Skip to main content

Acute Myeloid Leukemia (AML)

Quick Review


Patient is an adult (usually older, but can also be younger) with fatigue (due to anemia) and bleeding (due to thrombocytopenia) and on CBC there is decreased hemoglobin, decreased platelets, and WBC varies (can be normal, increased or decreased).  LDH will be elevated. The most important form of AML to know is acute promyelocytic leukemia (APML). On peripheral smear, AML presents with myeloblasts with Auer rods. Bone marrow biopsy will show myeloid blasts, for APML this would be atypical promyelocytes.

In AML, the bone marrow is crowded with immature myeloid cells ("blasts") preventing development of other cell types (platelets, RBCs, normal WBCs). These myeloblasts are also present in the peripheral blood in large numbers. This is why patients have fatigue (anemia), bleeding/ bruising (thrombocytopenia), increased infections (granulocytopenia).

APML can present with DIC (disseminated intravascular coagulation) which results in elevated PT and aPTT and reduced fibrinogen on coagulation studies.

For treatment, it is important to know that ATRA (all-trans-retinoic acid) is a key feature of the treatment for APML. This drug is also better known as tretinoin (isotretinoin is used to treat severe acne). This is because of pathology involving the  retinoic acid receptor.


Relevant images

Auer rods

APML blood smear

APML bone marrow aspirate




Labels:

Comments

  1. Troy AbleSeptember 3, 2020 at 6:30 PM

    How I WAS CURED FROM Chronic lymphocytic leukemia DISEASE  .
    I never wanted to post this testimony here because i don't want to violates the privacy of this page, but Is so important to pass this information to everyone who has been finding challenges of getting proper cure for Chronic lymphocytic leukemia, Breast cancer   DR OSO medicine is a perfect remedy to all kind of diseases, contact Dr OSO for treatment, my Chronic lymphocytic leukemia of 2 years within the space of few was cured through Dr OSO remedy. Reach him via email:
    drosohaberhome@gmail.com  
     call/whatsapp +2348162084839   

           Here is the DR OSO website.
    https://sites.google.com/view/drosohaberhome/

    His blog page https://drosohaberhome.blogspot.com 

    you can also email me for more info about DR oso  via troyabl100@gmail.com   ALL THANK TO DR OSO .  

    ReplyDelete
  2. AbigailFebruary 24, 2022 at 3:29 AM

    Good day everyone, two months ago  I was diagnosed with (urethral cancer), which had caused me a great deal of pain and pressure on my bladder. My doctor insisted that there was no other choice but to go under the knife. So everyday I was online searching for herbal medication. I never want to undergo any surgery. so. I have so many testimonies on how they were healed by dr. Imoloa herbal medication. without wasting time i contacted him (dr. Imoloa). on how to get the herbal remedies. I received the herbal package in less than a month, and I followed the steps and procedure on how I should be taking it. and one months later I was scheduled for an ultrasound check: it was shocking. The cancer had completely gone, I had consulted my doctor and canceled the surgery and with your dedicated counseling guidance I managed to completely treat the urethral cancer, along with the pain and anxiety that this condition had inflicted on me. a big thanks to God almighty, thank you Dr. Imoloa for the powerful herbal medication you have to cure people. you reach him on Email- drimolaherbalmademedicine@gmail.com WhatsApp number- +2347081986098.

    ReplyDelete

Post a Comment

Popular posts from this blog

Chronic Myeloid Leukemia (CML)

Quick Review Patient is often older, and can no symptoms or have B symptoms (night sweats, etc), fatigue, and weight loss (caused by early satiety due to enlarged spleen). On physical exam, an enlarged spleen can be palpated. CBC shows very high WBC count (typically >100,000) with elevated basophils on differential. Peripheral smear shows early, immature neutrophil precursors (myelocytes, metamyelocytes) as well as many basophils. It is important for CML to know the details of the genetic abnormality because it relates to the treatment. CML is due to a translocation of BCR and ABL on chromosomes 9 and 22 resulting a fusion BCR-ABL gene that produces a tyrosine kinase that is always active. The treatment of choice is a tyrosine kinase inhibitor e.g. imatinib. They work to suppress the tyrosine kinase and can induce disease remission. Relevant Images Immature neutrophil precursors on peripheral smear BCR-ABL translocation
7 comments
Read more

Chemotherapy

Terminology Adjuvant therapy - given in addition to standard therapy Consolidation therapy - given after induction therapy with multidrug regimens to further reduce tumor burden Induction therapy - initial dose of treatment to rapidly kill tumor cells and send the patient into remission Maintenance therapy - given after induction and consolidation therapies or after the initial standard therapy to kill any residual tumor cells and keep the patient in remission Neoadjuvant therapy - given before the standard therapy for a particular disease Remission - less than 5% tumor burden Salvage therapy - given when standard therapy fails Adjuvant therapies in various cancers Metastasis to bone - bisphosphonates (e.g. zoledronic acid) are given to prevent lytic lesions and pathologic fractures as well as malignant hypercalcemia. Bisphosphonates work by inhibiting osteoclasts and thereby preventing bone breakdown. Breast cancer Tamoxifen , a selective estrogen recep...
13 comments
Read more