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Acute Myeloid Leukem

Acute Myeloid Leukemia

Acute Myeloid Leukemia (AML) Overview ? * A tumor of hematopoietic progenitors caused by acquired oncogenic mutations ...... * cause bone pain due to the hyperproliferation..... * can be caused by the treatment of other malignancies (breast cancer)
AML Dx in bone marrow ? * based on 20% blasts in bone marrow
AML testing ? * CD34 is stem cell marker ...... * flow cytometry and FISH
AML Classification ? * FAB classification --M0 --M1 --M2 --M3, M3v --M4 --M5a, M5b --M6a, M6b --M7
AML Morphology ? * see 20% of blasts in bone marrow or peripheral blood.... * Myeloblasts - see Auer Rods and are MPO+ ..... * Monoblasts - no Auer Rods and are NSE+
AML M0 ? * M0 = minimally differentiated ..... * Acute myeloblastic leukemia...... * MPO & Sudan Black B (SBB) negative ....... * CD13, CD33, CD117 – all myleoid markers
AML M1 ? * Acute myeloid leukemia without complete maturation ...... * MPO+, SBB+ staind ..... *CD13, CD33, CD117, MPO, CD34, HLA-DR +
AML M3 (APL) ? * Acute Promeylocytic Leukemia..... * >20% Promyelocytes in BM..... * see bundles or Auer Rods = faggot cells .... * HLA-DR(-); CD33+, CD34(-)..... * translocxations at t(15;17) --> to PML-RARa ....... * high incidence of DIC (clot and bd at same time)
AML M4 ? * Acute Myelomonocytic Leukemia ..... * see typical myeloblasts and monoblasts are large and blue..... * see hypercellular bone marrow .... * CD13, CD33, CD14, CD4, C11c + ..... * translocation at t(11q23;v)  diverse MLL fusion gene
AML M4eo ? * Acute Myelomonocytic leukemia in younger pts. .... * Same as M4 but with eosinophils at all stages of maturation containing abnormally large purple-violet granules .... * CD2 + also..... * Inversion of (16)(p13q22)
AML M2 ? * translocation of(8;21)(q22;q22) – CBFa/ETO fusion gene --- ETO = 8 21
AML M5 ? * Acute Monoblastic (M5a) and Monocytic (M5b) leukemia ..... * see MPO(-); NSE+..... * see translocation t(11q23;v) – diverse MLL fusion gene
AML M6 ? * Acute Erythroleukemia (DiGuglielmo Disease) .... * see Dysplastic erythroid precursors .... * stains are Ringed sideroblasts with Prussian blue; PAS+ in globular or diffuse.... * immunophenotype = Glycophorin A and Hemoglobin A in erythroid elements
AML M7 ? * Acute Megakaryoblastic leukemia ..... * Cytoplasm blue , agranular with pseudopod formation .... * EM – platelet peroxidase + .... * Immunophenotype – CD41 (IIb/IIIa)+, CD61 (IIIa)+, CD42 (Ib) variable..... * most common AML in Downs Syndrome
AML with MDS-like Features ? * meets at the feaures of MDS, but the blast ratio is > 20%, which is AML.... * poor prognosis
AML Therapy Related ? * poor prognosis... * Alkylating therapy or radiation .... * Topoisomerase II inhibitor (etoposide)- see Translocations involving MLL (11q23)
AML Clinical ? * Symptoms related to thrombocytopenia, anemia and neutropenia ....* Fever, fatigue, spontaneous bleeding, petechiae and bruising, guu bleeding, and infections.... * no CNS involvement
Most common AML when the gums bleed ? * M4 and 5
Process of Dx AML ? * blood to see if >20% blasts --> see if MPO is + or - --> Flow cytometry if MPO + = CD13, CD33, HLA-DR and if MPO - = CD10, CD19, or CD2, CD3, CD5 + (ALL)
Created by: thamrick800