Acute leukemia: Difference between revisions
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**see [[Tumor Lysis Syndrome]] | **see [[Tumor Lysis Syndrome]] | ||
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== Acute Lymphocytic Leukemia == | == Acute Lymphocytic Leukemia == | ||
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=== Work-Up === | === Work-Up === | ||
*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 | *Aggressive IV hydration | ||
Revision as of 02:14, 9 August 2011
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)
Diagnosis
- Presents with anemia, neutropenia, thrombocytopenia,
- weakness, easy fatigability, infections, gingival bleeding/enlargement, ecchymoses, epistaxis, menorrhagia
Work-Up
- 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
Acute Lymphocytic Leukemia
Background
- Characterized by proliferation of immature lymphoblast( >20% in periphery)
- Less than 20% of acute leukemias in adults,
- Most common form in children (see also Leukemia (Peds))
- Highest incidence in 7th decade of life
Diagnosis
- Lymphocytosis, neutropenia, anemia, thrombocytopenia,
- Lymphadenopathy, hepatosplenomegaly
- CNS and testes involvement common
DDX
- Hodgkin and non-Hodgkin lymphomas
Work-Up
- 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
Source
Uptodate & MKSAP15