Myeloid Malignancy Flashcards
What is the difference between AML and myeloproliferative disorders?
AML is proliferation without differentiation, but also get myeloproliferative disorders where differentiation has occurred:
![](https://s3.amazonaws.com/brainscape-prod/system/cm/338/052/106/a_image_thumb.png?1609888290)
What are the main groups of myeloid malignancy?
- Acute myeloid leukaemia (AML)
- Chronic myeloid leukaemia (CML)
- Myelodysplastic syndromes (MDS)
- Pre-leukaemia conditions
- Myeloproliferative neoplasm (MPN)
What does AML stand for?
- Acute myeloid leukaemia (AML)
What does CML stand for?
- Chronic myeloid leukaemia (CML)
What does MDS stand for?
- Myelodysplastic syndromes (MDS)
- Pre-leukaemia conditions
What does MPN stand for?
- Myeloproliferative neoplasm (MPN)
What is the difference between acute and chronic myeloid leukaemia?
Old terms, basically describes how long patients survive with illness:
![](https://s3.amazonaws.com/brainscape-prod/system/cm/338/052/112/a_image_thumb.png?1609888380)
Compare and contrast acute and chronic myeloid leukaemia for:
- ability to differentiate
- bone marrow failure
- prognosis
- curability
Describe the pathophysiology of AML?
- Acute myeloid leukaemia replaces bone marrow leading to bone marrow failure
- Proliferation without differentiation
Describe the clinical features of AML?
- Bone marrow failure (triad)
- Anaemia
- Thrombocytopenic bleeding (purpura and mucosal membrane bleeding)
- Infection because of neutropenia (predominantly bacterial and fungal)
What forms the triad of bone marrow failure symptoms?
- Anaemia
- Thrombocytopenic bleeding (purpura and mucosal membrane bleeding)
- Infection because of neutropenia (predominantly bacterial and fungal)
What pattern of bleeding occurs in bone marrow failure?
Thrombocytopenic bleeding (purpura and mucosal membrane bleeding)
What investigations should be done for AML?
- Blood count and blood film
- Bone marrow aspirate
- Blasts > 20% of marrow cells in acute leukaemia
- Cytogenetics (Karyotype) from leukaemic blasts
- Prognostic info
- Immunophenotyping of leukaemic blasts
- Prognostic info – to identify as myeloid or lymphoid
- CSF examination if symptoms
- Prognostic info
- Targeted molecular genetics for associated acquired gene mutations
- Looks at individual genes for mutations, such as FLT3 and NPM1
What genetic mutations are potentially important for AML?
- Targeted molecular genetics for associated acquired gene mutations
- Looks at individual genes for mutations, such as FLT3 and NPM1
What % of cells in bone marrow do blasts form in AML?
- Bone marrow aspirate
- Blasts > 20% of marrow cells in acute leukaemia
Describe the treatment for AML?
- Supportive care
- Anti-leukaemic chemotherapy
- Remission induction (1-2 cycles)
- Classified as normal blood counts and <5% blasts
- Consolidation (1-3 cycles)
- Maintenance
- Remission induction (1-2 cycles)