Hematology and Oncology Book

http://www.fpnotebook.com/

Acute Myelogenous Leukemia

Aka: Acute Myelogenous Leukemia, AML
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  1. Epidemiology
    1. Most common Acute Leukemia of adults
  2. Pathophysiology
    1. Myelodysplastic disorder or preleukemia in 25%
      1. Anemia or Cytopenia precedes Leukemia by years
  3. Risk Factors
    1. Prior Chemotherapy
      1. Agents
        1. Alkylating Agents
          1. Chlorambucil
          2. Cyclophosphamide
        2. Nitrosourea
        3. Procarbazine
      2. Conditions
        1. Hodgkin's Disease
        2. Multiple Myeloma
        3. Ovarian Cancer
  4. Signs and Symptoms
    1. See Acute Leukemia
  5. Pathology
    1. Immature Myeloblasts on smear
  6. Management
    1. Induction of Severe Myelosuppression (60-80% remission)
      1. Cytarabine
      2. Daunorubicin or Mitoxantrone or amsacrine
      3. 6-Thioguanine
    2. Repeat cycles of consolidation Chemotherapy
    3. Bone Marrow transplantation improves survival
  7. Complications
    1. CNS Leukemia (10-20%)
  8. Prognosis
    1. Remission 9 months to 2 years after Chemotherapy
    2. Five year survival: 10-30%
    3. Relapse is common
      1. Much less amenable to treatment
      2. Median survival after relapse: 3-6 months
    4. Factors suggestive of better prognosis
      1. Chromosomal abnormalities: t(8;21), t(15;17), inv 16
    5. Factors suggestive of poor prognosis
      1. Age over 60 years
      2. Chromosomal abnormalities: -5, -7, t(9;22)
      3. Acute Promyelocytic Leukemia
      4. Monocytic or myelomonocytic Leukemia
      5. Preleukemia history
      6. Cytotoxic Chemotherapy for prior malignancy

Leukemia, Myelocytic, Acute (C0023467)

Definition (NCI) This term refers to acute myeloid leukemias that do not fulfill the criteria for inclusion in the group of acute myeloid leukemias which have recurrent genetic abnormalities or myelodysplastic changes, or are therapy-related. It includes entities classified according to the French-American-British classification scheme.
Definition (MEDLINEPLUS)

Leukemia is cancer of the white blood cells. White blood cells help your body fight infection. Your blood cells form in your bone marrow. In leukemia, however, the bone marrow produces abnormal white blood cells. These cells crowd out the healthy blood cells, making it hard for blood to do its work. In acute myeloid leukemia (AML), there are too many of a specific type of white blood cell called a myeloblast.

AML is the most common type of acute leukemia in adults. This type of cancer usually gets worse quickly if it is not treated. Possible risk factors include smoking, previous chemotherapy treatment, and exposure to radiation.

Symptoms of AML include:

  • Fever
  • Shortness of breath
  • Easy bruising or bleeding
  • Bleeding under the skin
  • Weakness or feeling tired
  • Weight loss or loss of appetite

Tests that examine the blood and bone marrow diagnose AML. Treatments include chemotherapy, other drugs, radiation therapy, stem cell transplants, and targeted immune therapy. Once the leukemia is in remission, you need additional treatment to make sure that it does not come back.

NIH: National Cancer Institute
Definition (NCI) An aggressive (fast-growing) disease in which too many myeloblasts (immature white blood cells that are not lymphoblasts) are found in the bone marrow and blood.
Definition (CSP) leukemia commonly occurring after alkylating agent treatment; manifestations include pancytopenia, megaloblastic bone marrow, and nucleated red cells in peripheral marrow; patients usually have chromosomal abnormalities in marrow cells.
Definition (CSP) acute leukemia arising from myeloid tissue in which the granular, polymorphonuclear leukocytes and their precursors predominate.
Definition (NCI) A clonal expansion of myeloid blasts in the bone marrow, blood or other tissues. The classification of acute myeloid leukemias (AMLs) encompasses four major categories: 1) AML with recurrent genetic abnormalities 2) AML with multilineage dysplasia 3) Therapy-related AML 4) AML not otherwise categorized. The required bone marrow or peripheral blood blast percentage for the diagnosis of AML has been recently reduced from 30% (French-American-British [FAB] classification) to 20% (WHO classification). (WHO, 2001)
Definition (MSH) Clonal expansion of myeloid blasts in bone marrow, blood, and other tissue. Myeloid leukemias develop from changes in cells that normally produce NEUTROPHILS; BASOPHILS; EOSINOPHILS; and MONOCYTES.
Concepts Neoplastic Process (T191)
MSH D015470
ICD9 205.0
ICD10 C92.0, M9861/3, C92.00
SnomedCT 154591002, 17788007, 91861009, 413443009, 277600006
English Acute Nonlymphoblastic Leukemia, Acute Nonlymphoblastic Leukemias, Acute Nonlymphocytic Leukemias, Leukemia, Acute Nonlymphoblastic, Leukemia, Acute Nonlymphocytic, Leukemia, Myelocytic, Acute, Leukemias, Acute Nonlymphoblastic, Leukemias, Acute Nonlymphocytic, Nonlymphoblastic Leukemias, Acute, Nonlymphocytic Leukemia, Acute, Nonlymphocytic Leukemias, Acute, Myeloid leukemia, acute, ACUTE MYELOBLASTIC LEUKEMIA, LEUKEMIA MYELOBLASTIC ACUTE, LEUKEMIA, GRANULOCYTIC, ACUTE, LEUKEMIA, MYELOBLASTIC, ACUTE, LEUKEMIA, MYELOCYTIC, ACUTE, LEUKEMIA, MYELOGENOUS, ACUTE, LEUKEMIA, MYELOID, ACUTE, AML - Acute myelobl leukaemia, AML - Acute myelobl leukemia, LEUKEMIA ACUTE MYELOBLASTIC, AML, LEUKEMIA, ACUTE MYELOID, LEUKEMIA, ACUTE MYELOGENOUS, ACUTE MYELOGENOUS LEUKEMIA, [M]Acute myeloid leukaemia, [M]Acute myeloid leukemia, Acute Myeloblastic Leukemias, Myeloid Leukemias, Acute, Nonlymphoblastic Leukemia, Acute, Myeloblastic Leukemias, Acute, Myelogenous Leukemia, Acute, Myelogenous Leukemias, Acute, Leukemia, Myelogenous, Acute, Leukemia, Acute Myeloid, Leukemias, Acute Myeloblastic, Myelocytic Leukemias, Acute, Leukemia, Acute Myelogenous, Myeloid Leukemia, Acute, Leukemia, Acute Myeloblastic, Leukemia, Nonlymphoblastic, Acute, Leukemia, Myeloid, Acute, Myeloblastic Leukemia, Acute, Myelocytic Leukemia, Acute, Acute Myelocytic Leukemias, Leukemias, Acute Myelocytic, Leukemia, Myeloblastic, Acute, ANLL, Leukemia, Acute Myelocytic, Leukemia, Nonlymphocytic, Acute, Leukemias, Acute Myelogenous, Acute Myeloid Leukemia, Acute Myeloid Leukemias, Leukemias, Acute Myeloid, acute granulocytic leukemia, acute myelocytic leukemia, AML (acute myelogenous leukemia), acute myelogenous leukemia, acute myelogenous leukemia (diagnosis), aml, [M]Acute myeloid leukaemia (disorder), Acute myeloid leukemia, no ICD-O subtype, Acute myeloid leukaemia, no ICD-O subtype, Non-lymphoblastic leukaemia acute, Acute myeloid leukaemia NOS, Myeloid leukaemia, acute, Non-lymphoblastic leukemia acute, Leukemia myeloblastic acute, Acute myeloid leukemia NOS, LEUKEMIA ACUTE MYELOGENOUS, acute myelogenous leukemia (AML), Acute Myeloid Leukemia Not Otherwise Specified, AML, NOS, Acute Myeloid Leukemia, NOS, Acute Myeloid Leukemia Not Otherwise Categorized, Hematopoeitic - Acute Myleogenous Leukemia (AML), Acute Myeloid Leukemia NOS, Acute myeloblastic leukemia NOS, Leukemia, Myeloid, Acute [Disease/Finding], Leukaemia;acute myeloid, acute myeloid leukemias, acute non-lymphoblastic leukemia, non-lymphoblastic leukemia acute, acute non-lymphocytic leukemia, acute myelocytic leukaemia, acute myelogenous leukaemia, acute nonlymphoblastic leukemia, acute leukemias non lymphoblastic, acute nonlymphocytic leukemia (ANLL), anll, acute myeloblastic leukemia, Leukaemias acute myeloid, Leukaemia myeloblastic acute, Acute myeloid leukemia, Acute granulocytic leukemia, Acute myelogenous leukemia, Acute myelocytic leukemia, AML - Acute myeloid leukaemia, AML - Acute myeloid leukemia, Acute myeloblastic leukaemia, Acute myeloblastic leukemia, Acute myeloid leukaemia, Acute granulocytic leukaemia, Acute myelocytic leukaemia, Acute myelogenous leukaemia, Acute myeloid leukaemia, disease, Acute myeloid leukemia, disease (disorder), Acute myeloid leukemia, disease, Acute myeloid leukemia, no ICD-O subtype (morphologic abnormality), Acute non-lymphocytic leukaemia, Acute non-lymphocytic leukemia, acute nonlymphocytic leukemia, acute myeloid leukemia, leukemia, acute myeloid, leukemia, acute nonlymphocytic, granulocytic; leukemia, acute, leukemia; granulocytic, acute, leukemia; myelocytic, acute, leukemia; myeloid, acute, myelocytic; leukemia, acute, myeloid; leukemia, acute, Acute Myelogenous Leukemias, Acute Nonlymphocytic Leukemia, Acute Myeloblastic Leukemia, Acute Myelocytic Leukemia, Acute Myelogenous Leukemia, AML - Acute Myeloid Leukemia, AML - Acute myeloblastic leukaemia, AML - Acute myeloblastic leukemia, Acute myeloid leukemia - category (morphologic abnormality), Acute myeloid leukemia - category, Acute myeloblastic leukemia (disorder), Acute myeloid leukaemia - category, Leukemias acute myeloid, Leukemia;acute myeloid, acute myeloid leukaemia
Spanish leucemia mieloide aguda, enfermedad, morfología: leucemia mielocítica aguda, no clasificada como subtipo en CIE - O, Leucemia mielógena aguda NEOM, Leucemia mieloide aguda, Leucemia aguda no linfoblástica, Leucemia mielocítica aguda, Leucemia mieloide aguda NEOM, Leucemia mieloblástica aguda, LMA, Leucemia granulocítica aguda, Leucemia no linfoblástica aguda, leucemia mieloblástica aguda (trastorno), leucemia mieloblástica aguda, [M]Acute myeloid leukemia, [M]Acute myeloid leukaemia, Leucemia no Linfocitica Aguda, Leucemia Aguda Mieloide, Leucemia Mielógena Aguda, Leucemia no Linfocítica Aguda, Leucemia Mielogena Aguda, Leucemia Mieloide Aguda, LMA - leucemia mieloide aguda, leucemia granulocítica aguda, leucemia mielocítica aguda, leucemia mieloide aguda, enfermedad (trastorno), leucemia mieloide aguda, leucemia mielógena aguda, morfología: leucemia mielocítica aguda, no clasificada como subtipo en CIE - O (anomalía morfológica), Leucemia aguda mielógena, Leucemia mielógena aguda, leucemia mieloide aguda - categoría (anomalía morfológica), leucemia mieloide aguda - categoría
Italian Leucemie acute mieloidi, Leucemia mieloblastica acuta, Leucemia non linfoblastica acuta, Leucemia mieloide, acuta, Leucemia mieloide acuta, NAS, Leucemia mielogena acuta, Leucemia granulocitica acuta, Leucemia mielocitica acuta, Leucemia mieloide acuta
Dutch acute myeloïde leukemie NAO, acute myelocytaire leukemie, AML, leukemie myeloblastisch acuut, myeloïde leukemie, acuut, acute granulocytaire leukemie, acute myeloblastische leukemie, acute niet-lymfoblastische leukemie, niet-lymfoblastische leukemie acuut, myeloblastische leukemie acuut, acute myeloïde leukemia NAO, granulocytair; leukemie, acuut, leukemie; granulocytair, acuut, leukemie; myelocytair, acuut, leukemie; myeloïd, acuut, myelocytair; leukemie, acuut, myeloïd; leukemie, acuut, Acute myeloïde leukemie, acute myeloïde leukemie, myeloïde leukemieën acuut, Acute non-lymfocytenleukemie, Leukemie, acute niet-lymfatische, Leukemie, acute non-lymfocyten-, Leukemie, non-lymfoblastaire acute, Non-lymfoblastenleukemie, acute, Non-lymfocytenleukemie, acute
French Leucémie non lymphoblastique aiguë, Leucémie granuleuse aiguë, LMA, Leucémie granulocytaire aiguë, Leucémie aiguë myéloïde SAI, Leucémie myéloïde aiguë SAI, Leucémie aiguë myélocytaire, Leucémie myéloïde aiguë, Leucémie myéloïde aigüe, Leucémie myélogène aigüe, Leucémie myélogène aiguë, LAM, Leucémie aiguë non lymphoblastique, Leucémie aigüe myéloïde, Leucémie myéloblastique aigüe, Leucémie aigüe non lymphoblastique, Leucémie myéloblastique aiguë, Leucémie aiguë myéloblastique, Leucémie aiguë myéloïde, Leucémie aigüe myéloblastique, Leucémies myéloïdes aiguës, LANL
German akute granulozytische Leukaemie, AML, akute myeloische Leukaemie NNB, nicht-lymphoblastische Leukaemie akut, akute myelozytische Leukaemie, myeloische Leukaemie, akut, akute Myeloblastenleukaemie, Myeloblastenleukaemie akut, akute myeloblastische Leukaemie, Leukämie, myeloische, akute, Leukämie, myelogene, akute, Leukämie, myelozytäre, akute, Leukämie, nichtlymphatische, akute, Leukämie, myeloblastische, akute, Akute myeloische Leukaemie, Leukaemien akut myeloid, akute myeloische Leukaemie, ANLL, Leukämie, nichtlymphoblastische, akute, Nichtlymphoblastische Leukämie, akute, Nichtlymphozytäre Leukämie, akute
Portuguese Leucemia granulocítica aguda, Leucemia mieloblástica aguda, Leucemia mielóide aguda NE, Leucemia mielocítica aguda, Leucemia não linfoblástica aguda, Leucemia Aguda Mielóide, Leucemia Mielóide Aguda, Leucemia não-Linfocítica Aguda, Leucemia não Linfocítica Aguda, Leucemia Mielógena Aguda, Leucemia mielóide aguda, Leucemias mielóides agudas
Japanese 急性顆粒球性白血病, 急性骨髄性白血病ＮＯＳ, ＡＭＬ, ｷｭｳｾｲｺﾂｽﾞｲｾｲﾊｯｹﾂﾋﾞｮｳ, ｷｭｳｾｲｶﾘｭｳｷｭｳｾｲﾊｯｹﾂﾋﾞｮｳ, ｷｭｳｾｲｺﾂｽﾞｲｶﾞｷｭｳｾｲﾊｯｹﾂﾋﾞｮｳ, ｷｭｳｾｲｺﾂｽﾞｲｾｲﾊｯｹﾂﾋﾞｮｳNOS, AML, ｷｭｳｾｲﾋﾘﾝﾊﾟｶﾞｷｭｳｾｲﾊｯｹﾂﾋﾞｮｳ, 骨髄性白血病-急性, 急性M2骨髄性白血病, 白血病-急性骨髄球性, M2急性骨髄性白血病, 白血病-急性骨髄芽球性, 急性骨髄白血病, 急性骨髄性白血病, 骨髄芽球性白血病, 骨髄芽球性白血病-急性, 急性骨髄性白血病-M2, 骨髄性白血病-急性-M1, 骨髄性白血病-急性-M2, 急性骨髄芽球性白血病, 白血病-急性M2骨髄性, 白血病-骨髄性-急性, 急性骨髄性白血病-M1, 白血病-骨髄芽球性-急性, 白血病-骨髄性-急性-M1, 白血病-急性骨髄性M1, 白血病-急性骨髄性M2, 白血病-骨髄芽球性, 急性M1骨髄性白血病, 白血病-骨髄性-急性-M2, 急性骨髄球性白血病, 白血病-急性M1骨髄性, 白血病-急性非リンパ性, 白血病-急性骨髄性, M1急性骨髄性白血病, 急性非リンパ性白血病, 急性非リンパ芽球性白血病, 白血病-非リンパ性-急性, 白血病-急性非リンパ芽球性, 白血病-非リンパ芽球性-急性, 非リンパ性白血病-急性, 非リンパ芽球性白血病-急性
Finnish Akuutti myeloidi leukemia
Russian ЛЕЙКОЗ МИЕЛОИДНЫЙ ОСТРЫЙ, LEIKEMIIA MIELOTSITARNAIA OSTRAIA, ЛЕЙКОЗ НЕЛИМФОЦИТАРНЫЙ ОСТРЫЙ, LEIKOZ NELIMFOTSITARNYI OSTRYI, LEIKEMIIA MIELOBLASTNAIA OSTRAIA, LEIKOZ NELIMFOBLASTNYI OSTRYI, МИЕЛОИДНАЯ ЛЕЙКЕМИЯ ОСТРАЯ M1, МИЕЛОИДНАЯ ЛЕЙКЕМИЯ ОСТРАЯ M2, LEIKOZ MIELOIDNYI OSTRYI, MIELOIDNAIA LEIKEMIIA OSTRAIA M1, ЛЕЙКОЗ МИЕЛОБЛАСТНЫЙ, LEIKOZ MIELOTSITARNYI OSTRYI, MIELOIDNAIA LEIKEMIIA OSTRAIA M2, OSTRYI NELIMFOBLASTNYI LEIKOZ, LEIKOZ MIELOBLASTNYI, МИЕЛОЛЕЙКОЗ ОСТРЫЙ, MIELOLEIKOZ OSTRYI, ЛЕЙКЕМИЯ МИЕЛОЦИТАРНАЯ ОСТРАЯ, ЛЕЙКОЗ МИЕЛОЦИТАРНЫЙ ОСТРЫЙ, NELIMFOBLASTNYI LEIKOZ OSTRYI, ЛЕЙКЕМИЯ МИЕЛОБЛАСТНАЯ ОСТРАЯ, ЛЕЙКОЗ НЕЛИМФОБЛАСТНЫЙ ОСТРЫЙ, НЕЛИМФОБЛАСТНЫЙ ЛЕЙКОЗ ОСТРЫЙ, ОСТРЫЙ НЕЛИМФОБЛАСТНЫЙ ЛЕЙКОЗ
Swedish Leukemia, myeloisk, akut
Czech Akutní myeloidní leukemie, Akutní myeloblastická leukemie, Akutní nelymfoblastická leukemie, Akutní myeloidní leukemie NOS, Akutní myelocytická leukemie, Akutní granulocytická leukemie, Leukemie akutní myeloidní, AML, leukémie myeloidní akutní, akutní myelogenní leukémie, akutní myelocytární leukémie, leukémie nonlymfocytární akutní
Korean 급성 골수성 백혈병
Croatian Not Translated[Leukemia, Myeloid, Acute]
Polish Ostra białaczka szpikowa, Białaczka mieloblastyczna ostra, Białaczka szpikowa ostra, Białaczka nielimfoblastyczna ostra, ANLL
Hungarian Heveny granulocytás leukaemia, Myeloid leukemia, acut, Nem-lymphoblastos acut leukaemia, Acut myeloid leukemia k.m.n., Leukémia myeloblastos heveny, Acut myeloid leukemia, Acut myeloid leukaemia, Acut myeloblastos leukaemia, Acut myelocytás leukaemia, Heveny myeloblastos fehérvérűség, Fehérvérűség myeloblastos heveny, Acut granulocytás leukemia, Acut nem-lymphoblastos leukemia, Leukemiák, acut myeloid, AML, Acut myelocytás leukemia
Sources
Derived from the NIH UMLS (Unified Medical Language System)


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