Acute myeloid leukemia • Malignant clonal disorder of immature myeloid progenitor cells characterized by clonal proliferation of abnormal blast cells and impaired production of normal blood cells • Leukamic blasts may express capabilities for maturation to a variable degree, which lead to morphological heterogeneity
23
Embed
Acute myeloid leukemia Malignant clonal disorder of immature myeloid progenitor cells characterized by clonal proliferation of abnormal blast cells and.
This document is posted to help you gain knowledge. Please leave a comment to let me know what you think about it! Share it to your friends and learn new things together.
Transcript
Acute myeloid leukemia
• Malignant clonal disorder of immature myeloid progenitor cells characterized by clonal proliferation of abnormal blast cells and impaired production of normal blood cells • Leukamic blasts may express capabilities for maturation to a variable degree, which lead to morphological heterogeneity
Approximate frequency of organ infiltration Organ Percent on initial exam Percent at autopsy
Lymph nodes
Liver
Spleen
Bone and joint
Lungs
Heart
CUN
GI
10
40
35
2
5
2
1
-
50
90
90
5
50
35
27
10
Acute myeloid leukemia- diagnosis
• The diagnosis of AML primarily based on morphological and cytochemical criteria
– >20% of blasts and suppression of other lineages
• Immunophenotyping, cytogenetic analysis and molecular examination employed to add specific information for a more precise diagnosis
Cytological criteria for the diagnosis of acute myeloid leukaemia:
French-American-British (FAB) classification
• Eight morphologic subtypes (M0-M7) are distinguished according to FAB classification system based on the morphologic features of the blasts and histochemical staining
AML M3 Hypergranular PromyelocytesMultiple Auer rodsStrong positivity for MPO/SBB and CAE. NSE +/-
AML M3v Deeply notched nuclei. Fine dust granules. (Multiple) Auer rods +/-Cytochemical features like the hypergranular variant
AML M4 > 30% Blasts. Monocytic component > 20%, granulocytic component >20%MPO ³3%, CAE > 20%, NSE > 20%.A distinctive subtype, M4Eos- a variable increase of abnormal eosinophils with basophilic granules.
AML M5a >30% Blasts. Granulocytic component < 20%. Monocytic component ³80%. Monoblasts ³80% of monocytic component. MPO may be < 3%, NSE > 80% inhibited by fluoride
AML M5b ³30% Blasts. Granulocytic component < 20%. Monocytic component ³80%. Monoblasts < 80% of monocytic component. MPO may be <3%, NSE >80% inhibited by fluoride
AML M6 ³30% Blasts (nonerythroid population)³50% Erythroid precursors (total marrow cells) MPO³3% in blasts. PAS, Acid phosphatase and NSE may be positive in erithroblasts
Acute myeloid leukemia cytogenetic risk groups
• Favorable risk disease
- t(8;21), t(15;17), inv 16
• Intermadiate risk disease
• Unfavorable risk disease
– abnormalities of chromosome 5, complex changes, monosomy 7 and 3q-
WHO classification of acute myeloid leukemia (2008)
• Acute myeloid leukemia with recurrent cytogenetic abnormalities– t (8:21)– t (15:17)– inv (16)– 11q23 abnormalities