Flashcards in Acute Myeloid Leukaemia Deck (54)
What is acute myeloid leukaemia (AML)?
A malignant disease of the bone marrow
What happens in AML?
The precursors of blood cells are arrested in an early stage of development
What do most AML subtypes show, in terms of blasts?
More than 30% blasts of a myeloid lineage in blood, bone marrow, or both
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
What is the effect of the maturation arrest in an early stage of development in AML?
Reduces the normal blood cells
What does failure of apoptosis in AML lead to?
Accumulation in various organs, especially the liver and spleen
How common is AML, compared to other leukaemias?
It is the most common leukaemia in adults
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
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
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
What does the subtype of AML and MDS, therapy related include?
Patients who had had prior chemotherapy and/or radiation
What are the risk factors for AML?
- Other haematological disorders
- Congenital disorders
- Exposure to benzene
- Survivors of cancer chemotherapy
What other haematological disorders increase the risk of AML?
- Myelodysplastic syndrome
- Aplastic anaemia
What congenital disorders increase the risk of AML?
- Bloom's syndrome
- Down's syndrome
- Fanconi's anaemia
What is the presentation of AML related to?
Bone marrow failure or organ infiltration
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
What are the symptoms of AML?
- Dizziness and shortness of breath on exertion
- Early satiety and fullness in LUQ
- Bone pain
What feature of the fever may be present with AML?
Failure to respond to antibiotics
is that a feature? idk
What causes the early satiety and fullness in LUQ in AML?
What are the emergency presentations of AML?
- Haemorrhage into lungs, GI tract, or CNS
What cause leukostasis in AML?
Extremely high WBC
What are the most common sites for infiltration of AML?
Why is knowing the most common sites of infiltration of AML clinically important?
Should look for signs in those locations
What examination features may be present in AML?
- Signs of infection, e.g. fever, pneumonia
- Hepatomegaly and splenomegaly
- Petechiae on lower limbs
- Gingivitis, with swollen, bleeding gums
What does the diagnosis of AML require?
The examination of peripheral blood and bone marrow specimens
What tests are done on the peripheral blood and bone marrow specimens in AML?
- Molecular genetics
What investigations are done in AML?
- Blood testing
- Bone marrow aspiration
- Cytochemical testing
What blood tests should be done in AML?
- Clotting screen
- Liver and renal function
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