Acute Myeloid Leukaemia Flashcards Preview

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Flashcards in Acute Myeloid Leukaemia Deck (54)
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1

What is acute myeloid leukaemia (AML)?

A malignant disease of the bone marrow

2

What happens in AML?

The precursors of blood cells are arrested in an early stage of development

3

What do most AML subtypes show, in terms of blasts?

More than 30% blasts of a myeloid lineage in blood, bone marrow, or both

4

What does the mechanism of maturation arrest in an early stage of development in AML involve?

The activation of abnormal genes through chromosomal translocations and other genetic abnormalities

5

What is the effect of the maturation arrest in an early stage of development in AML?

Reduces the normal blood cells

6

What does failure of apoptosis in AML lead to?

Accumulation in various organs, especially the liver and spleen

7

How common is AML, compared to other leukaemias?

It is the most common leukaemia in adults

8

At what age does AML occur?

It can occur at any age, but the incidence increases with age, and the median age of onset is 67

9

What are the subtypes of AML?

- AML with characteristic genetic abnormalities
- AML with multi-lineage dysplasia
- AML and MDS, therapy related
- AML not otherwise categorised

10

Who does the subtype of AML with multi-lineage dysplasia include?

Patients who have had prior myelodysplastic syndrome (MDS) or myeloproliferative disease that transforms into AML

11

What does the subtype of AML and MDS, therapy related include?

Patients who had had prior chemotherapy and/or radiation

12

What are the risk factors for AML?

- Other haematological disorders
- Radiation
- Congenital disorders
- Exposure to benzene
- Survivors of cancer chemotherapy

13

What other haematological disorders increase the risk of AML?

- Myelodysplastic syndrome
- Aplastic anaemia
- Myelofibrosis

14

What congenital disorders increase the risk of AML?

- Bloom's syndrome
- Down's syndrome
- Fanconi's anaemia
- Neurofibromatosis

15

What is the presentation of AML related to?

Bone marrow failure or organ infiltration

16

How does the presentation of AML differ between children and older people?

Children or young adults may present with acute symptoms over a few days to weeks, whereas older people may present with fatigue over weeks or months

17

What are the symptoms of AML?

- Dizziness and shortness of breath on exertion
- Fever
- Early satiety and fullness in LUQ
- Bone pain

18

What feature of the fever may be present with AML?

Failure to respond to antibiotics

is that a feature? idk

19

What causes the early satiety and fullness in LUQ in AML?

Splenomegaly

20

What are the emergency presentations of AML?

- Haemorrhage into lungs, GI tract, or CNS
- Leukostasis

21

What cause leukostasis in AML?

Extremely high WBC

22

What are the most common sites for infiltration of AML?

- Liver
- Spleen
- Gums

23

Why is knowing the most common sites of infiltration of AML clinically important?

Should look for signs in those locations

24

What examination features may be present in AML?

- Pallor
- Signs of infection, e.g. fever, pneumonia
- Hepatomegaly and splenomegaly
- Petechiae on lower limbs
- Gingivitis, with swollen, bleeding gums

25

What does the diagnosis of AML require?

The examination of peripheral blood and bone marrow specimens

26

What tests are done on the peripheral blood and bone marrow specimens in AML?

- Morphology
- Cytochemistry
- Immunophenotyping
- Cytogenetics
- Molecular genetics

27

What investigations are done in AML?

- Blood testing
- Bone marrow aspiration
- Allotyping
- Cytochemical testing

28

What blood tests should be done in AML?

- FBC
- Clotting screen
- LDH
- Liver and renal function

29

What may be found on FBC in AML?

- Variable degree of anaemia and thrombocytopenia
- Total WBC may be normal, high, or low, and sometimes extremely high
- Neutrophils usually depleted

30

What condition is commonly found on clotting screen in AML?

DIC