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Acute Myeloid Leukaemia. A disease of ALL ages Rare in under twenties (15% of childhood leukaemias) (Leukaemic transformations). Acute Myeloid Leukaemia. Symptoms: Bruising Bleeding Sudden acute infection Joint pains symptoms are of an acute onset

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slide1

Acute Myeloid Leukaemia

A disease of ALL ages

Rare in under twenties (15% of childhood leukaemias)

(Leukaemic transformations)

slide2

Acute Myeloid Leukaemia

  • Symptoms:
    • Bruising
    • Bleeding
    • Sudden acute infection
    • Joint pains
  • symptoms are of an acute onset
  • result from a reduction in effective haemopoesis
slide3

Acute Myeloid Leukaemia

In AML there is a proliferation of a clone of Myeloid cells

Which stop maturing at the blast stage

So there is no effective myelopoesis

So myelopoesis is accelerated

And the marrow fills with leukaemic Myeloid cells at the expense of “normal” cells

How is this different from CLL & CML ? These cells proliferate RAPIDLY !!!!

slide4

Acute Myeloid Leukaemia

Diagnosis:

The symptoms may be indicative of a range of conditions.

The blood count is the give-away

Hb

Normal – ish

On the low side

Plts

LOW !

< 50

50 what ?

Wbc

Total count normal/high/huge

Blast cells seen

slide5

Acute Myeloid Leukaemia

Diagnosis:

And bone marrow aspiration as a confirmation

What would you expect to see ?

slide6

Acute Myeloid Leukaemia

Diagnosis:

An aside – sort of

What causes AML ?

Unknown but……

It is prevalent in those with Down’s syndrome & other chromosomal conditions

It is frequent in the identical twins of those who have it -which is problem !!

slide7

Acute Myeloid Leukaemia

Classification

M1 - acute myeloblastic leukemia

represents 10% of acute myelocytic leukemia

common in adults

prognosis is poor with survival 6 months to 2 years.

slide8

Acute Myeloid Leukaemia

Classification

M2 - myeloblastic leukemia with maturation

more maturation observed in granulocytes than M1

slide9

Acute Myeloid Leukaemia

Classification

M3 acute promyelocytic leukemia

approximately 10 % of acute myelocytic leukemia

DIC is frequent complication – what’s that ?

prognosis is poor with survival 6 months to 2 years.

slide10

Acute Myeloid Leukaemia

Classification

M4 acute myelomonocytic leukemia

constitutes 20 % of acute myleocyte leukemia

Prognosis is better than M1, M2, or M3.

slide11

Acute Myeloid Leukaemia

Classification

M5 acute monocytic leukemia

10 % of all acute myelocytic leukemia

It has a very poor prognosis , 6 -12 months.

slide12

Acute Myeloid Leukaemia

Classification

M6 erythroleukemia

10 % of all acute myelocytic leukemia

prognosis is poor with survival 6 months to 2 years.

slide13

Acute Myeloid Leukaemia

Treatment:

The aim is to destroy the leukaemic cells

And restore bone marrow function.

slide14

Acute Myeloid Leukaemia

Treatment:

Radiotherapy

As a backup to the chemotherapy

Round the head & the testes – why ?

(We’re not just being rude here !!)

slide15

Acute Myeloid Leukaemia

Treatment:

research…

Colichiamycin

can be attached to a protein

which locks on to particular receptors on the surface of myeloid leukaemia cells (CD33 receptor)

slide16

Acute Myeloid Leukaemia

Treatment:

research…

Colichiamycin

can then enter the cell & kill it selectively

Doing away with the need for chemo

slide17

Acute Myeloid Leukaemia

Treatment:

Following successful treatment

Leukaemia has now gone.

Chances are bone marrow function has too – why ?

Bone marrow transplant

Monitor for relapse

slide18

Acute Myeloid Leukaemia

  • Treatment:
  • Relapse
  • Three main sites of relapse:
  • Bone marrow
  • CSF
  • Testes
slide19

Acute Myeloid Leukaemia

Treatment:

Relapse

Treated with

Different combinations of chemotherapy.

slide20

Acute Myeloid Leukaemia

Prognosis:

As treatment improves, cure rates are increasing.

(This statement is deliberately vague)