{"id":5738,"date":"2011-04-25T02:00:43","date_gmt":"2011-04-25T06:00:43","guid":{"rendered":"http:\/\/insidesurgery.com\/?p=5738"},"modified":"2013-03-13T12:41:53","modified_gmt":"2013-03-13T16:41:53","slug":"aml-acute-myelogenous-leukemia","status":"publish","type":"post","link":"https:\/\/insidesurgery.com\/2011\/04\/aml-acute-myelogenous-leukemia\/","title":{"rendered":"AML (Acute Myelogenous Leukemia)"},"content":{"rendered":"

Pathophysiology of AML<\/h4>\n

AML is:<\/p>\n

group of disorders (at least nine different variants) in which a hematopoietic stem cell becomes neoplastic or alternately an individual lineage of stem cells (e.g., erythrocytes, monocytes, granulocytes, or megakaryocytes) becomes neoplastic<\/p>\n

<\/p>\n

Signs and Symptoms<\/h4>\n

1)<\/strong> usually presents with signs of anemia – pallor, fatigue, weakness 2)<\/strong> splenomegaly 3)<\/strong> hepatomegaly 4)<\/strong> hemorrhage in GI tract and CNS if platelets are < 20,000\/dL 5)<\/strong> dyspnea owing to infiltration of lung by leukocytes 6)<\/strong> secondary infections 7)<\/strong> gingival hyperplasia<\/p>\n

Characteristic Test Findings<\/h4>\n

Bone marrow<\/em> – 1)<\/strong> by definition, > 30% of nucleated cells are blasts Laboratory<\/em> – 2)<\/strong> anemia 3)<\/strong> thrombocytopenia 4)<\/strong> neutrophilia (but total leukocyte count may be increased or decreased)<\/p>\n

Histology\/Gross Pathology<\/h4>\n

1)<\/strong> accumulation of blasts infiltrate and replace normal marrow 2)<\/strong> marrow fibrosis 3)<\/strong> Pelger-Huet cells with bilobed leukocytes and dense chromatin 4)<\/strong> Auer rods<\/p>\n

\"Pelger-Huet<\/a>

Pelger-Huet cell is center or photo with dark bilobed nucleus (photo courtesy Wikimedia Commons)<\/p><\/div>\n

Associated Conditions<\/h4>\n

1)<\/strong> 20-40% of myelodysplastic syndromes convert to acute myelogenous leukemia 2)<\/strong> increased incidence with – Down’s syndrome, Fanconi’s anemia, Bloom’s syndrome, paroxysmal nocturnal hemoglobinuria, benzene exposure, alkylating agents, radiation (if > 100 rads (cGy)<\/p>\n

Biochemistry<\/h4>\n

1)<\/strong> neoplastic event is failure of affected cell to mature 2)<\/strong> arrested development with accumulation of these blasts occurring in the bone marrow<\/p>\n

Inheritance\/Epidemiology<\/h4>\n

1)<\/strong> makes up 20% of all leukemias in Western nations 2)<\/strong> 85% of all adult leukemias 3)<\/strong> 20% of all childhood leukemias 4)<\/strong> slightly more prevalent in men 5)<\/strong> occurs as a “superimposed” terminal event in myeloproliferative disorders 6)<\/strong> occured as “blast crisis” in 80% of cases of chronic myelogenous leukemia before the advent of Gleevec 7)<\/strong> specific variations correspond to specific genetic defects – translocations between chromosomes 15 and 17 and 8 and 21, deletions in chromosomes 5 and 7 and trisomy 8 8)<\/strong> poor prognostic indicators are > 60 years of age at diagnosis, deletions on chromosomes 5 and 7, prior chemotherapy or radiation, severe leukocytosis (> 100,000 cells\/dL)<\/p>\n

Tips for USMLE<\/h4>\n

the key pathologic problem is accumulation in the bone marrow of immature myelogenous cells that are in arrested development and replace the normally developing cells<\/p>\n","protected":false},"excerpt":{"rendered":"

Pathophysiology of AML AML is: group of disorders (at least nine different variants) in which a hematopoietic stem cell becomes neoplastic or alternately an individual lineage of stem cells (e.g., erythrocytes, monocytes, granulocytes, or megakaryocytes) becomes neoplastic<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_exactmetrics_skip_tracking":false,"_exactmetrics_sitenote_active":false,"_exactmetrics_sitenote_note":"","_exactmetrics_sitenote_category":0,"_genesis_hide_title":false,"_genesis_hide_breadcrumbs":false,"_genesis_hide_singular_image":false,"_genesis_hide_footer_widgets":false,"_genesis_custom_body_class":"","_genesis_custom_post_class":"","_genesis_layout":"","footnotes":""},"categories":[63],"tags":[4401,4405,4407,4404,4408,4402,4406,569,4403,4409],"yoast_head":"\nAML (Acute Myelogenous Leukemia) - InsideSurgery Medical Information Blog<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/insidesurgery.com\/2011\/04\/aml-acute-myelogenous-leukemia\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"AML (Acute Myelogenous Leukemia) - 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