AML and MDS Flashcards
Who has chronic leukemia?
adults
Acute leukemia vs. chronic leukemia cells
acute: blasts chronic: fewer immature cells, mostly differentiated cells
AML vs. ALL names
acute myeloid leukemia acute lymphoblastic leukemia
This general term encompasses the general symptoms of acute leukemias
bone marrow failure (fatigue, infections, bleeding due to lack of cell types)
AML cutoff for Dx
20% blasts (myeloblasts) or equivalents
Prognosis for AML
bad

Auer rods
malignant blasts-myeloid
AML-M0
Minimally Differentiated
- very high myeloblasts (barely differentiated)
- bland
- MPO negative (myeloperoxidase)
- Need markers
These tests differentiate AML-M0 and AML-M1
M1 has + MPO (myeloperoxidase stain)
Auer rods
AML-M1
AML: w/o Maturation
- high myeloblasts (look like myeloblasts)
- no further maturation
- Auer rods
- MPO positive
AML-M2
AML: w/ Differentiation
- high myeloblasts
- maturing neutrophils
- t(8;21) in some cases
AML-M3
Acute Promyelocytic Leukemia
- very high promyelocytes
- Faggot cells (many Auer rods)
- DIC (from Faggot cells busting open)
- t(15;17) in all cases
Genetic translocation in AML-M3
Acute Promyelocytic Leukemia
t(15;17)
What happens if you give someone with AML-M3 normal chemo?
Acute Promyelocytic Leukemia
Faggot cells lyse and release coagulation factors
–> DIC
AML-M3 t(15:17) translocation treatment
Acute Promyelocytic Leukemia
all-trans-retinoic acid
promotes differentiation
prevents lysis
What kind of cell are most prominent in AML-M3
Acute Promyelocytic Leukemia
promyelocytes

Faggot cell
AML-M3: Acute Promyelocytic Leukemia
Sh*t ton of Auer rods (>42)
AML-M4
Acute Myelomonocytic Leukemia
- increased myeloblasts
- increased monocytic cells
- extramedullary tumor masses
- inv(16) in some cases
This type of AML has extramedullary tumor masses
monocytic leukemias
AML-4 or AML-5
acute myelomonocytic leukemia
acute monocytic leukemia
AML-5
Acute Monocytic Leukemia
- increased monocytic cells
- NSE positive (nonspecific esterase)
- M5A and M5B
- extramedullary tumor masses
NSE stain
non-specific esterase
finds cells of monocyte lineage
AML-M6
acute erythroblastic leukemia
- increased erythroblasts
- increased myeloblasts
- dyserythropoiesis
AML-M7
Acute megakaroblastic leukemia
- increased megakaryoblasts
- bland blasts
- MPO negative
- Need markers
FLT-3 mutation
(encodes tyrosine kinase)
- poor prognosis
- high proliferation rate
- WBC count skyrockets
AML with multilineage dysplasia
- normally in elderly
- ≥ 2 cell lineages involved
- severe pancytopenia
Severe pancytopenia: which AML subtype
AML with multilineage dysplasia
t(15;17) translocation
promyelocytic leukemia
AML-M3
Need to treat first with all-trans retinoic acid before normal chemo to avoid DIC
Myelodysplastic Syndrome (MDS)
General principles
- dysmyelopoiesis
- may evolve into acute leukemia
2 big findings of MDS
- bone marrow failure
- macrocytic anemia