Lecture 2: Acute Myeloid Leukaemia Flashcards
What is Acute Myeloid Leukaemia?
AML is a disease primarily associated with adulthood, it is a cancer stemming from Common Myeloid Progenitors, or lineages of these cells.
What percentage of all adult leukaemias is made up by AML?
Around 33% of all leukaemias.
What percentage of AML cases are in adults?
Around 95%.
What is the median age of diagnosis of AML?
68 Years of Age.
Why is there a higher incidence rate of AML in males, and developed countries?
What is the aetiology of AML?
What are some examples of risk factors that can influence development?
Much like other cancers, carcinogens that damage DNA, or other environmental exposures can cause mutations that may build up to cancer.
Risk factors/exposures:
- Environmental factors, such as benzene (an industrial solvent used in chemical or pharmaceutical production).
- Tobacco is another risk factor
- Ionizing radiation
- Chemotherapy from previous cancer, for example alkylating agents that***
What classification systems exist for AML?
What do these classification systems typically assess?
The French-American-British system, which categorises AML into 7 subtypes, M0-M7.
The FAB system will typically look at the maturation of blasts and/or the lineage of cells. This system was developed in the 1970s and is still used but not by doctors in the UK.
The WHO system is more commonly used, it was introduced in 2001 (has been updated several times) and is what is used by doctors in the UK. It still relies on morphology, but incorporates many other factors such as molecular (e.g. proteins), genetic, and immunophenotypic characteristics. As such there are significantly more subtypes of AML in the WHO system.
Why would a genetic predisposition such as a p53 mutation result in AML**
What is the difference between myelodysplastic and myeloproliferative disorders?
Myelodysplastic syndromes involve the production of incorrect cell populations, e.g. erythrocytes.
Myeloproliferative disorders involve the overproduction of certain cell populations, e.g. an overproduction of erythrocytes (polycythemia vera), megakaryocytes (essential thrombocytopenia).
What is multiple myeloma?
Cancer of the Long-Lived Plasma Cells present in the bone marrow.
Are leukemias myeloproliferative or myelodysplastic?
TIP FOR CASE STUDIES
BY LECTURE 4, ALL DISEASES COVERED IN CASE STUDIES SHOULD HAVE BEEN COVERED.
THERE IS AN AML CASE WITH AUERS RODS.
What are all the classifications of AML under the FAB system?
What are megakaryocytes?
What is their appearance?
Cells of myeloid lineage that produce large numbers of thrombocytes.
They are very large, with abundant cytoplasm and multiple nuclei, will have thrombocytes present in cytoplasm or coming off cell surface.
What are two extremely significant chromosomal rearrangements that can result in development of AML?
