Acute Myeloid Leukemia

Question 1

This is the most common leukemia in older patients, with a median age of diagnosis of 67 years. Long-term survival is infrequent.

Answer 1

Acute Myeloid Leukemia

Question 2

True or false. Down syndrome with trisomy 21, is associated with an increased incidence of AML.

Answer 2

True

Question 3

True or false. Anticancer drugs are the leading cause of therapy-associated AML.

Answer 3

True

Question 4

Marrow (or blood) blast count of ___ is required to establish the diagnosis of AML.

Answer 4

> =20%

Question 5

This provide the most important independent prognostic information of AML.

Answer 5

Chromosome findings at diagnosis

Question 6

Advancing age is associated with poor prognosis for AML because of 2 reasons:

Answer 6

1. Its influence on the ability to survive induction therapy due to existing medical comorbidities, and
2. With each successive decade of age, a greater proportion of patients have intrinsically more resistant disease.

Question 7

True or false. Cytopenia is a clinical feature associated with a lower complete remission (CR) rate and shorter survival time. The CR rate is lower in patients who have had anemia, leukopenia, and/or thrombocytopenia for more than 3 months before the diagnosis of AML.

Answer 7

True

Question 8

What is true of complete remission (CR) in AML?
A. Blood neutrophil count must be >=1000/ul and the platelet count >=100,000
B. Hemoglobin concentration is NOT considered in determining CR.
C. Circulating blast must be absent
D. The bone marrow should contain <5% blasts, and Auer rods should be absent.
E. Extramedullary leukemia should not be present.

Answer 8

All are true.

Question 9

Among AML types, hemorrhagic complications are most commonly and classically found in ___. They often present with DIC-associated minor hemorrhage but may have significant gastrointestinal bleeding, intrapulmonary hemorrhage, or intracranial hemorrhage.

Answer 9

Acute promyelocytic leukemia (APL)

Question 10

This rod-shaped granules are not uniformly present in AML, but when they are, AML is virtually certain.

Answer 10

Auer rods

Question 11

What are the 2 phases of AML treatment?

Answer 11

1. Induction

2. Postremission management (consolidation)

Question 12

These consist the most commonly used induction regimens (for patients other than those with APL) in AML.

Answer 12

Combination chemotherapy with cytarabine and an anthracycline (eg, daunorubicin, idarubicin).

Question 13

This is a cell cycle S-phase-specific antimetabolite that becomes phosphorylated intracellularly to an active triphosphate form that interferes with DNA synthesis, and used in induction chemotherapy in AML.

Answer 13

Cytarabine

Question 14

These are DNA intercalators that inhibits topoisomerase II, leading to DNA breaks, used in induction chemotherapy in AML.

Answer 14

anthracycline (eg, daunorubicin, idarubicin).

Question 15

What is the goal of post remission therapy?

Answer 15

To eradicate residual (typically undetectable) leukemic cells to prevent relapse and prolong survival

Question 16

This is the best relapse-prevention strategy currently available in AML.

Answer 16

Allogeneic HCT

Question 17

This complication occurs within 3 weeks of treatment of APL, characterized by fever, fluid retention, dyspnea, chest pain, pulmonary infiltrates, pleural and pericardial effusions, and hypoxemia. This is related to adhesion of differentiated neoplastic cells to the pulmonary vasculature endothelium.

Answer 17

APL differentiation syndrome