AML Flashcards
What is Acute Myeloid Leukemia (AML)?
A clonal hematopoietic malignancy characterized by the accumulation of immature myeloid cells (blasts) in the bone marrow, peripheral blood, or other tissues.
What are the hallmark features of AML?
Bone marrow failure (anemia, neutropenia, thrombocytopenia).
Rapid proliferation of myeloid blasts.
Organ infiltration (e.g., hepatosplenomegaly).
How is AML classified?
Based on morphology (FAB classification).
Molecular and genetic abnormalities (WHO classification).
What are the common risk factors for AML?
Genetic predispositions: Down syndrome,
Fanconi anemia, and Bloom syndrome.
Previous chemotherapy/radiation therapy (therapy-related AML).
Environmental exposures: Benzene, smoking, pesticides.
Myelodysplastic syndrome (MDS) or other hematologic disorders.
What are common genetic abnormalities associated with AML?
Translocations: t(8;21), inv(16), t(15;17) (associated with APL).
FLT3 mutations: Poor prognosis.
NPM1 mutations: Favorable prognosis when no FLT3 mutation is present.
What causes AML?
Mutations in hematopoietic stem cells disrupt normal differentiation, leading to the accumulation of immature myeloid blasts that impair normal hematopoiesis.
How does AML lead to bone marrow failure?
Replacement of normal bone marrow with blasts suppresses normal hematopoiesis, causing anemia, neutropenia, and thrombocytopenia.
What are the common presenting symptoms of AML?
Fatigue and weakness (anemia).
Fever and infections (neutropenia).
Easy bruising or bleeding (thrombocytopenia).
Bone pain or discomfort.
What are common signs of AML on physical examination?
Pallor.
Petechiae or ecchymoses.
Hepatosplenomegaly or lymphadenopathy (less common).
Gum hypertrophy (monocytic AML).
What is leukostasis, and how does it present in AML?
A medical emergency caused by high blast counts (>100,000/μL), leading to impaired microcirculation and symptoms like headache, dyspnea, or visual changes.
How is AML diagnosed?
Peripheral blood smear: Presence of blasts.
Bone marrow biopsy: Hypercellularity with >20% myeloid blasts.
Cytogenetic analysis: To identify chromosomal abnormalities.
Flow cytometry: To confirm lineage and immunophenotype.
What are characteristic findings in AML on a blood smear?
Blasts with Auer rods (specific for AML).
Anemia, thrombocytopenia, and variable leukocyte counts.
What laboratory findings are commonly seen in AML?
Elevated lactate dehydrogenase (LDH).
Hyperuricemia.
Disseminated intravascular coagulation (DIC) in acute promyelocytic leukemia (APL).
What is the French-American-British (FAB) classification for AML?
Based on morphology and cytochemistry, includes subtypes M0 to M7 (e.g., M3: APL, M5: Monocytic AML).
What is the primary treatment approach for AML?
Induction therapy: To achieve remission (e.g., “7+3” regimen: cytarabine and daunorubicin).
Consolidation therapy: To eliminate residual disease (e.g., high-dose cytarabine or allogeneic stem cell transplantation).
Targeted therapies: For specific mutations (e.g., FLT3 inhibitors, IDH inhibitors).
