Acute myeloid leukaemia


Acute myeloid leukaemia


The WHO system has now largely superseded the French-American-British (FAB) classification. The newer classification reduces the bone marrow leukaemic blast cell percentage differentiating AML from myelodysplastic syndrome (see p. 50) from 30% to 20%. Other key changes include the creation of specific subtypes with non-random cytogenetic or equivalent molecular abnormalities, and the distinction of patients with multilineage dysplasia and also previous chemotherapy. The major FAB subtypes are included in the ‘other’ category with the exception of acute promyelocytic leukaemia (previously FAB M3) which is now in the ‘recurrent translocations’ group due to the inevitable presence of t(15;17). It can be seen (Table 20.1) that occasional cases of AML show megakaryocytic or erythroid differentiation. Gene mutations are likely to become increasingly important in classification.

Clinical features

In practice there is little uniformity in presentation. Some patients are remarkably asymptomatic while others are seriously ill. Bone marrow infiltration by leukaemic blast cells usually leads to anaemia, neutropenia and thrombocytopenia. Thus, patients often have symptoms of anaemia, infection and haemorrhage.

One subtype of AML deserves special consideration as it must be treated as a medical emergency:

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Jun 12, 2016 | Posted by in HEMATOLOGY | Comments Off on Acute myeloid leukaemia

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