Leukaemia Part II Flashcards
What is the incidence rate of Acute Myeloid Leukaemia?
4.1/100000 and is more common in adults
What causes Acute Myeloid Leukaemia? (Etiology)
Genotoxic exposures such as radiation and chemotherapy
History of other myeloid cancers
Genetic predisposition syndrome (Fanconi anaemia)
Idiopathic (Acquired genetic abnormalities)
What are the symptoms of acute myeloid leukaemia?
Anaemia,
lethargy,
leucopenia,
Thrombocytopaenia, infections, fevers and bleeding, (more common in AML than ALL)
bruising,
“blast” cells,
bone pain (more common in ALL than in AML),
weight loss, loss of appetite
What are the signs of acute myeloid leukaemia?
Leukaemic cutis (Skin lesion that is not tender and contains collection of blast cells) [not expected in ALL]
Gingival hyperplasia (Swelling of gums due to infiltration of blast cells here)
Conjunctival pallor (White under eyelids)
Bruises
Hepatosplenomegaly and lymphadenopathy are less common than in ALL
What is seen in FBC of acute myeloid leukaemia?
Pancytopaenia + blast cells
What is seen on blood film in acute myeloid leukaemia?
Pancytopaenia
Myeloblasts
What are the 4 types of myeloblastic leukaemia?
Acute myeloblastic leukaemia (know how this blood slide looks)
Acute promyelocytic leukaemia (know how this blood slide looks)
Acute monoblastic leukaemia
Acute erythroblastic leukaemia
What is the defining feature of acute myeloblastic leukaemia?
presence of granules and a large nucleolus
What is the defining feature of acute promyelocytic leukaemia?
Double lobed nucleus and denser granules and darker coloured nucleus and granules
What is the defining feature of acute monoblastic leukaemia?
Huge nucleus which is folded in an irregular manner and fine granules.
Grey coloured cytoplasm compared to more pink colour in normal blood slide
What is the defining feature of acute erythroblastic leukaemia?
Big nucleus big cell and lots of cytoplasm.
What does trephine look like for AML?
Hypercellular
What does bone marrow aspirate show in AML?
Myeloblasts (nucleoli, variable cytoplasm volume, numerous granules + Auer rods)
What are Auer rods?
Granules that line up
What is expected on Acute Myeloid Leukaemia cytometry?
CD13, CD14, CD117, HLA-DR, and CD34
Which karyotype images indicate a good prognosis for AML?
t (15, 17), t (8,21), t(16/16)
Which karyotype images indicate a good prognosis for AML?
t (15, 17), t (8,21), t(16/16)
t=translocation
Which karyotype is associated with a bad prognosis?
Monosomy 3, 5, and 7
What is the prognosis of a normal karyotype in AML?
Intermediate
What do molecular studies tell us about intermediate risk patients?
Whether their risk is more or less favourable
Does NPM1 have a good or bad prognosis?
Good
Does FLT3 have a good or bad prognosis?
Poor