Acute myeloid leukemia
Download
1 / 20

Acute myeloid leukemia - PowerPoint PPT Presentation


  • 714 Views
  • Updated On :

Acute myeloid leukemia . Malignant clonal disorder of immature hematopoietic cells characterized by ab b erant hematopoietic cellular proliferation and maturation. Leukamic blasts may express capabilities for maturation to a variable degree,

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'Acute myeloid leukemia ' - Philip


An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
Slide1 l.jpg

Acute myeloid leukemia

  • Malignant clonal disorder of immature hematopoietic

  • cells characterized by abberant hematopoietic cellular

  • proliferation and maturation. Leukamic blasts may

  • express capabilities for maturation to a variable degree,

  • which lead to morphological heterogeneity


Slide2 l.jpg

Acute leukemias

  • Adults:

  • acute lymphoblastic leukemia (ALL) 20%

  • acute myeloid leukemia (AML) 80%


Slide3 l.jpg

Cytological criteria for the diagnosis

of acute myeloid leukaemia:

French-American-British (FAB) classification


Slide4 l.jpg

Cytological criteria for the diagnosis

of acute myeloid leukaemia:

French-American-British (FAB) classification


Slide5 l.jpg

Cytological criteria for the diagnosis

of acute myeloid leukaemia:

French-American-British (FAB) classification


Slide6 l.jpg

Cytological criteria for the diagnosis

of acute myeloid leukaemia:

French-American-British (FAB) classification


Slide7 l.jpg

Cytological criteria for the diagnosis

of acute myeloid leukaemia:

French-American-British (FAB) classification


Acute myeloid leukemia clinical features l.jpg
Acute myeloid leukemia Clinical features

  • Suddent onset of the disease and very fast progression

  • If not treated  death after a few months

  • Most of the common systemic manifestations, such a fatigue, weakness, fever and weight loss, are non-specific


Acute myeloid leukemia clinical features9 l.jpg
Acute myeloid leukemia Clinical features

  • Infiltration of bone marrow by leukemic cells

    supression of normal hematopoietic progenitor cells growth  granulocytopenia, thrombocytopenia and anemia

  • infection of skin, mucous membranes, gums, respiratory, GI and GU tracts

  • bleeding in skin, mucous membranes, gums, GI and GU tracts

  • fatigue, weakness


Acute myeloid leukemia clinical features10 l.jpg
Acute myeloid leukemia Clinical features

  • The prevalence and degree of organ infiltration vary somewhat with the different types of leukemia

  • abdominal fullness (enlargement of the liver and spleen)

  • gum hypertrophy (AML-M4 and M5)

  • bone and join pain and tenderness

  • neurological symptoms: headache, nausea, vomiting, blurred vision, cranial nerve dysfunction (AML-M4 and M5)

  • DIC (AML-M3)


Acute myeloid leukemia approximate frequency of organ infiltration l.jpg
Acute myeloid leukemiaApproximate frequency of organ infiltration


Acute myeloid leukemia l.jpg
Acute myeloid leukemia

  • The diagnosis of AML is primarily based on morphological (>30% of basts and suppression of other lineages) and cytochemical criteria

  • Immunophenotyping, cytogenetic analysis and molecular examination are employed to add specific information for a more precise diagnosis (e.g. to identify undifferentiated leukemias as being myeloid)


Acute myeloid leukemia remission induction treatment l.jpg
Acute myeloid leukemia Remission induction treatment

  • The mainstay drugs have been daunorubicin and cytosine arabinoside* given as a 3+7 day schedule

  • number of cycle 1-2

    REMISSION 60-80%

    *in the treatment of AML-M3 all-trans retinoic acid is also used

    REMISSION 80%


Acute myeloid leukemia the aims of the induction treatment l.jpg
Acute myeloid leukemia The aims of the induction treatment

  • obtain the complete remission (RC)*

    and restoration of polyclonal hemopoiesis

    * defined as reduction of the blast cells in the marrow < 5% (inapparent) and normalzation of the picture of the peripheral blood

 However, monoclonal hemopoiesis is still present!


Acute myeloid leukemia principle of the treatment l.jpg
Acute myeloid leukemia Principle of the treatment

  • CNS prophylaxis/treatment

  • if clinical symptoms suggest meningeal leukemia

    AML-M4 or 5

    patients < 18 years old

     combination of drugs administered intrathecally

    (Ara-C plus Fenicort, MTX plus Fenicort)

    or

    CNS radiotherapy


Acute myeloid leukemia post remission chemotherapy l.jpg
Acute myeloid leukemia Post-remission chemotherapy

The aims of the intensification treatment:

- elimination of residual disease

  • prolongation of the time of remission


Acute myeloid leukemia risk groups l.jpg
Acute myeloid leukemiarisk groups

  • Good risk disease

  • t(8;21), t(15;17) inv 16

  • Standard risk disease

  • Poor risk disease

    -abnormalities of chromosome 5, complex changes, monosomy 7 and 3q-


ad