USMLE

Acute Myelogenous Leukemia (AML)

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Leukemias and Lymphomas
  1. Acute Myelogenous Leukemia (AML)
  2. Acute Promyelocytic Leukemia (APL)
  3. Acute Lymphocytic Leukemia (ALL)
  4. Chronic Myelogenous Leukemia (CML)
  5. Chronic Lymphocytic Leukemia (CLL)
  6. Hairy Cell Leukemia (HCL)
  7. Hodgkin Lymphoma
  8. Burkitt Lymphoma
  9. Diffuse Large B Cell Lymphoma (DLBCL)
  10. Follicular Lymphoma
  11. Mantle Cell Lymphoma
  12. Marginal Zone Lymphoma
  13. Primary CNS Lymphoma (PCNSL)
  14. Acute T-Cell Leukemia/Lymphoma (ATLL)
  15. Mycosis Fungoides / Sezary Syndrome

Summary

Acute myelogenous Leukemia, or AML for short, is a myeloblast neoplasm. These myeloblast cells can be identified using an immunohistochemical stain for myeloperoxidase. AML occurs primarily in older patients, and presents with a triad of fatigue, recurrent infections, and easy bleeding. These symptoms reflect the underlying anemia, leukopenia, and thrombocytopenia that result from the bone marrow being overcrowded by myeloblasts. There are several important risk factors for AML, including prior chemotherapy or radiation exposure, myeloproliferative disorders, or down syndrome.

Key Points

  • Acute Myelogenous Leukemia (AML)
    • Is a myoblast neoplasm
    • Classically seen in older adults (median age ~65)
    • Presents with classic leukemia symptoms (bone marrow failure and pancytopenia), including
      • fatigue due to anemia
      • fever due to infection stemming from neutropenia
      • ecchymosis or epistaxis due to thrombocytopenia (Often presents as DIC -bleeding)
    • Risk factors
      • alkylating chemotherapy
      • Radiation
      • myeloproliferative disorders
      • Down syndrome
    • Increased circulating myeloblasts on peripheral smear/bone marrow biopsy
      • Usually, diagnosis requires the presence of  ≥20% myeloblasts in the bone marrow.
      • These blasts are usually NOT TDT positive (a marker for premature LYMPHoid cells - you should associate that with ALL instead)