acute myeloid leukemia not otherwise categorized Flashcards
⮚ This category is a revision of the older FAB classification, with some deletions and additions
⮚ The classification depends on morphologic and cytochemical characteristics of the blasts and their degree of differentiation and
maturation
a. 1). Acute myeloid leukemia not otherwise categorized
b. AML with recurrent genetic abnormalities
c. AML with multilineage dysplasia
d.AML and myelodysplastic syndromes, therapy-related
a. 1). Acute myeloid leukemia not otherwise categorized
Acute myeloid leukemia not otherwise
(M0-M7)
(M0-M7)
**AML minimally differentiated/ Undifferentiated **
a. (M5)
b. (M0)
c. (M1)
d. (M3)
b. (M0)
. Acute myeloid leukemia not otherwise categorized
30% blast cells which are indistinguishable.
a. AML Undifferentiated/Minimally Differentiated (M0)
b. AML Differentiated without maturation (M1)
a. AML Undifferentiated/Minimally Differentiated (M0)
Constitutes about 5% of AML and occurs mainly in adults
the blasts show no myeloid differentiation
a. AML Undifferentiated/Minimally Differentiated (M0)
b. AML Differentiated without maturation (M1)
a. AML Undifferentiated/Minimally Differentiated (M0)
On cytochemical studies fewer that 3% of the blasts react to Sudan black, a-naphthyl acetate, or stains that detects Myeloperoxidase
a. ML minimally differentiated/ Undifferentiated (M0)
b. ML without maturation (M1
c. Acute Megakaryoblastic leukemia (M7)
a. ML minimally differentiated/ Undifferentiated (M0)
Responsible for about 10% cases of AML
Usually in adults
a. AML Differentiated without maturation (M1)
b. AML with maturation (M2)
c. Acute erythroid leukemia (M6)
a. AML Differentiated without maturation (M1)
Azurophilic granules and Auer rods in the cytoplasm of the blasts may suggest their myeloid nature
a. m0
b.m1
c.m3
d.m2
b.m1
In other cases, the blasts resemble lymphoblasts, from which they are differentiated by positivity to myeloperoxidase stains or Sudan black
in at least 3% of blast cells
a. AML Differentiated without maturation (M1)
b. AML with maturation (M2)
a. AML Differentiated without maturation (M1)
30-45% of cases of AML
a. m1
b.m3
b.m2
b.m2
⮚ May occur in all ages
⮚ Blasts may show azurophilic granules and Auer rods, and evidence of maturation is present
a. m1
b.m3
b.m2
b.m2
⮚ With > 10% of marrow cells being promyelocytes, myelocytes, and mature neutrophils
⮚ < 20% being Monocytes
⮚ The neutrophils may show abnormally increased or decreased segmentation and lobulation
⮚ Basophils, eosinophils, and mast cells may be increased
a. m1
b.m2
c.m3
d.m4
b.m2
30% blasts, >10% granulocytic lineage and >10% Promyelocytes
a. m1
b.m2
c.m3
d.m4
c.m3
Highest number of Auer rods, collectively named as Faggot cells/Firewood cells (bundles)
a. AML Promyelomonocytic (M3)
b. AML with maturation (M2)
c.Acute myelomonocytic leukemia/ Naegeli Biphasic M1 & M5 (M4)
d. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
a. AML Promyelomonocytic (M3)
⮚ Associated with chromosomal translocation of 15:17
⮚ Increased incidence of Disseminated Intravascular Coagulation (DIC)
a. AML Promyelomonocytic (M3)
b. Acute myelomonocytic leukemia/ Naegeli Biphasic M1 & M5 (M4)
c. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
d. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
a. AML Promyelomonocytic (M3)
⮚ Accounts for about 15%-25% of AML
⮚ Usually in the elderly
⮚ Sometimes in patients preceding chronic myelomonocytic leukemia
a. AML Promyelomonocytic (M3)
b. Acute myelomonocytic leukemia/ Naegeli Biphasic M1 & M5 (M4)
c. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
d. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
b. Acute myelomonocytic leukemia/ Naegeli Biphasic M1 & M5 (M4)
⮚ Monoblasts are large cells with round containing one or more prominent nuclei and abundant basophilic cytoplasm, sometimes with fine azurophilic granules, vacuoles, and pseudopod formation
a. AML Promyelomonocytic (M3)
b. Acute myelomonocytic leukemia/ Naegeli Biphasic M1 & M5 (M4)
c. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
d. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
b. Acute myelomonocytic leukemia/ Naegeli Biphasic M1 & M5 (M4)
In both, at least 80% of the leukemic cells are in the monocytic line (specifically for monocytes)
a. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
b. (M4)
a. Acute monoblastic and acute monocytic leukemia (M5a, M5b)
**In acute monoblastic leukemia, at least 80% of the monocytic cells are **
a. promonoctes
b.monoblast
b.monoblast
very rare
** >80% of the marrow cells are erythroid**
a. Acute erythroid leukemia (M6a, M6b)
b. Acute monoblastic and acute monocytic leukemia (M5a, M5b
a. Acute erythroid leukemia (M6a, M6b)
At least 50% of the nucleated cells in the bone marrow is are erythroid– the erythroid cells are dysplastic, containing multiple and megaloblastoid nuclei, the cytoplasm often possessing poorly delineated, coalescing vacuoles
a. Acute erythroid leukemia (M6a, M6b)
b. Acute monoblastic and acute monocytic leukemia (M5a, M5b
c. Acute erythroid leukemia (M6a, M6
c. Acute erythroid leukemia (M6a, M6
⮚ At least of 20% of nonerythroid cells are myeloblast – the myeloblast are similar to those in AML with or without maturation
a. Acute erythroid leukemia (M6a, M6b)
b. Acute monoblastic and acute monocytic leukemia (M5a, M5b
c. Acute erythroid leukemia (M6a, M6)
c. Acute erythroid leukemia (M6a, M6)
⮚ Accounts for about 5% of AML
⮚ Affects all ages
⮚ At least 50% of the blast are from the megakaryocyte lineage (platelets)
a.Acute megakaryoblastic leukemia (M7)
b.Acute erythroid leukemia (M6a, M6b)
a.Acute megakaryoblastic leukemia (M7)
may demonstrate pseudopod and bleb formation, indicating budding platelets.
a.Acute megakaryoblastic leukemia (M7)
b.Acute erythroid leukemia (M6a, M6b)
a.Acute megakaryoblastic leukemia (M7)
Dysplastic platelets may be visible in the blood, as may be circulating micromegakaryocytes and megakaryocyte fragments.
a.Acute megakaryoblastic leukemia (M7)
b.Acute erythroid leukemia (M6a, M6b)
a.Acute megakaryoblastic leukemia (M7)
