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Acute Myeloid Leukaemia

Acute Myeloid Leukaemia. A disease of ALL ages Rare in under twenties (15% of childhood leukaemias) (Leukaemic transformations). Acute Myeloid Leukaemia. Symptoms: Bruising Bleeding Sudden acute infection Joint pains symptoms are of an acute onset

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Acute Myeloid Leukaemia

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  1. Acute Myeloid Leukaemia A disease of ALL ages Rare in under twenties (15% of childhood leukaemias) (Leukaemic transformations)

  2. Acute Myeloid Leukaemia • Symptoms: • Bruising • Bleeding • Sudden acute infection • Joint pains • symptoms are of an acute onset • result from a reduction in effective haemopoesis

  3. Acute Myeloid Leukaemia In AML there is a proliferation of a clone of Myeloid cells Which stop maturing at the blast stage So there is no effective myelopoesis So myelopoesis is accelerated And the marrow fills with leukaemic Myeloid cells at the expense of “normal” cells How is this different from CLL & CML ? These cells proliferate RAPIDLY !!!!

  4. Acute Myeloid Leukaemia Diagnosis: The symptoms may be indicative of a range of conditions. The blood count is the give-away Hb Normal – ish On the low side Plts LOW ! < 50 50 what ? Wbc Total count normal/high/huge Blast cells seen

  5. Acute Myeloid Leukaemia Diagnosis: And bone marrow aspiration as a confirmation What would you expect to see ?

  6. Acute Myeloid Leukaemia Diagnosis: An aside – sort of What causes AML ? Unknown but…… It is prevalent in those with Down’s syndrome & other chromosomal conditions It is frequent in the identical twins of those who have it -which is problem !!

  7. Acute Myeloid Leukaemia Classification M1 - acute myeloblastic leukemia represents 10% of acute myelocytic leukemia common in adults prognosis is poor with survival 6 months to 2 years.

  8. Acute Myeloid Leukaemia Classification M2 - myeloblastic leukemia with maturation more maturation observed in granulocytes than M1

  9. Acute Myeloid Leukaemia Classification M3 acute promyelocytic leukemia approximately 10 % of acute myelocytic leukemia DIC is frequent complication – what’s that ? prognosis is poor with survival 6 months to 2 years.

  10. Acute Myeloid Leukaemia Classification M4 acute myelomonocytic leukemia constitutes 20 % of acute myleocyte leukemia Prognosis is better than M1, M2, or M3.

  11. Acute Myeloid Leukaemia Classification M5 acute monocytic leukemia 10 % of all acute myelocytic leukemia It has a very poor prognosis , 6 -12 months.

  12. Acute Myeloid Leukaemia Classification M6 erythroleukemia 10 % of all acute myelocytic leukemia prognosis is poor with survival 6 months to 2 years.

  13. Acute Myeloid Leukaemia Treatment: The aim is to destroy the leukaemic cells And restore bone marrow function.

  14. Acute Myeloid Leukaemia Treatment: Radiotherapy As a backup to the chemotherapy Round the head & the testes – why ? (We’re not just being rude here !!)

  15. Acute Myeloid Leukaemia Treatment: research… Colichiamycin can be attached to a protein which locks on to particular receptors on the surface of myeloid leukaemia cells (CD33 receptor)

  16. Acute Myeloid Leukaemia Treatment: research… Colichiamycin can then enter the cell & kill it selectively Doing away with the need for chemo

  17. Acute Myeloid Leukaemia Treatment: Following successful treatment Leukaemia has now gone. Chances are bone marrow function has too – why ? Bone marrow transplant Monitor for relapse

  18. Acute Myeloid Leukaemia • Treatment: • Relapse • Three main sites of relapse: • Bone marrow • CSF • Testes

  19. Acute Myeloid Leukaemia Treatment: Relapse Treated with Different combinations of chemotherapy.

  20. Acute Myeloid Leukaemia Prognosis: As treatment improves, cure rates are increasing. (This statement is deliberately vague)

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