL treated?
Induction chemo to induce complete remission
Consolidation to prevent recurrence
Maintenance chemo (low dose over long period)
Prophylactic CNS radiation or MTX
