AML and CML

Question 1

What age is mostly affected by AML?

Answer 1

65-75yo

Question 2

What is the presentation of AML?

Answer 2

Bone marrow failure- infection, bruising, bleeding, anaemia

Systemic- fever, night sweats, weight loss

Question 3

What investigations are done for AML?

Answer 3

FBC- very high or very low WCC, anaemia and thrombocytopenia
Blood film- myeloblasts
Bone marrow aspirate

Question 4

What is the management of AML?

Answer 4

Chemotherapy
Allogenic stem cell transplant
Targeted treatment
Low risk= ATRA and ATO

Question 5

What ae the complications of AML?

Answer 5

High risk tumour lysis syndrome- prevent with allopurinol

Question 6

What are the features of tumour lysis syndrome?

Answer 6

High K, phosphate, uric acid

Low calcium

Question 7

What are the features of CML?

Answer 7

Usually asymptomatic
Hepatosplenomegaly- can be massive
Bone/joint pain
Systemic symptoms 
Less common- bleeding, gout, hyperleukostasis

Question 8

What are the features of hyperleukostasis?

Answer 8

Fundal haemorrhage and venous congestion
Altered conciousness
Resp failure

Question 9

What investigations are done for CML?

Answer 9

FBC- high WCC, anaemia
Blood film
Bone marrow aspirate
Philadelphia chromosome

Question 10

What is the management of CML?

Answer 10

Tyrosine kinase inhibitors

Rarely allogenic stem cell transplant

Question 11

What is the prognosis of AML and CML?

Answer 11

AML= 25% 5 year
CML= 90% 5 year