Acute Myeloblastic Leukaemia Flashcards
Define Acute Myeloblastic Leukaemia? (AML)
Malignancy of primitive myeloid lineage white blood cells (myeloblasts) with proliferation in the bone marrow and blood
How can AML be classified?
Using the FAB (French-American-British) system into eight morphological variants
What is the aetiology of AML?
Myeloblasts undergo malignant transformation and proliferation
This leads to replacement of normal marrow and bone marrow failure
What is the epidemiology of AML?
Most common acute leukaemia in Adults
Incidence increases with age
What are the presenting symptoms of AML?
Symptoms of Bone Marrow Failure
Symptoms of Tissue Infiltration
What are the symptoms of Bone Marrow Failure?
Anaemia (lethargy, dyspnoea)
Bleeding (due to thrombocytopaenia or DIC)
Opportunistic or recurrent infections
What are the symptoms of Tissue Infiltration?
Gum swelling or bleeding CNS involvement (headaches, nausea, diplopia)
What are the signs of AML on physical examination?
Signs of Bone Marrow Failure
Signs of Tissue Infiltration
What are the signs of Bone Marrow Failure in AML?
Pallor Cardiac Flow Murmur Ecchymosis Bleeding Opportunistic or recurrent infections (e.g. fever, mouth ulcers, skin infections)
What are the signs of Tissue Infiltration in AML?
Skin Rashes
Gum Hypertrophy
Deposit of leukaemic blasts in the eye, tongue and bone (RARE)
What bloods would you do for AML and what would you see on them?
FBC - Low Hb, Low Platelets, variable WCC
High Uric Acid
High LDH
Clotting studies, fibrinogen and D-Dimers (to check for DIC)
What would you see on an blood film for AML?
Myeloblasts
What would you see on a Bone Marrow aspirate or Biopsy for AML?
Hypercellular with > 20% blasts
What other investigations would you do for AML?
Immunophenotyping (Antibodies against surface antigens used to classify the lineage of the abnormal clones)
Cytogenics
Immunocytochemistry
