Acute Myeloid Leukaemia

• Most common acute leukaemia in adults- median age of onset 68 years

  ·       Responsible for about 25% of childhood leukaemia
• Acute myeloid leukaemia occurs due to the malignant transformation and proliferation of myeloid progenitor cells.
• The most common risk factor for AML is myeloproliferative disorders (myelofibrosis and polycythaemia vera) and other pre-existing haematological disorders
• AML often presents with signs of marrow failure or tissue infiltration.
• Marrow failure:

  • Anaemia - fatigue, breathlessness and angina
  • Neutropenia - recurrent infections
  • Thrombocytopenia - petechiae, nose bleeds and bruising
• The involvement and proliferation of lymphoid progenitors in body tissues is often clinically apparent at diagnosis:

  • Lymphadenopathy
  • Hepatosplenomegaly
  • Bone pain
  • Testicular enlargement
• Hepatomegaly and splenomegaly may cause symptoms such as early satiety or reduced appetite.
• Bone marrow aspirate and biopsy is required for formal diagnosis of AML.
• Blood tests:

  • FBC - anaemia, thrombocytopenia, leukopenia with raised white cell count
  • LDH - cell turn over
  • Uric acid - cell turn over
  • Blood smear
• A blood smear in AML will show Auer rods - structures seen in myeloid blasts
• A sample of bone marrow allows for a definitive diagnosis. AML is defined based on bone marrow findings with a myeloid blast count of > 20%