Acute myeloid leukemia

Background

• aka Acute myelogenous leukemia or non-lymphocytic leukemia
• Most common acute leukemia in adults (around 80% of cases)
• 65yo 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 anemia, neutropenia, thrombocytopenia,
• weakness, easy fatigability, infections, gingival bleeding/enlargement, ecchymoses, epistaxis, menorrhagia

Diagnosis

• CXR
• CBC with peripheral smear
• Chem7, ca, mg, phos, Uric Acid, UA, LDH (to check for Tumor Lysis)
• LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC)
• Get extra purple top for flow cytometry, especially before transfusion

Treatment

• Aggressive IV hydration
• If febrile, complete cultures and broad spectrum antibiotics
• Manage Complications
  • see DIC
  • see Leukostasis
  • see Tumor Lysis Syndrome

See Also

• Oncologic emergencies
• Lymphoma