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What is the primary purpose of classifying leukaemias?
What is the primary purpose of classifying leukaemias?
Acute Myeloid Leukaemia (AML) is classified under chronic leukaemias.
Acute Myeloid Leukaemia (AML) is classified under chronic leukaemias.
False
Name one feature of acute leukaemias.
Name one feature of acute leukaemias.
Rapid onset
Historically, leukaemia classification was based on the _____ classification system.
Historically, leukaemia classification was based on the _____ classification system.
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Match the following types of leukaemia with their classification:
Match the following types of leukaemia with their classification:
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Which classification system is currently used for leukaemia?
Which classification system is currently used for leukaemia?
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Acute leukaemias generally involve immature cells.
Acute leukaemias generally involve immature cells.
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What are the two types of acute leukaemia classified by cell lineage?
What are the two types of acute leukaemia classified by cell lineage?
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Acute leukaemias are known for their _____ onset in symptoms.
Acute leukaemias are known for their _____ onset in symptoms.
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Which type of leukaemia is generally controllable?
Which type of leukaemia is generally controllable?
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What percentage of blasts in the bone marrow is required for a diagnosis of Acute Myeloid Leukaemia (AML)?
What percentage of blasts in the bone marrow is required for a diagnosis of Acute Myeloid Leukaemia (AML)?
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Neutropenia is characterized by an elevated white blood cell count.
Neutropenia is characterized by an elevated white blood cell count.
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What is the fusion gene associated with Acute Myeloid Leukaemia that involves PML and RARα?
What is the fusion gene associated with Acute Myeloid Leukaemia that involves PML and RARα?
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In AML, the presence of ________ in the blood indicates thrombocytopenia.
In AML, the presence of ________ in the blood indicates thrombocytopenia.
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Match the following symptoms to their corresponding descriptions:
Match the following symptoms to their corresponding descriptions:
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Which of the following is NOT a subgroup of Acute Myeloid Leukaemia?
Which of the following is NOT a subgroup of Acute Myeloid Leukaemia?
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Acute Myeloid Leukaemia is considered a homogenous disease with a consistent prognosis.
Acute Myeloid Leukaemia is considered a homogenous disease with a consistent prognosis.
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What are Auer rods and in which disease are they typically found?
What are Auer rods and in which disease are they typically found?
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The ________ test is used to screen for genetic lesions associated with AML.
The ________ test is used to screen for genetic lesions associated with AML.
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Which of the following laboratory results is indicative of hyperleukocytosis in AML?
Which of the following laboratory results is indicative of hyperleukocytosis in AML?
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What is a primary factor in the classification of leukaemias?
What is a primary factor in the classification of leukaemias?
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What type of leukaemias generally involve immature cells?
What type of leukaemias generally involve immature cells?
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Which factor is NOT considered in the current WHO classification of leukaemias?
Which factor is NOT considered in the current WHO classification of leukaemias?
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Aggressive treatment is typically necessary for chronic leukaemias.
Aggressive treatment is typically necessary for chronic leukaemias.
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Name two symptoms commonly associated with acute leukaemias.
Name two symptoms commonly associated with acute leukaemias.
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Acute Myeloid Leukaemia is often characterized by the presence of _____ cells.
Acute Myeloid Leukaemia is often characterized by the presence of _____ cells.
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What is a common reason for classifying leukaemias?
What is a common reason for classifying leukaemias?
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What is the primary genetic abnormality associated with Acute Myeloid Leukaemia (AML)?
What is the primary genetic abnormality associated with Acute Myeloid Leukaemia (AML)?
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The presence of Auer rods in blood samples is a definitive indicator of Acute Myeloid Leukaemia.
The presence of Auer rods in blood samples is a definitive indicator of Acute Myeloid Leukaemia.
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What laboratory test is used to screen for genetic lesions in AML?
What laboratory test is used to screen for genetic lesions in AML?
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A patient with AML is likely to present with ________ due to thrombocytopenia.
A patient with AML is likely to present with ________ due to thrombocytopenia.
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Match the following symptoms with their descriptions:
Match the following symptoms with their descriptions:
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Acute Myeloid Leukaemia is considered a uniform disease with minimal variation in prognosis.
Acute Myeloid Leukaemia is considered a uniform disease with minimal variation in prognosis.
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What is the defining feature of AML according to the WHO 2016 classification?
What is the defining feature of AML according to the WHO 2016 classification?
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In AML, a red cell count of less than _____ x 10^12/L indicates anaemia.
In AML, a red cell count of less than _____ x 10^12/L indicates anaemia.
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What clinical symptom is likely to be observed in a patient with acute myeloid leukaemia?
What clinical symptom is likely to be observed in a patient with acute myeloid leukaemia?
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Study Notes
Hematological Malignancies - Part 1: Acute Myeloid Leukemia (AML)
- AML is the most common type of white blood cell malignancy
- AML is characterized by rapid onset, immature cells, and aggressive treatment
- Diagnosis is based upon cell lineage and rate of progression
- Acute vs Chronic:
- Acute: Rapid onset, immature cells, aggressive treatment
- Chronic: Slow onset, more mature cells, generally controllable
- AML is highly heterogeneous with variable prognosis
- WHO 2016 Classification: Includes at least 20% blasts in bone marrow or peripheral blood, and 6 main subgroups
- Important genetic abnormalities: t(15;17) PML-RARA (PML - promyelotic leukaemia gene, RARa - retinoic acid receptor); PML-RARα fusion protein acts as a transcriptional repressor
- Additional AML subgroups include AML with myelodysplasia-related changes, therapy-related myeloid neoplasms (t-AML), AML, not otherwise specified, myeloid sarcoma, myeloid proliferations related to Down Syndrome
AML - Symptoms
- Fatigue and pallor
- Recurrent infections
- Easy bruising
- Excessive bleeding
- Swollen gums
AML - Laboratory Diagnosis
-
Complete Blood Count (FBC):
- Reduced hemoglobin (anemia) - Result: 71 g/L, Reference Range: 120-170 g/L
- Reduced platelets (thrombocytopenia) - Result: 40, Reference Range: 150-450 x 10^9/L
- Elevated white blood cell count (hyperleukocytosis) - Result: 152, Reference Range: 3.0-11.0 x 10^9/L
- Reduced neutrophil count (neutropenia) - Result: 0.4, Reference Range: 2.0-7.5 x 10^9/L
- Peripheral Blood Film: Blast cells (≥20%)
- Auer Rods: Presence indicative of AML
- Genetic analysis (rt-PCR): Screens for genetic lesions, e.g., t(15;17) PML-RARA
- Immunophenotyping (flow cytometry): Analysis of surface and intracellular antigens to determine cell subtype (using monoclonal antibodies)
AML - Treatment
-
Chemotherapy:
- <60 years old: Induction and consolidation cycles aiming for complete remission (CR)
- Intensive chemotherapy regimens involve drugs like cytosine arabinoside and daunorubicin
- Maintenance therapy is often not given long-term.
- Stem Cell Transplant (SCT): Allogenic SCT reduces relapse rate
- Additional tests may include molecular studies, bone marrow aspiration, coagulation screen, biochemistry, and blood bank testing.
Hematological Malignancies - Part 2: Acute Lymphoblastic Leukemia (ALL)
- ALL is a clonal malignancy of lymphocyte-like blasts
- High incidence in children (3-7 years) and gradually increases in adulthood
- The majority of ALL cases is B-cell lineage, while some are T-cell lineage
- Symptoms include lethargy, pallor, fever, recurrent respiratory infections, bruises, hepatosplenomegaly, and bone pain
ALL - Laboratory Diagnosis
- Complete Blood Count (FBC): Reduced hemoglobin (anemia); reduced platelets (thrombocytopenia); elevated white blood cell count (hyperleukocytosis); reduced lymphocytes (low lymphocytes)
- Peripheral Blood Film: 20% blasts (bigger than red cells) which are agranular - high N:C ratio
- Genetic analysis (PCR): Screening for genetic lesions; t(12;21)(p13;q22) TEL-AML1
- Immunophenotyping (flow cytometry): Identifies ALL subtype (B-ALL or T-ALL)
- Additional tests include bone marrow aspiration, biochemistry, blood bank screening, radiography, cytogenetics, and molecular studies
ALL - Treatment
- Chemotherapy (induction, intensification, CNS-directed): Treatments aiming to rapidly kill tumor cells
- Remission: Achieving <5% blasts in bone marrow (successful in over 85% of children)
- Intensification: Usually involves multiple blocks in different drug combinations
- CNS-directed therapy: Specific therapy targeted at the central nervous system (CNS)
- Maintenance therapy: Follows remission and intensification
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Description
Dive into the world of Acute Myeloid Leukemia (AML) in this quiz. Learn about its characteristics, classification, and important genetic abnormalities. Understand the differences between acute and chronic forms, as well as the heterogeneous nature of AML prognosis.
