Acute Leukaemia 3.57.51 PM

Acute Leukaemia 3.57.51 PM - ACUTELEUKEMIA DrRoslineHassan

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    ACUTE LEUKEMIA Dr Rosline Hassan Hematology Department School of Medical Sciences USM
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OBJECTIVE Define acute leukemia Classify leukemia Understand the pathogenesis Understand the pathophysiology Able to list down the laboratory  investigations required for diagnosis Understand the basic management of  leukemia patients
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Acute Leukaemia Define :   heterogenous group of malignant  disorders  which is characterised by  uncontrolled clonal  and  accumulation of  blasts cells in the bone marrow  and body  tissues  Sudden onset  If left untreated is fatal within a few weeks or  months Incidence 1.8/100,000 –M’sia   
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Acute Leukemia Classification : Acute Acute myeloid leukemia Chronic Chronic myeloid leukemia Chronic lymphocytic leukemia
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FAB Acute Myeloid Leukemia Acute nonlymphocytic (ANLL) % Adult cases M0 Minimally differentiated AML              5% - 10% Negative  or < 3% blasts stain for MPO ,PAS and NSE  blasts are negative for B and T lymphoid antigens, platelet  glycoproteins and erythroid glycophorin A.  Myeloid antigens : CD13, CD33 and CD11b are  positive.  M1 Myeloblastic without maturation      10 - 20%     >90% cells are myeloblasts      3% of blasts stain for MPO     +8 frequently seen          
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M2 AML with maturation                            30 - 40%     30% - 90% are myeloblasts                                                                            ~ 15% with  t(8:21) 
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M3 Acute Promyelocytic Leukemia  (APML)                          10-15% marrow cells hypergranul  promeyelocytes   Auer rods/ faggot cells may be seen    Classical-Hypergranular , 80%  leukopaenic Variant-Hypogranular , leukocytosis   Granules contain procoagulants  (thromboplastin-like) -  massive DIC                                                                                      t(15:17) is  diagnostic  
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M4 Acute Myelomonocytic  Leukemia          10-15%      Incresed incidence CNS  involvement                                                    Monocytes and  promonocytes 20% - 80% M4 with eosinophilia ((M4-Eo),  assoc with del/inv 16q       – marrow eosinophil from 6% -  35%, 
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M5a Acute Monoblastic Leukemia       10-15%   M5b AMoL with differentiation  <5%  Often asso with infiltration into  gums/skin Weakness, bleeding and diffuse  erythematous skin rash  
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M6 Erythroleukemia  (Di 
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Acute Leukaemia 3.57.51 PM - ACUTELEUKEMIA DrRoslineHassan

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