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
Differential Diagnosis
Acute Leukemia/Lymphoma
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