Acute Myeloid Leukaemia Flashcards
Who does AML occur in?
Adults
Complication of chemotherapy e.g. for lymphoma
Also associated with myelodysplastic states
Radiation
Down’s
What is AML?
Neoplastic proliferation of blast cells derived from marrow myeloid lements
What are types of AML?
AML with recurrent genetic abnormalities
AML multilineage dysplasia
AML therapy related - in those previously treated with cytotoxic drugs
AML other such as acute promyelocytic leukaemia - genetic mutation that presents younger than other AMLs
What are clinical features of AML?
Bone marrow failure:
Anaemia: pallor, weakness, tiredness, lethargy
Neutropaenia - infection
Thrombocytopenia - bleeding
Infiltration: Splenomegaly Hepatomegaly Hum hypertrophy Skin involvement Bone pain
DIC occurs in acute promyelocytic leukaemia where there is thromboplastic release
How is AML diagnosed?
WCC raised
Bone marrow biopsy
Immunophenotyping
Molecular methods
On biopsy AML shows Auer rods where as ALL does not
What is seen on biopsy in AML
Auer rods
What Mx for AML
Supportive: Walking exercises to relieve fatigue Blood/platelet transfusion IV fluids Allopurinol to prevent tumour lysis syndrome IV access
Chemotherapy:
Long periods of marrow suppression with neutropenia and thrombocytopenia
Daunorubicin and cytarabine
Bone marrow Transplant
Pluripotent haematopoietic stem cells collected from marrow
Allogenic transplants from HLA matched donors indicated in refractory or relasping disease
Destroy immune cells and repopulate marrow with donor cells infused IV
What are complication of bone marrow transplant?
GVHD - new marrow attacking patient’s body
Opportunistic infection
Leukaemia relapse
Inferitlity
What are complication of AML
Predisposition to infection by disease and Mx
Bacterial, fungal or viral prophylaxis is given
Speticaemia - Candida and Aspergillus
Chemotherapy causes increased plasma urate from tumour lysis - give allopurinol with chemotherapy
Kepp well hydrated
Leucostasis can occur if very high WCC
