Acute Myeloid Leukemia

Question 1

List the FAB classification for AML

Answer 1

M0- undifferentiated
M1- minimally differentiated
M2- acute myelocytic
M3- acute promyekocytic
M4- myelomonocytic
M5- monocytic
M6- erythroid
M7- acute megakaryocytic leukemia

Question 2

What are the four characteristic cytogenetic changes where there is no minimal blast count required for a diagnosis of AML

Answer 2

T(8;21)
Inv16
T(15;17)
KMT2A

Question 3

Which FAB class are the 4 most common cytogenetic signatures seen with

Answer 3

T(15;17)- M3
T(8;21)- M2
inv16- m4
KMT2A- M5

Question 4

How does M5 AML typically present in infants?

Answer 4

Skin, gum and CNS disease

KMT2A rearranged

Question 5

Genetic conditions predisposing to AML

Answer 5

Li fraumeni syndrome
Fanconi Anemia
Severe congenital neutropenia
DKC
Diamond black fan anemia
GATA2
Familial leukemia and platelet dysfxn 
Runx1

Familial thrombocytopenia with predisposition to myeloid malignancy
EtV6
ANKRD26

Question 6

Treatment related AML- agents, cytogenetics and latency?

Answer 6

Topoisomerase II inhibitors- 1-3 years, MLL rearrangement

Alkylators- 5-7 years, monosomy 7

Question 7

Favourable cytogenetics and molecular features in AML?

Answer 7

T(8;21)
Inv16
CEBPA
NPM1

Question 8

Unfavourable cytogenetics/ molecular in AML

Answer 8

Monosomy 7
5q-
FLT3 high allergic ratio
Some MLL rearrangements