Acute leukemia
Revision as of 02:49, 6 August 2011 by Fsanchezmd (talk | contribs)
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, 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 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