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1432 Leukemias: Classification and Treatment

Leukemias: Classification and Treatment
VetBooks.ir Bone marrow cytologic evaluation

• Erythroid cells % of nucleated cells?

50% 50%
(M:E 1) (M:E 1)

Blast cells % of Blast cells % of Blast cells % of
nucleated cells? nonerythroid cells? nucleated cells?

20% 20% 20% 20% 20%
5% 5% 5% 5%
• AUL • MDS-EB • Normal MDS-ER Erythroid
• AML • MPN • Myeloid hyperplasia M6 hyperplasia M6-ER
• ALL; immunophenotype • CLL • MDS-RC
required for definitive • CLL
diagnosis

• Intensive supportive Supportive care may be • Usually clinically normal • Both granulocytic MDS: treated
care generally needed at diagnosis, but supportive and erythroid with hemato-
needed • MDS: treated with care may be needed in lineages affected poietic cytokines,
• ALL: treated with hematopoietic cytokines, some patients • Intensive supportive prednisone,
lymphoma protocols prednisone, differenti- • MDS: treated with care generally differentiating
• AML, AUL: poor ating agents hematopoietic cytokines, needed agents
response to • MPN: treatment depends prednisone, differentiating • Poor response
chemotherapy on type agents to chemotherapy
• CLL ( 20% mature • CLL ( 20% mature lympho- Prognosis: months
lymphocytes; if 15% are cytes): treated (if indicated) to years
lymphoblasts, consider with prednisone and
• ALL: may respond CLL in transition to chlorambucil • Only erythroid line
to treatment for ALL or lymphoma): see affected
survival time of a Poor • Associated with
few months box to right for CLL prognosis anemia
• AML/AUL: survival • MDS-RC: prognosis =
time likely a few months to years • Can transition to M6
weeks or less • MDS can be a preneo- • CLL: indolent, good response (see M6, above left)
plastic condition. MDS-RC to treatment (once indicated),
can respond to treatment, ≥1-2 year survival
whereas MDS-EB
prognosis is poor (days- ALL, acute lymphoid leukemia
weeks) AML, acute myeloid leukemias (M1-M5 and M7)
• MPN: indolent, some AUL, acute undifferentiated leukemia
respond well and can CBL, chronic basophilic leukemia
survive longer (PV, CML, CEL, chronic erythrocytic leukemia
CBL), others poorer CLL, chronic lymphocytic leukemia
prognosis (CEL), or CML, chronic myelogenous leukemia
unknown M6, erythroleukemia
• CLL: indolent, good M6-ER, erythroleukemia—erythroid predominant
response to treatment MDS-EB, myelodysplastic syndrome—excess blasts
(once indicated), ≥1-2 MDS-ER, myelodysplastic syndrome—erythroid predominant
year survival MDS-RC, myelodysplastic syndrome—refractory cytopenia
MPN, myeloproliferative neoplasm
PV, polycythemia vera
Based on the Animal Leukemia Study Group criteria for classification of acute myeloid leukemias in dogs and cats,
and modified from Jacobs RM, et al: Tumors of the hemolymphatic system. In Meuten DJ, editor: Tumors in domestic
animals, ed 4, Ames, IA, 2002, Iowa State Press, pp 119–198.
EDITED BY: Leah A. Cohn, DVM, PhD, DACVIM
ORIGINALLY WRITTEN BY: Nicole C. Northrup, DVM, DACVIM

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