Acute myeloid leukemia: Difference between revisions

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== Background ==
==Background==
*aka Acute myelogenous leukemia or non-lymphocytic leukemia  
*AKA Acute myelogenous leukemia or non-lymphocytic leukemia  
*Most common acute leukemia in adults (around 80% of cases)  
*Most common acute leukemia in adults (around 80% of cases)  
*65yo median age of diagnosis, Male:Female 5:3  
*65 yo median age of diagnosis, Male:Female 5:3  
*characterized by clonal proliferation of myeloid precursors(blast cells >20% in the periphery)
*Characterized by clonal proliferation of myeloid precursors(blast cells >20% in the periphery)


== Clinical Features ==
==Clinical Features==
*Presents with anemia, neutropenia, thrombocytopenia,
*Presents with symptoms of:
*weakness, easy fatigability, infections, gingival bleeding/enlargement, ecchymoses, epistaxis, menorrhagia
**[[Anemia]]: [[weakness]], easy [[fatigue|fatigability]], [[SOB]]
**[[Neutropenia]]: infections
**[[Thrombocytopenia]]: gingival bleeding/[[gingival hyperplasia|enlargement]], ecchymoses, [[epistaxis]], [[Vaginal Bleeding (Non-Pregnant)|menorrhagia]]


==Differential Diagnosis==
==Differential Diagnosis==
{{Leuk/lymph DDX}}


==Diagnosis==
==Evaluation==
*CXR  
*[[CXR]]
*CBC with peripheral smear  
*CBC with peripheral smear  
*Chem7, ca, mg, phos, Uric Acid, UA, LDH (to check for Tumor Lysis)  
*Chem7, ca, mg, phos, Uric Acid, [[UA]], LDH (to check for [[tumor lysis syndrome]])  
*LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC)  
*LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for [[DIC]])  
*ESR, CRP
*Reticulocyte count in anemia
*Get extra purple top for flow cytometry, especially before transfusion
*Get extra purple top for flow cytometry, especially before transfusion


== Treatment  ==
==Management==
*Aggressive IV hydration  
*Aggressive [[IV hydration]]
*If febrile, complete cultures and broad spectrum antibiotics  
*If [[neutropenic fever|febrile]], complete cultures and broad spectrum [[antibiotics]]
*Manage Complications  
*Manage Complications  
**see [[DIC]]  
**See [[DIC]]  
**see [[Leukostasis]]  
**See [[Leukostasis]]  
**see [[Tumor Lysis Syndrome]]
**See [[Hyperviscosity syndrome]]
**See [[Tumor Lysis Syndrome]]
**See [[Retinoic acid syndrome]]


== See Also ==
==See Also==
*[[Oncologic emergencies]]
*[[Oncologic emergencies]]
*[[Acute leukemia]]
*[[Acute leukemia]]


==References==
==References==
 
*Janz TG, Hamilton GC: Anemia, Polycythemia and White Blood Cell Disorders, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, (Ch) 121:p 1586-1605.
[[Category:Heme/Onc]]
[[Category:Heme/Onc]]

Latest revision as of 23:22, 30 September 2019

Background

  • AKA Acute myelogenous leukemia or non-lymphocytic leukemia
  • Most common acute leukemia in adults (around 80% of cases)
  • 65 yo median age of diagnosis, Male:Female 5:3
  • Characterized by clonal proliferation of myeloid precursors(blast cells >20% in the periphery)

Clinical Features

Differential Diagnosis

Acute Leukemia/Lymphoma

Evaluation

  • CXR
  • CBC with peripheral smear
  • Chem7, ca, mg, phos, Uric Acid, UA, LDH (to check for tumor lysis syndrome)
  • LFTs, Coags, FDP, D-Dimer, Haptoglobin, Fibrinogen (to check for DIC)
  • ESR, CRP
  • Reticulocyte count in anemia
  • Get extra purple top for flow cytometry, especially before transfusion

Management

See Also

References

  • Janz TG, Hamilton GC: Anemia, Polycythemia and White Blood Cell Disorders, in Marx JA, Hockberger RS, Walls RM, et al (eds): Rosen’s Emergency Medicine: Concepts and Clinical Practice, ed 8. St. Louis, Mosby, Inc., 2014, (Ch) 121:p 1586-1605.