Acute myeloid leukemia and it's genetic predisposition.pptx

Pact of aml

1. Acute myeloid leukemia

2. Occurs in younger age group mainly 15 to 39 years of age. Clinically presents as decreased hemoglobin, pallor, fatigue, increased risk of infections due to reduced TLC, bleeding tendencies. Hepatosplenomegaly and bone pains Gum bleeding and gum hyperplasia Chloroma Disseminated intravascular coagulation

3. 10% mature cells and MPO negative AML with maturation AML-M2 >10% mature cells Most common FAB type of AML T(8:21) RUNX1:RUNXT1 Most common associated with chloroma

4. AML-M3 Acute promyelocytic leukemia Granules combine to form aeur rods Faggot cells – criss cross pattern of aeur rods This has the best prognosis DIC is often seen with this as the coagulable material is released in the bloodstream.

5. Treatment of AML-M3 All- Transretinoic acid Arsenic trioxide

6. AML-M6 Also known as digoglemid disease Different PAS positive AML-M7 is acute megakaryocytic leukemia and is associated with down’s syndrome. CD41, CD61 markers Dry tap on BMA d/t myelofibrosis AML with recurrent genetic abnormality AML with t8:21 –RONX1-RONXT1 AML with MDS like features and therapy related is bad prognosis.

7. AML NOS – waste basket category AML undifferentiated AML with minimal maturation AML with maturation AML with myelomonocytic maturation AML with monocytic maturation AML with erythroid maturation AML with megakaryocytic maturation

8. Lab diagnosis of AML Hemoglobin is reduced TLC is reduced Platelet is reduced Peripheral smear has more than 20% myeloblasts Myeloperoxidase activity is seen Flowcytometry markers such as CD13, CD33, CD117 and MPO+ is present T15:17 translocation

9. Feature ALL AML CLL/SLL CML Age 2 to 9 years 15 to 39 years 6 th decade Elderly Clinically CNS, testis, lymph node invasion Gum bleeding, chloroma and DIC LAP, AIHA Massive splenomegaly p/s 20% lymphoblasts 20% myeloblasts Increased lymphocyte count, smudge cells All stages of myeloid maturation basophilia Stain PAS + MPO, sudan black B, oil red O Markers B ALL CD19 CD13, 33, 117, MPO CD5, CD23 Cytogenetics T8:21 T15:17 Trisomy 12 Del 13q 17p T9:22