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Acute myeloid leukemia
From WikEM
Contents
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
- Presents with symptoms of:
- Anemia: weakness, easy fatigability, SOB
- Neutropenia: infections
- Thrombocytopenia: ginvival bleeding/enlargement, ecchymoses, epistaxis, menorrhagia
Differential Diagnosis
Acute Leukemia/Lymphoma
- Acute myeloid leukemia
- Acute lymphocytic leukemia
- Hodgkin's lymphoma
- Non-Hodgkin's lymphoma
Evaluation
- 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)
- ESR, CRP
- Reticulocyte count in anemia
- 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 Hyperviscosity syndrome
- See Tumor Lysis Syndrome
- See Retinoic acid syndrome
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.
