Chapter 13 in Haematology
(Acute myeloid leukaemia) summary
-The leukaemia are a
groupof disorders characterized by the accumulation of malignant white cells in
the bone marrow and blood . they can be classified into four subtypes on the
basis of being either acute or chronic, and myeloid or lymphoid.
-Acute leukaemia are aggressive diseases in which transformation of a haemopoietic stem
cell leads to accumulation of >20% blast cells in the bone marrow.
-The clinical feature of
acute leukaemia result from bone marrow failure and include
anaemia ,infection and bleeding. Tissue infiltration can also occur.
-AML is rare i
chlidhood but becomes increasingly common with age with a median onset of 65
years.
-The diagnosis is made by analysis of blood and bone marrow using microscopic examination
(morphology)as well as immunophenotypic, cytogenetic and molecular studies.
-Cytogenetic and molecular
abnormalities are used to classify and indicate
prognosis in the majority of cases of AML.
-In younger patients treatmet is primarily with the use of intensive chemotherapy.This is usually
given in four blocks each of approximately 1 week usinng drugs such as cytosin
arabinoside and daunorbicin.
-Acute promyelocytic
leukaemia is a variant of AML that carries ar t
(15;17) chromosomal translocation. It commonly presents with bleeding and is
treated with retinoic acid and chemothrapy .
- The prognosis for patient with AML, has bee improving steadliy, particulary, for those under 60years of
age ,and appromixately one-thired of this group can except to achieve lond term
cure. The outcome for eldary people remins disappointing.
-Allogenetic stem cell
transplantation is useful in treating some subsets of
paients and may also be curative for patients with relapsed disease.
From
book: Essentail Haematology A.V.HOFFBRAND,P.A.H.MOSS.6EDITION
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