Acute myeloid leukaemia (AML) Flashcards
What is AML?
Cancer of the myeloid line of blood cells (progenitor cell for granulocytes, monocytes, erythrocytes or platelets).
Aetiology of AML?
More common in the elderly (>60 years)
Often associated with myelodysplastic syndromes.
Clinical features of AML?
Similar to ALL (marrow failure)
Subgroups of AML may have characteristic presentation
- Coagulation defect/DIC in acute promyelocytic leukaemia
- Gum infiltration most commonly seen in acute monocytic leukaemia and acute myelomonocytic leukaemia
Blood test investigations for AML?
Blood count and film: reduction in normal cells, presence of abnormal cells (“blasts”) - large size, high nuclear : cytoplasmic ratio, prominent nucleolus
Coagulation screen
What is the definition of an acute leukaemia?
By definition an acute leukaemia involves an excess of “blasts” (>/=20%) in either the peripheral blood or bone marrow.
What are Auer rods ?
When blast cells have rods inside their cytoplasm. Sometimes observed in AML.
What can be checked in bone marrow aspirate?
Morphology
Immunophenotype
Cyto/molecular genetics
Trephine
Management of AML?
Multi-agent chemotherapy
- Between 2-4 cycles of chemotherapy
- Prolonged hospitalisation
- Targeted treatments in subsets
- Hickman line can be used to provide long-term central venous access.
Complications of AML?
Same as for ALL
Acute leukaemias = rapidly progressing. True/false?
True
Acute = rapidly progressing
Chronic = slowly progressing
What is are the key features of each of the leukaemia types?
ALL is the most common leukaemia in children and is associated with Down syndrome
CLL is associated with warm haemolytic anaemia, Richter’s transformation and smudge cells
CML has three phases, including a long chronic phase, and is associated with the Philadelphia chromosome
AML may result in a transformation from a myeloproliferative disorder and is associated with Auer rods
