Acute myeloid leukemia: Difference between revisions
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==Clinical Features== | ==Clinical Features== | ||
*Presents with symptoms of: | *Presents with symptoms of: | ||
**[[Anemia]]: [[weakness]], easy fatigability, [[SOB]] | **[[Anemia]]: [[weakness]], easy [[fatigue|fatigability]], [[SOB]] | ||
**[[Neutropenia]]: infections | **[[Neutropenia]]: infections | ||
**[[Thrombocytopenia]]: | **[[Thrombocytopenia]]: gingival bleeding/[[gingival hyperplasia|enlargement]], ecchymoses, [[epistaxis]], [[Vaginal Bleeding (Non-Pregnant)|menorrhagia]] | ||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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*[[CXR]] | *[[CXR]] | ||
*CBC with peripheral smear | *CBC with peripheral smear | ||
*Chem7, ca, mg, phos, Uric Acid, UA, LDH (to check for | *Chem7, ca, mg, phos, Uric Acid, [[UA]], LDH (to check for [[tumor lysis syndrome]]) | ||
*LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC) | *LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for [[DIC]]) | ||
*ESR, CRP | *ESR, CRP | ||
*Reticulocyte count in anemia | *Reticulocyte count in anemia | ||
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==Management== | ==Management== | ||
*Aggressive IV hydration | *Aggressive [[IV hydration]] | ||
*If febrile, complete cultures and broad spectrum antibiotics | *If [[neutropenic fever|febrile]], complete cultures and broad spectrum [[antibiotics]] | ||
*Manage Complications | *Manage Complications | ||
**See [[DIC]] | **See [[DIC]] | ||
Latest revision as of 23:22, 30 September 2019
Background
- AKA Acute myelogenous leukemia or non-lymphocytic leukemia
- Most common acute leukemia in adults (around 80% of cases)
- 65 yo median age of diagnosis, Male:Female 5:3
- Characterized by clonal proliferation of myeloid precursors(blast cells >20% in the periphery)
Clinical Features
- Presents with symptoms of:
- Anemia: weakness, easy fatigability, SOB
- Neutropenia: infections
- Thrombocytopenia: gingival bleeding/enlargement, ecchymoses, epistaxis, menorrhagia
Differential Diagnosis
Acute Leukemia/Lymphoma
Evaluation
- CXR
- CBC with peripheral smear
- Chem7, ca, mg, phos, Uric Acid, UA, LDH (to check for tumor lysis syndrome)
- LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC)
- ESR, CRP
- Reticulocyte count in anemia
- Get extra purple top for flow cytometry, especially before transfusion
Management
- Aggressive IV hydration
- If febrile, complete cultures and broad spectrum antibiotics
- Manage Complications
- See DIC
- See Leukostasis
- See Hyperviscosity syndrome
- See Tumor Lysis Syndrome
- See Retinoic acid syndrome
See Also
References
- Janz TG, Hamilton GC: Anemia, Polycythemia and White Blood Cell Disorders, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, (Ch) 121:p 1586-1605.