AML M1-M7 Flashcards
M1 ACUTE MYELOBLASTIC LEUKEMIA WITHOUT MATURATION
Origin Cell Types Nucleus Cytoplasm Clinical Presentation
Myelocytic
> 30% myeloblasts (Type I and II blasts)
One or more nucleoli; fine stripped chromatin
Few azurophilic granules
Auer rods
All age groups; seen commonly in adults
Varied organomegaly
M2 ACUTE MYELOBLASTIC LEUKEMIA WITH MATURATION
Origin Cell Types Nucleus Cytoplasm Clinical Presentation
- Myelocytic
- > 30% myeloblasts with >10% granulocytic component
- One or more nucleoli; fine stripped chromatin
-Various amounts of azurophilic granules
Auer rods
-Cytogenetic abnormality t(8q; 21q)
M3 HYPERGRANULAR PROMYELOCYTIC LEUKEMIA
Origin Cell Types Nucleus Cytoplasm Clinical Presentation
Myelocytic - Abnormal promyelocytes predominate - Reniform or bilobed shaped - Heavy granulation Bundles of Auer rods (Faggot cells) - Disseminated Intravascular coagulation prone Cytogenetic abnormality – t(15;17) Prolonged PT and PTT Low fibrinogen levels (+) Fibrin split products
M4 ACUTE MYELOMONOCYTIC LEUKEMIA
Origin Cell Types Nucleus Cytoplasm Clinical Presentation
Myelocytic Monocytic - >30% blasts >20% granulocytic component >20% promonocytes and monocytes - Non contributory - Non contributory - Tissue infiltrates CNS involvement Affects Chromosome 16 Increased lysozyme values
M5a POORLY DIFFERENTIATED MONOCYTIC LEUKEMIA
Origin Cell Types Nucleus Cytoplasm Clinical Presentation
Monocytic
Monoblasts predominate
Few promonocytes
Lacy chromatin with nucleoli
Basophilic
Pseudopods
Occasional granules
Tissue infiltrates CNS involvement Cytogenetic abnormality : t(9;11) Increased lysozyme (+) erythematous skin rash
M5b WELL DIFFERENTIATED MONOCYTIC LEUKEMIA
Origin Cell Types Nucleus Cytoplasm Clinical Presentation
Monocytic
Blasts, promonocytes, and monocytes
Promonocytes predominate in the bone marrow
Monocytes predominate in blood
Cerebriform shape with nucleoli
Ground glass appearance
Fine azurophilic granules
Tissue infiltrates
CNS involvement
Increased lysozyme
(-) erythematous skin rash
M6 ACUTE ERYTHROLEUKEMIA
Origin Cell Types Nucleus Cytoplasm Clinical Presentation
Erythrocytic
Myelocytic
> 50% erythroid cells in all stages of maturation
30% myeloblasts
Multiple nuclear lobes
Multiple nuclei
Nuclear fragments
Megaloblastic changes
N:C asynchrony
(+) PAS
Gigantism
Vacoulization
Significant peripheral normoblasts
M7 ACUTE MEGAKARYOCYTIC LEUKEMIA
Origin Cell Types Nucleus Cytoplasm Clinical Presentation
Megakaryocytic
Megakaryocytes predominate
Dense chromatin (lymphoid blasts) Fine reticulated chromatin with nucleoli
Scant
Blebs and vacuoles
Platelet shedding
Myelosclerosis
Chromosome 21
(+) platelet peroxidase
CLINICAL FEATURES
Tx
ANEMIA
Pallor Lethargy Dyspnea Fatigue Weakness
RED CELL TRANSFUSION
CLINICAL FEATURES
Tx
NEUTROPENIA
Fever
Malaise
Infection
WBC TRANSFUSION
ANTIBIOTICS
ISOLATION
CLINICAL FEATURES
Tx
THROMBOCYTOPENIA
Hemorrhage Bruising Purpura Epistaxis Gingival bleeding Menorrhagia
PLATELET TRANSFUSION
CLINICAL FEATURES
Tx
ORGAN INFILTRATION
Bone tenderness Splenomegaly Hepatomegaly Lymphadenopathy Gum hypertrophy Skin infiltrates Ulceration of mucous membranes Meningeal syndrome Headache Nausea Vomiting
RADIOTHERAPY
Modes of treatment:
Chemotherapy
Radiotherapy
Immunotherapy
Bone marrow transplantation
Differentiation treatment – (ex: retinoic acid, phorbol esters, etc)
