Summary Rodak's Hematology (MLHE); Acute Myeloid Leukemias

Hematology 2: Acute Myeloid Leukemias o Lymph Node and CNS Involvement almost n
- Myeloblasts are present in peripheral blood of 90%
- Acute Nonlymphocytic Leukemia (ANLL) – General Term applied to All
- Chemical Laboratory Findings in AML
Leukemias Involving Cells Other than Lymphocytes
Hyperphosphatemia, Hypocalcemia and Hypokalem
- Most Common Family of Leukemias in Children Younger than 1 Year of
- Tumor Lysis Syndrome
Age
o Caused by Breakdown Products of Dying Ca
- Most Common Type of Leukemia in Adults (incidence increases as age
increases) o Causes Acute Uric Acid Nephropathy and Re

- Has Slight Predisposition for Males o Occurs in Patients w/ Malignancy of Lymphom

- Factors that may Cause Leukemias: o Hyperkalemia, Hyperphosphatemia, Hyperur
o Radiation and Hypocalcemia
o Chemicals (Leukemogens) = Drugs that cause Bone Marrow - Bone Marrow = Hypercellular = Greater than 20% o

Depression or Aplasia such as Chloramphenicol, Benzene and - Undifferentiated Leukemias = Blasts with No Obvio

Sulfonamides Intermediate Forms Present and Negative for Specia

o Genetics and Viruses - 2 Classifications of AML:

- Perform CBC, Peripheral Blood Film Exam, Bone Marrow Aspirate and o WHO = Based on Cytogenetics and Molecul

Bone Marrow Biopsy  At least 20% Blasts in Bone Marrow to

- Causes ANT = Anemia, Neutropenia, Thrombocytopenia o FAB (French-American-British) = Based

- WBC Count is Variable Cytochemistry
- Has Nonspecific Clinical Presentations:  Based on Romanowsky-Stained Blood F
o Pallor, Fatigue and Fever w/ Infections  Pseudo-Pelger-Huet Cells = Granuloc

o Bruising and Bleeding  Auer Rods = Acute Myeloid Leukemia

o Disseminated Intravascular Coagulopathy (DIC)  Type 1 Blasts
 No Evidence of Cytoplasmic Di
o Bone and Joint Pain = 1st Symptoms Experienced in 25% of AML
 Absent Cytoplasmic Granules
Patients
 Prominent Nuclei Present
o Splenomegaly = Occurs in 50% of AML Patients

,  Stippled Chromatin with No Condensation and High
N:C Ratio
M0 (Acute Myeloid Leukemia, Minimally Differentiated)
 Type 2 Blasts
- Blasts having CD13, CD33, CD34 and CD117
 Shows Evidence of Differentiation
- No Evidence of Cellular Maturation of Blasts
 Few Azurophilic Granules in Cytoplasm
- Auer Rods (-), Myeloperoxidase (-), Sudan Black B
 Centrally Located Nucleus
- Less than 5% of All AML
 Low N:C Ratio
- Patients are usually infants or older adults
 Promyelocyte
 Eccentric Nucleus M1 (Acute Myeloid Leukemia, Without Maturation)

 Well-Developed Golgi Bodies - Blasts having CD13, CD33, CD34 and CD117 similar
 Condensed Chromatin - 90% of Cells in BM are BLASTS
 Numerous Cytoplasmic Granules - Found in All Age Groups with Highest Incidence in
 Diminished N:C Ratio - Has No Male or Female Predominance
- Nuclear:Cytoplasmic Maturational Asynchrony
FAB Classification of AML:
o Common Finding in M1 Leukemia
1. M0 – Acute Myeloid Leukemia, Minimally Differentiated
o Morphologically = Nucleus appears more imm
2. M1 – Acute Myeloid Leukemia, Without Maturation
o Functionally = Leukemic Blasts exhibits P
3. M2 – Acute Myeloid Leukemia, With Maturation
property only of a Mature WBC
4. M3 – Acute Promyelocytic Leukemia
- Auer Rods (+), Myeloperoxidase (+), Sudan Black B
5. M4 – Acute Myelomonocytic Leukemia
- Chloroacetate Esterase (+), Acetate Esterase (-)
6. M4eo – Acute Myelomonocytic Leukemia With Eosinophilia
7. M5a – Acute Monocytic Leukemia Poorly Differentiated
8. M5b – Acute Monocytic Leukemia Well Differentiated
9. M6 – Acute Erythroleukemia
10. M7 – Acute Megakaryocytic Leukemia