Acute leukemia: Difference between revisions
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== Acute Myeloid Leukemia == | == Acute Myeloid Leukemia == | ||
=== Background === | === Background === | ||
*aka Acute myelogenous leukemia or non-lymphocytic leukemia | *aka Acute myelogenous leukemia or non-lymphocytic leukemia | ||
*Most common acute leukemia in adulst (around 80% of cases) | *Most common acute leukemia in adulst (around 80% of cases) | ||
*65yo is median age of diagnosis, Male:Female 5:3 | *65yo is median age of diagnosis, Male:Female 5:3 | ||
*characterized by clonal proliferation of myeloid precursors(blast cells | *characterized by clonal proliferation of myeloid precursors(blast cells >20% in the periphery) | ||
=== Diagnosis === | === Diagnosis === | ||
*Presents with anemia, neutropenia, thrombocytopenia, | *Presents with anemia, neutropenia, thrombocytopenia, | ||
*weakness, easy fatigability, infections, gingival bleeding/enlargement, ecchymoses, epistaxis, menorrhagia | *weakness, easy fatigability, infections, gingival bleeding/enlargement, ecchymoses, epistaxis, menorrhagia | ||
<br> | |||
=== Work-Up === | === Work-Up === | ||
*CXR | *CXR | ||
*CBC with peripheral smear | *CBC with peripheral smear | ||
*Chem7, mg, phos, Uric Acid, UA, LDH (to check for Tumor Lysis) | *Chem7, mg, phos, Uric Acid, UA, LDH (to check for Tumor Lysis) | ||
*LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC) | *LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC) | ||
*Get extra purple top for flow cytometry, especially | *Get extra purple top for flow cytometry, especially before transfusion | ||
<br> | |||
=== Treatment === | === Treatment === | ||
*Aggressive IV hydration | *Aggressive IV hydration | ||
*If febrile, complete cultures and broad spectrum antibiotics | *If febrile, complete cultures and broad spectrum antibiotics | ||
*Manage Complications | *Manage Complications | ||
**(see DIC) | **(see DIC) | ||
**(see Leukostasis) | **(see Leukostasis) | ||
**(see Tumor Lysis Syndrome) | **(see Tumor Lysis Syndrome) | ||
== Acute Lymphocytic Leukemia == | == Acute Lymphocytic Leukemia == | ||
=== Background === | === Background === | ||
*characterized by proliferation of immature lymphoblast( | *characterized by proliferation of immature lymphoblast( >20% in periphery) | ||
*less than 20% of acute leukemias in adults, most common form in children (see also Acute Leukemia Peds) | *less than 20% of acute leukemias in adults, most common form in children (see also Acute Leukemia Peds) | ||
*Highest incidence in 7th decade of life | *Highest incidence in 7th decade of life | ||
=== Diagnosis === | === Diagnosis === | ||
*Lymphocytosis, neutropenia, anemia, thrombocytopenia, | *Lymphocytosis, neutropenia, anemia, thrombocytopenia, | ||
*Lymphadenopathy, hepatosplenomegaly | *Lymphadenopathy, hepatosplenomegaly | ||
*CNS and testes involvement common | *CNS and testes involvement common | ||
=== DDX === | === DDX === | ||
*Hodgkin and non-Hodgkin lymphomas | *Hodgkin and non-Hodgkin lymphomas | ||
=== Work-Up === | === Work-Up === | ||
*Aggressive IV hydration | *Aggressive IV hydration | ||
*If febrile, complete cultures and broad spectrum antibiotics | *If febrile, complete cultures and broad spectrum antibiotics | ||
*Manage Complications | *Manage Complications | ||
**(see DIC) | **(see DIC) | ||
**(see Leukostasis) | **(see Leukostasis) | ||
**(see Tumor Lysis Syndrome) | **(see Tumor Lysis Syndrome) | ||
<br> | |||
== Source == | == Source == | ||
Uptodate & MKSAP15 | Uptodate & MKSAP15 | ||
[[Category:Heme/Onc]] | [[Category:Heme/Onc]] | ||
Revision as of 02:32, 6 August 2011
Acute Myeloid Leukemia
Background
- aka Acute myelogenous leukemia or non-lymphocytic leukemia
- Most common acute leukemia in adulst (around 80% of cases)
- 65yo is 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, 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 Acute 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
- Aggressive IV hydration
- If febrile, complete cultures and broad spectrum antibiotics
- Manage Complications
- (see DIC)
- (see Leukostasis)
- (see Tumor Lysis Syndrome)
Source
Uptodate & MKSAP15