acute myeloid leukemia

Question 1

Acute myeloid leukemia

Answer 1

Acquired haempoetic stem cell disorder

can arise de novo
can arise from MDS or as part of a MDN like CML

90% of cases is myeloblastic in adults
10% of cases is meyloblastic in children
lymphoblastic is the opposite

Question 2

diagnosis of AML

Answer 2

> 20% blast cells on peripheral blood smear

bone marrow is usually hypercellular due to a partial or almost total replacement of the normal cellular components of the marrow by immature or undifferentiated cells

The blasts in AML must be identified as cells of the myeloid, monocytic, erythroid, or megakaryocytic lineage

any of the following:
aur rods
flow cytometry for myeloid

Question 3

patient presentation in AML

Answer 3

complications of pancytopenia (eg, anemia, neutropenia, and thrombocytopenia), including weakness and easy fatigability

anemia
thrombocytopenia

Question 4

treatment of AML

Answer 4

focused on getting patients into remission

high risk patients who are young and fit consider induction and allogenic stem cell transplant

lower risk patients or unfit patients should have chemotherapy and consolidation chemotherapy

anthracycline based therapy
idarubucin

Question 5

Anthracycline chemoptherapy

Answer 5

Inhibition of DNA and RNA synthesis by intercalating between base pairs of the DNA/RNA strand,

Inhibition of topoisomerase II enzyme, preventing the relaxing of supercoiled DNA

on-mediated generation of free oxygen radicals that damage the DNA

Induction of histone eviction from chromatin that deregulates DNA damage response

doxorubicin
daunorubicin
idarubicin

Question 6

Cytarabine

Answer 6

Cytosine arabinoside interferes with the synthesis of DNA