Myeloid: Leukemia
Myeloid: Leukemia
Myeloid: Leukemia
ACUTE
LEUKEMIA
• Objective :To study the blood picture of Acute
myeloid leukemia.
• Classification:
• Acute- 1. Myeloblastic 15%
2.Lymphoblastic 35%
• Chronic- 1.Chronic Myeloid leukemia 40%
2.Chronic lymphocytic leukemia 10%
Acute leukemia
-They are characterized by predominance of undifferentiated
20% blasts.(WHO)
investigations.
SIGNS AND SYMPTOMS
• Fatigue
• Easy bruising
• Petechiae
• Mild fever
SIGNS AND SYMPTOMS
• Total WBC Count between 5x109/L and 30x109/L with
myeloblasts in the peripheral blood smear
• Bone and joint pain are the first symptoms in 25% of patients.
• Elevated serum lysozyme (especially in monocytic subtypes),
Hyperuricemia (caused by increased cellular turnover),
Hyperkalemia (caused by cell breakdown),
Hyperphosphatemia, and hypocalcemia.
• Renal failure, tetany, and lethal heart arrhythmias may develop.
RISK FACTORS
•Age
Older adults are more likely to develop AML
•Smoking
20% of AML cases are linked to smoking
Doubles the risk of disease in people older than 60
•Genetic disorders
Down syndrome, Fanconi’s anemia
RISK FACTORS
•High doses of radiation
Long-term survivors of atomic bombs
Size- 10-18um
Nucleus – Round or oval
Nuclear chromatin- Fine
Cytoplasm- Scanty to moderate with fine
azurophilic granules,Auer rods may be seen.
Nucleoli- 3-5
Cytochemical stain- Peroxidase stain +ve
except in Mo type / Sudan black positive
CLINICAL OVERVIEW
Classification of AML
• FAB classification
• WHO classification
Differences between FAB and WHO
FAB-classification
1) Morphologic Findings Heavily used
2) Special staining (SBB, MPO, NSE, etc), if required
WHO-classification
1) Morphologic findings
2) Special staining (decreased role)
3) Immunophenotyping (in the form of FC and IHC) heavily
used.
4) Cytogentics and Molecular genetics studies frequently used.
FAB Classification of AML
Primitive myeloblasts are identified by monoclonal Monoblasts are characterized by strong reaction
antibodies against myeloid-associated antigens with Alpha-naphthyl acetate esterase (ANAE),
(MPO, CD13, CD33, CD117). Alpha-naphthyl butyrate esterase (ANBE), or
More mature myeloblasts can also be identified by antibodies including antilysozyme, CD68, CD64,
cytochemical reactions with graulocyte-associated and CD36.
enzymes using Myeloperoxidase, Sudan Black B,
and Chloroacetate esterase (CAE) assays.
Myelocytes
DIAGNOSIS
Myeloblasts
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