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AML
Lecture 9/27
31
Medical
Professional
09/29/2013

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Term
Define Acute Myeloid Leukemia
Definition
Proliferating neoplastic myeloid cells in BM that suppresses normal hematopoietic cells by physical replacement
Term
What is the clinical picture of Acute Myeloid Leukemia?
Definition
Anemia, Neutropenia, and Thrombocytopenia leading to the symptoms: fatigue, bleeding, etc
Term
What all can cause Acute Myeloid Leukemia?
Definition
Ionizing radiation, Drugs/Chemical agents (known as therapy relayed meyloid neoplasms), Viruses (EBV), trisomy 21
Term
What is the Diagnostic criteria for Acute Myeloid Leukemia?
Definition
Myeloid lineage blasts comprised of at least 20% of bone marrow/peripheral blood -OR- any of these genetic abnormalities: t(15;17), t(8;21), inv(16)
Term
How do you determine Myeloblast vs Lymphocyte in peripheral blood since they look so similar?
Definition
Auer rods (Myeloid cells only, so sort of neoplasm causes it)
Term
What is the WHO classification for Acute Myeloid Leukemia?
Definition
Recurrent chromosomal abnormalities, prior drug exposure and a history of myelodysplastic syndrome
Term
FAB classification M1
Definition
AML without maturation or differentiation
Term
FAB classification M2
Definition
AML with differentiation or maturation
Term
FAB classification M3
Definition
Acute Promyelocytic Leukemia
Term
FAB classification M4
Definition
Acute Myelomonocytic Leukemia
Term
FAB classification M5
Definition
Acute Monocytic Leukemia
Term
FAB classification M6
Definition
Acute Erythroleukemia
Term
FAB classification M7
Definition
Acute Megakaryoblastic Leukemia
Term
What are the 3 different classifications of Acute Myeloid Leukemia based on WHO classificaiton?
Definition
1) AML with t(8;21), 2) AML with inv(16), 3) APL with t(15;17)
Term
How does WHO classify the non-recurrent genetic Acute Myeloid Leukemias?
Definition
Acute Myeloid Leukemia, not otherwise specified
Term
Which 3 Acute Myeloid Leukemias (AMLs) have the most favorable prognosis?
Definition
t(8;21)/M2, inv(16)/M4, t(15;17)/M3
Term
Describe Acute Promyelocyte Leukemia (APL) with t(15;17) (similar to AML-M3)
Definition
t(15;17) results in PML-RARA fusion that arrests maturation in promyelocytes resulting in proliferation of abnormal promyelocytes
Term
APL with t(15;17) does not express what biomarkers uring immunophenotyping?
Definition
CD34 or HLA-DR
Term
What is the prognosis of APL with t(15;17)?
Definition
Initially horrible due to possibility of DIC, but excellent if the initial phase is taken care of
Term
What is APL with t(15;17) treated with effectively?
Definition
ATRA
Term
What does AML with t(8;21) correspond with in FAB class?
Definition
AML-M2
Term
What do the blasts in bone marrow look like in AML with t(8;21)?
Definition
Cytoplasmic hofs, Auer rods, Salmon-colored granules
Term
Immunophenotyping of AML with t(8;21) shows what?
Definition
Aberrant CD19 epxression
Term
AML with inv(16) corresponds to what FAB classification?
Definition
AML-M4
Term
What do the blasts look like in bone marrow of AML with inv(16)?
Definition
Monocytic differentiation of the blasts with Eosinophils that have Dense Blue Granules (atypical)
Term
AML with FLT3 mutations have what prognosis?
Definition
Horrible prognosis require transplant
Term
Define Myelodysplastic Syndrome
Definition
Group of clonal stem cell disorders characterized by maturation defects resulting in ineffective hematopoiesis
Term
The abnormal stem cell clone takes up space in the bone marrow and eventually will transform to what?
Definition
AML
Term
How do Myelodysplastic Syndromes usually manifest?
Definition
Peripheral blood cytopenias due to early cell death in BM
Term
What lineages do Myelodysplastic Syndromes show abnormalities in?
Definition
Can be just one (WBCs, RBCs, Megakaryocytes) OR all 3 or 2... doesn't matter
Term
*What defines Myelodysplastic Syndrome associated with isolated del(5q)?
Definition
Anemia, Normal/Increased Megakaryocytes with hypolobated nuclei (elderly lady q-stem)
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