1 / 20

Acute myeloid leukemia

Acute myeloid leukemia . Malignant clonal disorder of immature hematopoietic cells characterized by ab b erant hematopoietic cellular proliferation and maturation. Leukamic blasts may express capabilities for maturation to a variable degree,

whitney
Download Presentation

Acute myeloid leukemia

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. Acute myeloid leukemia • Malignant clonal disorder of immature hematopoietic • cells characterized by abberant hematopoietic cellular • proliferation and maturation. Leukamic blasts may • express capabilities for maturation to a variable degree, • which lead to morphological heterogeneity

  2. Acute leukemias • Adults: • acute lymphoblastic leukemia (ALL) 20% • acute myeloid leukemia (AML) 80%

  3. Cytological criteria for the diagnosis of acute myeloid leukaemia: French-American-British (FAB) classification

  4. Cytological criteria for the diagnosis of acute myeloid leukaemia: French-American-British (FAB) classification

  5. Cytological criteria for the diagnosis of acute myeloid leukaemia: French-American-British (FAB) classification

  6. Cytological criteria for the diagnosis of acute myeloid leukaemia: French-American-British (FAB) classification

  7. Cytological criteria for the diagnosis of acute myeloid leukaemia: French-American-British (FAB) classification

  8. Acute myeloid leukemia Clinical features • Suddent onset of the disease and very fast progression • If not treated  death after a few months • Most of the common systemic manifestations, such a fatigue, weakness, fever and weight loss, are non-specific

  9. Acute myeloid leukemia Clinical features • Infiltration of bone marrow by leukemic cells supression of normal hematopoietic progenitor cells growth  granulocytopenia, thrombocytopenia and anemia • infection of skin, mucous membranes, gums, respiratory, GI and GU tracts • bleeding in skin, mucous membranes, gums, GI and GU tracts • fatigue, weakness

  10. Acute myeloid leukemia Clinical features • The prevalence and degree of organ infiltration vary somewhat with the different types of leukemia • abdominal fullness (enlargement of the liver and spleen) • gum hypertrophy (AML-M4 and M5) • bone and join pain and tenderness • neurological symptoms: headache, nausea, vomiting, blurred vision, cranial nerve dysfunction (AML-M4 and M5) • DIC (AML-M3)

  11. Acute myeloid leukemiaApproximate frequency of organ infiltration

  12. Acute myeloid leukemia • The diagnosis of AML is primarily based on morphological (>30% of basts and suppression of other lineages) and cytochemical criteria • Immunophenotyping, cytogenetic analysis and molecular examination are employed to add specific information for a more precise diagnosis (e.g. to identify undifferentiated leukemias as being myeloid)

  13. Acute myeloid leukemia Remission induction treatment • The mainstay drugs have been daunorubicin and cytosine arabinoside* given as a 3+7 day schedule • number of cycle 1-2 REMISSION 60-80% *in the treatment of AML-M3 all-trans retinoic acid is also used REMISSION 80%

  14. Acute myeloid leukemia The aims of the induction treatment • obtain the complete remission (RC)* and restoration of polyclonal hemopoiesis * defined as reduction of the blast cells in the marrow < 5% (inapparent) and normalzation of the picture of the peripheral blood  However, monoclonal hemopoiesis is still present!

  15. Acute myeloid leukemia Principle of the treatment • CNS prophylaxis/treatment • if clinical symptoms suggest meningeal leukemia AML-M4 or 5 patients < 18 years old  combination of drugs administered intrathecally (Ara-C plus Fenicort, MTX plus Fenicort) or CNS radiotherapy

  16. Acute myeloid leukemia Post-remission chemotherapy The aims of the intensification treatment: - elimination of residual disease • prolongation of the time of remission

  17. Acute myeloid leukemiarisk groups • Good risk disease • t(8;21), t(15;17) inv 16 • Standard risk disease • Poor risk disease -abnormalities of chromosome 5, complex changes, monosomy 7 and 3q-

More Related